06 August 2017

Administrative Order No. 57 s. 1989


January 3, 1989


ADMINISTRATIVE ORDER
No. 57 series 1989


REVISED RULES AND REGULATION GOVERNING THE COLLECTION, PROCESSING AND PROVISION OF HUMAN BLOOD AND THE ESTABLISHMENT AND OPERATION OF BLOOD BANKS


Section 1
Title


These rules shall be known as “Revised rules and regulations governing the collection, processing and provision of human blood and the establishment and operation of blood banks.”


Section 2
Authority


These rules and regulations are issued to implement the Blood Bank Law (R.A. 1517) consistent with Executive Order No. 119 (Reorganization Act of the Ministry of Health)


Section 3
Purpose


These rules and regulation are promulgated to protect and promote the health of the people by preventing the operation and maintenance of sub–standard, improperly managed and poorly–equipped blood banks and by elevating the quality of blood banking services and blood products.


Section 4
Scope


1. These regulations shall apply to all entities performing the activities and functions of blood banks in the Philippines including those in all government or private hospitals.

2. A blood bank or blood processing center is an institution or laboratory in which any three (3) or more of the following are done (referred to as blood bank):

(a)   Recruitment and screening of blood donors
(b)   Collection of blood for transfusion
(c)    Processing and/or storage of blood
(d)   Transport and/or issuance to hospitals
(e)   Compatibility testing of blood


Section 5
Regulatory authority


The Department of Health through the Bureau of Research and Laboratories in the Office of Standards and Regulations shall exercise the licensing and regulatory functions under these rules and regulations.


Section 6
Classification of Blood Banks


1. For purposes of service extent and level, the blood banks are both (1) primary (2) secondary (3) tertiary depending on the range of blood bank services provided and the presence of certain manpower, equipment and facilities required. The minimum services required for each respective category of blood bank shall be:

(a)   Primary Category

(1)   Donor screening and selection
(2)   Collection and processing of blood
(3)   Storage of blood
(4)   Transport and issuance of blood
(5)   Compatibility testing (for hospital)
(6)   Transfusion of whole blood (for hospital)

(b)   Secondary Category

(1)   Services required for Primary Category
(2)   Provision of packed red cells, plasma and platelet rich plasma
(3)   Investigations for transfusion reaction (for hospitals)

(c)    Tertiary Category

(1)   Services required for Primary category
(2)   Services required for Secondary category
(3)   Provision of blood components, products or derivatives not included in secondary category
(4)   Investigations of incompatible crossmatches (for hospitals)

2. For purposes of institutional character, Blood Banks may be classified into hospital blood banks or free standing (non–hospital) blood banks depending on whether or not they operate within a licensed hospital.

3. The permit issued shall state or indicate the institutional type (hospital or free standing) and category (primary, secondary or tertiary) of the blood bank.


Section 7
License to Operate a Blood Bank


1. No Blood Bank shall be allowed to operate nor any person allowed to collect, process and distribute human blood either for sale or for free without having secured a proper and valid license issued by the Bureau of Research and Laboratories.

2. The following are not required to obtain a license to operate a blood bank:

(a)   In cases of emergency, physician in hospitals with a license for a secondary or tertiary category of laboratory may be allowed to extract and transfuse blood immediately for their own patients provided:

(1)   Donors are screened under medical supervision including history, physical examination and tests for hemoglobin level, presence of malarial parasites and serologic test for syphilis.

(2)   Collection of blood is done under aseptic condition into proper plastic blood bags.

(3)   Compatibility testing including cross matching shall follow acceptable standards.

(4)   The blood transfusion shall be medically supervised. A hospital with a laboratory licensed as secondary or tertiary category may screen donors and collect blood provided such blood is processed in duly licensed blood bank.

A hospital with a laboratory licensed as secondary or tertiary category may screen donors and collect blood provided such blood is processed in a duly licensed blood bank.


Section 8
Licensed requirements for a Blood Bank
(Technical Standards)


1. All Blood Banks shall be required to demonstrate compliance with the following Technical Standards as requirement to licensing:

(a)   The blood shall be under the competent supervision and management by a physicians licensed and duly registered with the Board of Medicine (PRC) and duly authorized by the Undersecretary of Health for Standards and Regulation.

(b)   The Blood Bank shall be adequately staffed by qualified and trained personnel with at least one (1) medical technologist registered with the Board of Medical Technology (PRC).

