A recent FDA Warning Letter to a device manufacturer has lessons on the possible difference between procedures and reality.The findings included:

- touching contaminated surfaces with gloved hands and then returning to the supposedly protected activity

- using tap water for sterile surface cleaning

- rapid movements in sterile areas when the procedure requires slow and deliberate movement (to control air disturbance)

The question then is how much monitoring is there of what is actually happening as opposed to what is supposed to be happening?.