<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".09" citation="COMAR 10.34.19.09" title_num="10" subtitle_num="34" chapter_num="19" heading="Minimum Facility Requirements.">
  <paragraph num="A.">
    <text>Controlled Environment.</text>
    <paragraph num="(1)">
      <text>The pharmacy shall have a controlled environment that meets USP 797 Standards.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A pharmacist shall ensure that the controlled environment is:</text>
      <paragraph num="(a)">
        <text>Accessible only to designated personnel; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Used only for the preparation of compounded sterile preparations, or such other tasks that require a controlled environment.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>The permit holder shall ensure that the controlled environment is:</text>
      <paragraph num="(a)">
        <text>Structurally isolated from other areas within the pharmacy by means of restricted entry or access; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Air conditioned to maintain a temperature of the controlled environment according to USP 797 standards.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Controlled Environment — Clean Room. The permit holder shall ensure that the clean room in the controlled environment:</text>
    <paragraph num="(1)">
      <text>Meets USP 797 Standards for design and USP 797 performance criteria quality standards for clean rooms;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Contains no sinks or floor drains;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Contains work surfaces constructed of smooth, impervious materials, such as stainless steel or molded plastic, so that the work surfaces may be readily cleaned and sanitized;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>If cytotoxic agents are routinely used in compounding preparations, contains room or rooms equipped with special pressurization requirements consistent with USP 797 Standards and the National Institute for Occupational Safety and Health (NIOSH) standards;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Has in place appropriate environmental engineering control devices capable of maintaining USP 797 air-quality standards during normal compounding activity; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Contains the following equipment:</text>
      <paragraph num="(a)">
        <text>A laminar airflow workstation or other suitable International Standards Organization (ISO) Class 5 compounding environment;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Waste containers that are approved by Occupational Safety and Health Administration (OSHA) for used needles and syringes, and for chemotherapy waste; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Ancillary supplies required for proper compounding.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Controlled Environment — Anteroom. The permit holder shall ensure that the anteroom in the controlled environment:</text>
    <paragraph num="(1)">
      <text>Meets USP 797 Standards for design and USP 797 performance criteria quality standards for anterooms; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Contains the following equipment:</text>
      <paragraph num="(a)">
        <text>A sink with hot and cold running water;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Waste containers for personal protective equipment;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>An eyewash station or sink design suitable for flushing an eye injury; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A hazardous waste spill kit, if applicable.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The requirements specified in §§B(1) and C(1) of this regulation are not applicable if a compounding aseptic isolator is used to compound sterile preparations in accordance with the:</text>
    <paragraph num="(1)">
      <text>Compounding aseptic isolator conditions set forth in USP 797 Standards; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Isolator vendor or manufacturer specifications.</text>
    </paragraph>
  </paragraph>
</regulation>