(c)    The physical plant shall be housed in well–lighted and ventilated, dust free areas with an adequate supply of water. The space should be sufficient to accommodate the various activities of the blood bank.

(d)   The blood bank shall have the equipment, furniture, glassware, plastic blood bags, reagents, and other supplies needed to properly undertake the required services.

2. The Bureau of Research and Laboratories shall evaluate compliance with such technical standards in accordance to minimum requirements for such category of blood bank and other requirements as may be promulgated under these Rules and Regulations.


Section 9
Management of Blood Bank


The Head (Chief, Director, Physician–In–charge, etc.) is the person who assumes technical and administrative supervision and control of activities in the blood bank.

1. For all categories of blood banks, the head shall be licensed physician certified by the Philippine Board of Pathology in Clinical Pathology or Blood Banking of Philippine Board of Hematology and Blood Transfusion provided that:

(a)   This shall be mandatory for all categories of free standing blood banks and all secondary and tertiary categories of hospital blood banks.

(b)   This shall be voluntary for all primary category hospital blood banks. For those blood banks unable to comply with the above requirement, they may be headed by a licensed physician who has completed at least three (3) months of training in blood banking including quality control and management in an acceptable institution and passed an examination given or approved by the Bureau of Research and Laboratories.

2.      A certified Pathologist or Hematologist may be authorized to head and manage not more than two (2) blood banks.

3.      A physician under 9.1 paragraph (2) may be authorized to head only one (1) hospital blood bank (primary category).


Section 10
Requirements for the collection, processing and disposition of Blood and Blood products


1. Donor requirements

(a)   Determination of the suitability of the donor shall be the responsibility of the head of the blood bank and shall be done by him or under his supervision with the assistance of the necessary trained personnel.

(b)   Blood donors shall be in good physical condition and free of diseases transmissible by blood transfusion as far as can be determined from the donor’s personal history and from such physical examination and laboratory tests as prescribed by the Bureau of Research and Laboratories.

2.      Collection of Blood

(a)   Drawing blood from donors shall be the responsibility of the Head and shall be done by him or under his direct supervision with the assistance of the necessary trained personnel

(b)   The drawing shall be performed in a suitable bleeding areas located in the blood bank.

(c)    The expiration date for preserved blood shall be specified in the label in accordance with the anticoagulant used as specified in the Technical requirements.

3.      Whole Blood and Blood products

(a)   The preparation of whole blood and blood products shall be according to standard procedures acceptable to the Bureau of Research and Laboratories

(b)   The characteristics, quality or components, quality of cellular elements, properties and other specifications of whole blood and blood product s shall be prescribed by the Bureau of Research and Laboratories and compliance with such specification shall be determined by periodic Quality Control Test (Section 13).

4.      Dispensing of blood

Blood or its products is to be dispensed only upon the presentation of a proper request from the attending physician or hospital authority or another blood bank, which shall be kept on file and subject to inspection.

5.      Records

(a)   Blood Banks shall maintain a permanent record to show the donor’s name, card number, data pertaining to the donor, the result of blood grouping, serologic and other screening tests, for whom the blood was issued, and the date of issue.

(b)   Provisions must be made for recording reactions if any have occurred.

(c)    Records must be kept of the quantity of blood in storage, disposed or transferred daily, and temperature of storage.

6.      Labels

All blood containers shall have labels which shall contain data specified in the technical requirements


Section 11
Reporting


Each blood bank shall report annually the volume of blood collected and utilized or otherwise disposed of and any adverse reactions that have occurred in accordance with the format prescribed by the Bureau of Research and Laboratories.


Section 12
Quality Control Tests


The Director of the Bureau of Research and Laboratories or his representative is hereby authorized to conduct such quality control tests as he does appropriate or necessary for the administration of these regulations, for the control of operations and as criteria for the renewal license. These include tests on blood products to determine if they comply with specifications prescribed by the Bureau of Research and Laboratories.


Section 13
Donor Registries


1. The Bureau of Research and Laboratories may establish control donor registries of rare blood types or hazardous donors as the Director may deem necessary.

2. Each blood bank shall establish such registries for the supply of rare blood and protection recipients


Section 14
Blood Bank Rates


1. Blood Banks should be operated on a non–profit basis. The fees charged shall be based on actual cost including expenses for recruitment of donors, collections, processing, storage and transportation of blood with reasonable allowance for spoilage and professional services rendered.

