From Intermittent
to Flow
SMART Data Integrity Lessons and
Commonsense Driving Pharma's
Manufacturing Evolution
A j a z S . H u s s a i n P h . D .
7 M a y 2 0 2 5
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1
The moment we’re in, trust is
fragile
• Why is common sense essential, especially
now? Why, then, is common sense not so
common?
• How can this moment become a shared
experience, not just a personal one?
• What are you feeling in the moment you’re in
now?
What can you learn from this experience?
What can we learn from this experience,
together?
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2
Pharmaceutical
knowledge, trust, and
quality flow can not be
intermittent: In a post-
truth world, flow is
how integrity is
appraised.
Why Flow Matters? Flow is not just
movement but coherence of intent, evidence,
and action.
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 3
Dissolution Failures:
A Personal Reflection
• FDA cases reveal blind spots in
how dissolution was understood.
• Measurement uncertainty and
national security risks weren’t just
theoretical
• Addressing Blind Spots In
Assuring Therapeutic Equivalence
(2025)
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 4
Dissolution
failures impacting
national security
5 / 7 / 2 0 2 5
Few “experts” adequately appreciate
measurement uncertainties, particularly in
solid-state. Why?
A J A Z | I N S I G H T S 5
A heart medicine case that symbolizes deeper
systemic cracks
• From policy to practice, what failed—and why?
• “What is going on with this heart medicine?” (2017)
• NDA 019962, TOPROL-XL approved 01/10/1992, Supplement 003: Change in
formulation/manufacturing and dissolution test (March 1994).
• Blood-Pressure Drug With Thousands of Complaints Draws FDA Test – Bloomberg (2014)
• RFA-FD-14-024: Pharmacokinetic and Pharmacodynamic (PK-PD) Studies of Cardiovascular Drugs
(U01) (2014)
• Recall(s) of Metoprolol Succinate Tablet, Film Coated, Extended-Release Oral (2022….): All because
of “Failed Dissolution Specification”.
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 6
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 7
From policy to practice, what failed—and why?
From SUPAC to
QbD [to Continuous
Manufacturing]
5 / 7 / 2 0 2 5
• Intermittent manufacturing of an extended-release product similar to the selected case
study products (RLD: TOPROL-XL & generics).
• In 2013, I became aware of “no exception” and consistently short cycle time
manufacturing of a generic. Wow, a flow state or too good to be true?
• Decades of reform attempted to fix the “intermittent” flow, yet the turbulence persists.
A J A Z | I N S I G H T S 8
What Dissolution
Taught Me
• Dissolution became a metaphor for
professional fragmentation and
blind spots in pharmaceutical
knowledge
• Performance testing &
pharmaceutical quality (2004) | PPT
• Product Quality & Patient Safety USP
Workshop Mumbai 12 June 2015 |
PPT
• Past, Present, and Future of
Pharmaceutical Dissolution Testing: A
Disciplined Reflection and Synthesis 2019
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 9
"Alchemy Pharma Quality," Dissolution a Metaphor for Pharmaceutical Transformation | LinkedIn
Feedback Loops That Fail
• Blame replaces feedback when our systems
interrupt flow. We must move from intermittent
reaction to continuous learning
• Physicochemical failure modes for Narrow
Therapeutic Index (NTI) drugs (2 July 2021,
European Pharmaceutical Review)
• “New Prior Knowledge”: Twenty-First Century
Assurance of Therapeutic Equivalence. AAPS
PharmSciTech 20, 140 (2019).
https://doi.org/10.1208/s12249-019-1347-6
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 0
The Procrustean
Problem → “One-
Size-Fits-All: A
Barrier to Flow
• “We punish what doesn’t
fit, or we fake it
• Flow can’t happen in
rigid frames.
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 1
Built-In
Recalls
• Failures built into
approved
submissions show
how deep the
intermittency runs
• What are we still
overlooking?
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 2
State of QbD Implementation: Adoption, Success, and Challenges:
Ted Fur, McKinsey & Co (June 2010), FDA ACPS Meeting 27 July 2011
Recalls due to “the
company’s [own] test”
The FDA insisted on this [test] as a condition of
ANDA approval (after development was
completed)!
Failures built into “Approved” submission!
(ANDA review 2005/6). Several “complete
response letters” (2017-2019) indicate that this
practice has continued …
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 3
Statistical Thinking and Pharmaceutical Professional Development, a
keynote by Ajaz NCB 2023 20 June 2023 | PPT
From policy to practice, what
failed—and why?
