Root Cause Determination for Customer Complaint Biopharmaceutical Drug Product Samples with Abnormal Appearance

Customer complaints due to drug product abnormalities may arise even with strict quality control measures at the manufacturing and healthcare provider levels, posing serious challenges for the manufacturers. In this paper, we report three compelling case studies which exemplify effectiveness of root cause analyses in addressing customer complaints of Amgen drug products. The three customer complaints from three different drug products reported the following issues: pink discoloration in one drug product vial, cloudy liquid with suspended particles in another drug product vial, and brown discoloration in the third drug product vial. Consequently, a comprehensive root cause analyses were performed to identify and rectify the underlying issue, thereby mitigating the recurrence of complaints. The root cause analysis of the three events ruled out manufacturing processes as the source of contamination. Instead, it was more likely that the contamination originated at the healthcare providers' facilities. Orthogonal analytical test methodologies were employed on the samples to identify any potential contaminants. The cloudy appearance, pink and brown discolorations in the three customers returned vials were caused by non-Amgen products. The first vial had cyanocobalamin injectable (vitamin B12), the second vial had fosaprepitant (a non-Amgen drug), and the third vial had iron and saline solution (likely injectable anemia drug). A possible explanation for the three complaint samples is that they were mishandled during the process of administering the drug products at the facilities of the healthcare providers. Following the identification of the likely sources of contamination, Amgen followed standard compliant-handling procedures, which may include communicating results back to complaints or health providers as appropriate. In conclusion, the pursuit of root cause determination is paramount in addressing customer complaints and ensuring the quality, safety, and efficacy of biopharmaceutical products.