2. The Bureau of Research and Laboratories shall prescribe from time to time the maximum rates for blood and the products in consultation with the appropriate professional societies.


Section 15
Basic License Requirements


1. Any person, firm or corporation desiring to establish or operate and maintain a blood bank shall submit to the Bureau of Research and Laboratories a sworn petition/application on the prescribed form containing among others the following data:

(a)   Name, citizenship and domicile of the Head of the Blood Bank
(b)   Place, municipality and province where it is to be established
(c)    Name of the establishment
(d)   Name, citizenship and domicile of the owner
(e)   Scope of the nature of work to be undertaken
(f)     Statement of duly notarized that applicant has complied with all business requirement under existing laws or ordinances that are necessary in pursuance of the activity for which license is herein applied for.

2. If the applicant is a partnership or corporation, it must be duly registered existing laws and that the copy of its registration papers be attached to the corresponding petition.


Section 16
Applicant for License


1. An application for a license shall be filed by the owner in a form “Petition to Establish/Operate a Blood Bank” together with the application to Head of Blood Bank and Information Sheet with the Office of the Bureau of Research and Laboratories for screening and approval.

2. Each application shall be signed under oath or affirmation by the applicant or a person duly authorized to act for and on his behalf.

3. The license free should be submitted together with the application.

4. Within 60 days after receipt of said application, an inspector of the Bureau of Research and Laboratories shall inspect the establishment and verify if the applicant has complied with the requirements prescribed in these regulations.

5. Any false statement in the application or failure to comply with the requirements may serve as basis for refusal to issue a license to operate a blood bank.


Section 17
License Fees


1. A non–refundable fee shall be charged for every application for a license to open and operate a blood bank with government and private.

2. A non–refundable fee shall be charged on application for renewal filed during the first three (3) months of each year.

3. All fees shall be payable to the Bureau of Research and Laboratories in accordance with the following schedule:

For new licenses:

(a)   Primary Category                                     P200.00
(b)   Secondary Category                      P300.00
(c)    Tertiary Category                         P500.00

4. A penalty of P100.00 for late renewal shall be charged in addition to the renewal fee for all blood bank categories; if the application is filed during the next (2) months after March 31.

5. After the fifth month un–renewed license shall be considered lapsed, and a new license shall be applied for.


Section 18
Inspection


Blood Banks and their facilities shall be subject to regular inspection and records made available to determine compliance with above regulations

1. Each license shall afford to give the Director of the Bureau of Research and Laboratories or his duly authorized representative at any reasonable time opportunity to inspect the premises and facilities wherein blood bank activities are being performed.

2. Each license shall make available to the Director of the Bureau of Research and Laboratories or his duly authorized representative of inspection, records kept pursuant to these regulations.

3. The Director of the Bureau of Research and Laboratories of his representative may be assisted by duly designated experts from professional associations in such inspections.

4. Directors of Regional Health Office, Provincial, City and Municipal Health Offices are hereby empowered to report the existence of unlicensed blood banks or any private party processing blood without proper permit or license and/or violations of these rules to the Bureau of Research and Laboratories.


Section 19
Issuance of a License


An applicant for a license will be approved and issued by the Undersecretary of Health for Standards and Regulation if

1. The blood bank shall be operated on a non–profit basis;

2. The blood bank has satisfied the standards and requirements promulgated by the Bureau of Research and Laboratories and paid the license fee;

3. The owner/manager must not have had any record of illegal operation of a blood bank or the head a record of connection with a blood bank that has been illegally operated.


Section 20
Terms and Condition of License


1. The license is granted on the basis of specific conditions and limitations in compliance with certain requirements as established during the inspection and defined in the issuance of the license.

2. The license as herein granted as well as any right under the license shall not be assigned or otherwise transferred directly or indirectly to an authorized party.

3. The owner or a blood bank desiring to transfer to another place shall inform in writing the Bureau of Research and Laboratories within fifteen (15) days after such transfer. The blood bank in its new location shall be subject to re–inspection and should comply with these rules.

4. A blood bank desiring to stop operation should notify in writing the Bureau of Research and Laboratories of this fact starting the date of termination.

5. A blood bank physician who decides to terminate services or transfer supervision should inform in writing the Bureau of Research and Laboratories within fifteen (15) days of such termination or transfer.