• Product recall and defects…unacceptably high occurrences
of problems attributed to inherent defects in product and
process design
• Current regulatory review and inspection practices tend to
treat all products equally, in some cases without
considering specific risks to the consumer or individual
product failure modes
• Inspection is not well-connected to the knowledge gained
from the product review. Inspections often cannot cover all
products and processes
• [21st Century Initiative 2.0.” What happened to 1.0?
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 4
White-Paper--FDA-Pharmaceutical-Quality-Oversight.pdf
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 5
“New Prior Knowledge”: Twenty-First Century Assurance of Therapeutic Equivalence. AAPS PharmSciTech 20, 140 (2019). https://doi.org/10.1208/s12249-019-1347-6
Effective CAPA to Continual Improvement with Continuous Development
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 6
How to Break the Pharmaceutical 2-3 Sigma Barrier (Like Amgen) (2017)
SMART as a Practice, Not Just a Tool
• SMART objective: annual
professional, process, and product
performance (Annual Reports)
• SMART practice: Self-monitoring and
reporting transformations
• With practice and constructive
feedback, SMART practices reflect
flow as a developmental stance.
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 7
Flow and Orders of Consciousness
• From reactive compliance → self-authored leadership → self-transforming systems.
• W. Edwards Deming’s Journey to Profound Knowledge
• Theory of knowledge
• Knowledge of variation
• Psychology of change
• Appreciation of systems
• Immunity to Change – Harvard
• In Over Our Heads: The Mental Demands of Modern Life by Robert Kegan
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 8
How do you feel →
Public Sentiment: The
Mirror We Ignore
5 / 7 / 2 0 2 5
• A sentiment analysis – comments posted after another
recall in 2017
A J A Z | I N S I G H T S 1 9
Sentiment Analysis and Trust Fractures
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 0
Sentiment Category Grok ChatGPT Deepseek Key Themes
Negative: Fear/Anxiety 55% 55% 60%
Health risks, uncertainty (e.g.,
"terrifying…don’t know what’s coming")
Negative: Anger/Outrage 20 20 15
Frustration with the system (e.g., "a class
action lawsuit should be done")
Negative: Distrust 15 15 20
Skepticism of generics, FDA (e.g., "never,
ever take Indian generics")
Neutral/Informational 8 8 5
Factual reports, queries (e.g., "Is there a
recall on metoprolol tartrate?")
Positive/Relief 2 2 0
Relief from switching brands (e.g., "felt like a
new person" on Toprol XL)
“What is going on with this heart medicine?” (2017)
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 1
Are we listening well enough?
At the precipice
a decade ago
5 / 7 / 2 0 2 5
• We didn’t change – what prevented us from changing, as in
improving?
• Now in the chaos of deconstructing and decoupling from
the global supply chain – what options do we have?
A J A Z | I N S I G H T S 2 2
Should the pharmaceutical
industry adopt a harm
reduction stance?
I raised this question in my report:
"Chaos to Continual Improvement:
Path to Harmonization" (CPhI Annual
Industry Report 2019).
What do you think?
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 3
Learning from experience
[FD&C Act, “scientific training and experience” to make “effectiveness” decisions “fairly and responsibly.”]
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 4
2012: Chemometrics, Pharmacometrics and Econometrics Dimensions of Quality by Design | PPT
New Prior Knowledge and
Continued Process Verification
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 5
Process Validation: General Principles and Practices (2011)| FDA
ASTM E2709: Standard Practice for Demonstrating Capability to Comply with an Acceptance Procedure
& ASTM E2281: Standard Practice for Process and Measurement Capability Indices.
Karthik Iyer, April 1st , 2014, ISPE PV
Minding the gap: What we know vs. practice
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 6
Welcome to the Experience Economy (hbr.org) (1998)
To-Err-is-Human-1999—report. (IOM)
A Design Thinking, Systems Approach to Well-Being Within Education
and Practice | The National Academies Press
In Over Our Heads: The Mental
Demands of Modern Life,
Robert Kegan (1994)
5 / 7 / 2 0 2 5
• As experts, we are self-authored in our tiny compartment
• Much of the sector is suck in 3rd order of consciousness
• Often imperialist rule
• In chaos, we get stuck in “fight/flight” mode
A J A Z | I N S I G H T S 2 7
The Experience
Economy &
Scientific
Responsibility
"Experience is not what happens to you; it’s what you
do with what happens to you." — Aldous Huxley.
