LC Paraneoplast CSF SOW SAM.pdf

STATEMENT OF WORK (SOW)

Paraneoplastic, Autoantibody Profile on CSF

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1. Contracting Officer’s Representative or Program POC.

Name:

Section: Pathology Medicine Address: University Drive

Pittsburgh, PA 15240 Phone Number:

Fax Number: Fax# 412-360-6922 E-Mail Address:

2. Contract Title. Paraneoplastic, Autoantibody profile, CSF

3. Background.

Paraneoplastic, Autoantibody Profile is a comprehensive approach to the detection of known antineuronal antibodies that aid in the diagnosis of paraneoplastic syndromes.

This test is for the differential evaluation of patients with subacute neurological disorders of undetermined etiology.

4. Scope.

This contract includes all the costs associated with performing the Paraneoplastic, Autoantibody panel on CSF that is performed at LabCorp. In addition, the contract includes pricing for performing the testing and any reflex testing that is associated with the Paraneoplastic, Autoantibody panel.

This contract is specifically for the use of the Pittsburgh VA Medical Center Laboratory send out section only.

5. Specific Tasks.

This contract is required to provide pricing for all necessary consumables required to perform the Paraneoplastic, Autoantibody panel test on CSF including quality control materials. In addition, the contract will include pricing for required reflex testing. These items will be permitted to be ordered as needed by the Pittsburgh VA.

Task 2 – Test Configurations

Deliverables: The following routine Autoimmune Encephalopathy Profile on serum and any reflex testing are ordered as needed.

The following table is the Autoimmune Encephalopathy Profile on serum and all the reflex tests included in the panel.

Item # Description Qty 505700 Interpretation 1

Anti-Hu Ab 1 Anti-Ri Ab 1 Antineuronal nuclear Ab

Type 3

PCA Type 1 (Anti-Yo Ab) 1 Purkinje cell cyto ab Type 2 1 Purkinje cell cyto ab Type Tr 1 Amphipysin Ab 1 CRMP-5 IgG 1

AGNA-1 1

VGCC ab 1 CASPR2 Ab, cell based IFA 1 LGI1 Ab, cell based IFA 1

6. Performance Monitoring

It will be the responsibility of the Pittsburgh VA Medical center send out testing Supervisor/designee to monitor all performance issues with the vendor. Timely delivery of testing results compared to the terms of the contract.

7. Security Requirements

In accordance with VA policy, contractors’ storage, generation, transmission or exchanging of VA sensitive information is faxed to the VA Pittsburgh when results are completed.

8. Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI).

No GFE or GFI will be needed in any capacity.

9. Other Pertinent Information or Special Considerations.

1. The send out testing will include all tests listed in the Paraneoplastic, Autoantibody profile on CSF, results will be delivered in a timely manner.

2. All testing that was not able to be performed will be communicated to supervisor/designee.

10. Period of Performance

This is a one-time purchase of a Paraneoplastic, Autoantibody Profile on CSF.

11. Delivery Schedule.

All required items will be ordered as needed directly by the lab and delivered within 14 days.

All testing results will be delivered to:

Attn: Hope Demosky VA Pittsburgh Healthcare System University Drive Pittsburgh, PA 15240 Fax: 412-360-6922

The send out testing supervisor/designee are the designated individuals able to place orders against this contract.