6. Failure to report in writing 15 days of any substantial change of conditions of the license may be the basis for suspension or revocation of the license.


Section 21
Exhibition of license and Rules and regulations


The license of the blood bank must be placed in a conspicuous place within the blood bank. The head of the blood bank must likewise place his certificates of his specialty. A notice must be posted informing the public that complaints about the services may be addressed to the Bureau of Research and Laboratories. A copy of this Rules and regulations and related Bureau orders should be readily available for guidance of all personnel of the blood bank.


Section 22
Expiration of License


Each specific license of the blood bank shall expire on the last day of December of the year stated herein including the authorization of the head.


Section 23
Renewal


1. Application for renewal of the license shall be filled during the first three months of the current year.

2. The Bureau of Research and Laboratories shall process applications for renewal of license upon receipt thereof provided that blood banks may continue operations during the pendency of final action on their application, unless otherwise advised or ordered by the Director of the Bureau of Research and Laboratories to cease operation.

3. A blood bank whose license has been suspended or revoked shall not be allowed to reopen without first securing a new permit which shall be issued upon payment of the required fee and upon satisfactory evidence that such owner has already complied with requirements prescribed in these regulations.


Section 24
Publication of list of Blood Banks


1. A list of licensed blood banks according to their type and category shall be published periodically and made available to any person, agency or organization for legitimate purposes.

2. The results of quality control testing shall likewise be published


Section 25
Modification and revocation of license

The terms and conditions of each license shall be subject to amendments of modification by means of amendments to these regulations as the Secretary of Health may deem necessary. Except in cases of willful or repeated violations hereof, or where public health interest or safety requires otherwise, no license shall be modified, suspended or revoked unless prior notice has been made and the corresponding investigation conducted.  


Section 26
Violations


1. The license to operate a blood bank may be suspended or revoked by the Undersecretary of Health for Standards and Regulation upon violation of the Blood Bank Law (R.A. 1517) or the rules and regulations issued in pursuance thereto or the commission of the following acts by the persons owning or operating a blood bank and the persons under their authority.

(a)   Operation of a blood bank without a certified Pathologist or Hematologist or a qualified licensed Physician authorized by the Undersecretary of Health for Standards and Regulation as Head without employing a duly registered Medical Technologist;

(b)   Any false statement in the application;

(c)    Change of ownership, location, head of Blood Bank or personnel without informing the Bureau of Research and Laboratories in writing;

(d)   Refusal to allow inspection of the Blood Bank by persons authorized by the Director of the Bureau of Research and Laboratories during reasonable hours;

(e)   Refusal to perform quality control tests or submit samples of blood products for quality control evaluation as required by the Bureau of Research and Laboratories.

(f)     Imposing charges on blood products higher than those promulgated by the Bureau of Research and Laboratories.

(g)   Failure to correct deficiencies within a reasonable time after due notice from the Bureau of Research and Laboratories.

2. Any person who operated a blood bank without the proper license from the Bureau of Research and Laboratories or violated any provision of these Rules and Regulations shall upon conviction be punished with an imprisonment for not less than one (1) month but not more than one (1) year or a fine not less than one hundred pesos (P100.00) but not more than one thousand pesos (P1,000.00) or both such fine and imprisonment at the discretion of the court. Provided, however, that if the offender is a firm or corporation, the head and owners thereof shall be liable to the penalty imposed herein.


Section 27
Investigations of Charges and Complaints


Upon the filing of a complaint or charges duly sworn by any person, interested party or corporation, against a blood bank or any of its personnel to the effect that one or more of such personnel of an approved blood bank have violated or are violating R.A. 1517 or the provision of these regulations, the Undersecretary of Health for Standards and Regulations or his duly authorized representatives shall investigate the complaints or charges and verify if the licensed blood bank concerned or any of its personnel is guilty of the charges. If upon investigations, a person or persons are found violating the provision of R.A. 1517 or any of these regulations, the Undersecretary of Health for Standards and Regulations shall suspend for a definite or indefinite period of time or cancel or revoke the license blood bank and the authority of the offending person or persons, without prejudice to taking the case to judicial authorities for criminal action.


Section 29
Effectivity


These rules and regulation shall take effect 15 days after publication in the Official Gazette or a newspaper of general circulation and shall supersede all issuances inconsistent thereof.



ALFREDO R.A. BENGZON, M.D.
Secretary of Health





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