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 8
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 9
FD&C Act, “scientific training and
experience” to make “effectiveness”
decisions “fairly and responsibly.”
The moment we are in
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 3 0
Outsourced Pharma Guest Column | April 15, 2025
SMART Shepherding in Turbulent Times
• Shepherding = guiding others while
tending your [own] awareness.
• It’s an internal feedback loop.
• From insight to flow
• This is how systems mature
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 3 1
Final Reflection
5 / 7 / 2 0 2 5
• SMART isn't just a tool. It’s a mindset for transforming
how we know, lead, and flow.
A J A Z | I N S I G H T S 3 2
From Intermittent to
Flow
• Correcting repeatedly, continual
improvement with continuous [P]
development → Prevention [Procrustean
Profiteer, Patient,
Professional…Pharmaceutical systems]
• Adaptive learning or learning from
experience, without fear, with passion
[FD&C Act, “scientific training and
experience” to make “effectiveness”
decisions “fairly and responsibly.”]
• A case study, a framework, a [SMART]
practice to achieve and sustain the flow
state, the peak state of human
consciousness, where engagement and
performance are unrivaled
SMART Shepherding Practices, a LinkedIn Newsletter (#188)
5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 3 3

From Intermittent to Flow SMART Integrity Lessons and Commonsense

  • 1.
    From Intermittent to Flow SMARTData Integrity Lessons and Commonsense Driving Pharma's Manufacturing Evolution A j a z S . H u s s a i n P h . D . 7 M a y 2 0 2 5 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1
  • 2.
    The moment we’rein, trust is fragile • Why is common sense essential, especially now? Why, then, is common sense not so common? • How can this moment become a shared experience, not just a personal one? • What are you feeling in the moment you’re in now? What can you learn from this experience? What can we learn from this experience, together? 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2
  • 3.
    Pharmaceutical knowledge, trust, and qualityflow can not be intermittent: In a post- truth world, flow is how integrity is appraised. Why Flow Matters? Flow is not just movement but coherence of intent, evidence, and action. 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 3
  • 4.
    Dissolution Failures: A PersonalReflection • FDA cases reveal blind spots in how dissolution was understood. • Measurement uncertainty and national security risks weren’t just theoretical • Addressing Blind Spots In Assuring Therapeutic Equivalence (2025) 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 4
  • 5.
    Dissolution failures impacting national security 5/ 7 / 2 0 2 5 Few “experts” adequately appreciate measurement uncertainties, particularly in solid-state. Why? A J A Z | I N S I G H T S 5
  • 6.
    A heart medicinecase that symbolizes deeper systemic cracks • From policy to practice, what failed—and why? • “What is going on with this heart medicine?” (2017) • NDA 019962, TOPROL-XL approved 01/10/1992, Supplement 003: Change in formulation/manufacturing and dissolution test (March 1994). • Blood-Pressure Drug With Thousands of Complaints Draws FDA Test – Bloomberg (2014) • RFA-FD-14-024: Pharmacokinetic and Pharmacodynamic (PK-PD) Studies of Cardiovascular Drugs (U01) (2014) • Recall(s) of Metoprolol Succinate Tablet, Film Coated, Extended-Release Oral (2022….): All because of “Failed Dissolution Specification”. 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 6
  • 7.
    5 / 7/ 2 0 2 5 A J A Z | I N S I G H T S 7 From policy to practice, what failed—and why?
  • 8.
    From SUPAC to QbD[to Continuous Manufacturing] 5 / 7 / 2 0 2 5 • Intermittent manufacturing of an extended-release product similar to the selected case study products (RLD: TOPROL-XL & generics). • In 2013, I became aware of “no exception” and consistently short cycle time manufacturing of a generic. Wow, a flow state or too good to be true? • Decades of reform attempted to fix the “intermittent” flow, yet the turbulence persists. A J A Z | I N S I G H T S 8
  • 9.
    What Dissolution Taught Me •Dissolution became a metaphor for professional fragmentation and blind spots in pharmaceutical knowledge • Performance testing & pharmaceutical quality (2004) | PPT • Product Quality & Patient Safety USP Workshop Mumbai 12 June 2015 | PPT • Past, Present, and Future of Pharmaceutical Dissolution Testing: A Disciplined Reflection and Synthesis 2019 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 9 "Alchemy Pharma Quality," Dissolution a Metaphor for Pharmaceutical Transformation | LinkedIn
  • 10.
    Feedback Loops ThatFail • Blame replaces feedback when our systems interrupt flow. We must move from intermittent reaction to continuous learning • Physicochemical failure modes for Narrow Therapeutic Index (NTI) drugs (2 July 2021, European Pharmaceutical Review) • “New Prior Knowledge”: Twenty-First Century Assurance of Therapeutic Equivalence. AAPS PharmSciTech 20, 140 (2019). https://doi.org/10.1208/s12249-019-1347-6 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 0
  • 11.
    The Procrustean Problem →“One- Size-Fits-All: A Barrier to Flow • “We punish what doesn’t fit, or we fake it • Flow can’t happen in rigid frames. 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 1
  • 12.
    Built-In Recalls • Failures builtinto approved submissions show how deep the intermittency runs • What are we still overlooking? 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 2 State of QbD Implementation: Adoption, Success, and Challenges: Ted Fur, McKinsey & Co (June 2010), FDA ACPS Meeting 27 July 2011
  • 13.
    Recalls due to“the company’s [own] test” The FDA insisted on this [test] as a condition of ANDA approval (after development was completed)! Failures built into “Approved” submission! (ANDA review 2005/6). Several “complete response letters” (2017-2019) indicate that this practice has continued … 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 3 Statistical Thinking and Pharmaceutical Professional Development, a keynote by Ajaz NCB 2023 20 June 2023 | PPT
  • 14.
    From policy topractice, what failed—and why? • Product recall and defects…unacceptably high occurrences of problems attributed to inherent defects in product and process design • Current regulatory review and inspection practices tend to treat all products equally, in some cases without considering specific risks to the consumer or individual product failure modes • Inspection is not well-connected to the knowledge gained from the product review. Inspections often cannot cover all products and processes • [21st Century Initiative 2.0.” What happened to 1.0? 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 4 White-Paper--FDA-Pharmaceutical-Quality-Oversight.pdf
  • 15.
    5 / 7/ 2 0 2 5 A J A Z | I N S I G H T S 1 5 “New Prior Knowledge”: Twenty-First Century Assurance of Therapeutic Equivalence. AAPS PharmSciTech 20, 140 (2019). https://doi.org/10.1208/s12249-019-1347-6
  • 16.
    Effective CAPA toContinual Improvement with Continuous Development 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 6 How to Break the Pharmaceutical 2-3 Sigma Barrier (Like Amgen) (2017)
  • 17.
    SMART as aPractice, Not Just a Tool • SMART objective: annual professional, process, and product performance (Annual Reports) • SMART practice: Self-monitoring and reporting transformations • With practice and constructive feedback, SMART practices reflect flow as a developmental stance. 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 7
  • 18.
    Flow and Ordersof Consciousness • From reactive compliance → self-authored leadership → self-transforming systems. • W. Edwards Deming’s Journey to Profound Knowledge • Theory of knowledge • Knowledge of variation • Psychology of change • Appreciation of systems • Immunity to Change – Harvard • In Over Our Heads: The Mental Demands of Modern Life by Robert Kegan 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 1 8
  • 19.
    How do youfeel → Public Sentiment: The Mirror We Ignore 5 / 7 / 2 0 2 5 • A sentiment analysis – comments posted after another recall in 2017 A J A Z | I N S I G H T S 1 9
  • 20.
    Sentiment Analysis andTrust Fractures 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 0 Sentiment Category Grok ChatGPT Deepseek Key Themes Negative: Fear/Anxiety 55% 55% 60% Health risks, uncertainty (e.g., "terrifying…don’t know what’s coming") Negative: Anger/Outrage 20 20 15 Frustration with the system (e.g., "a class action lawsuit should be done") Negative: Distrust 15 15 20 Skepticism of generics, FDA (e.g., "never, ever take Indian generics") Neutral/Informational 8 8 5 Factual reports, queries (e.g., "Is there a recall on metoprolol tartrate?") Positive/Relief 2 2 0 Relief from switching brands (e.g., "felt like a new person" on Toprol XL) “What is going on with this heart medicine?” (2017)
  • 21.
    5 / 7/ 2 0 2 5 A J A Z | I N S I G H T S 2 1 Are we listening well enough?
  • 22.
    At the precipice adecade ago 5 / 7 / 2 0 2 5 • We didn’t change – what prevented us from changing, as in improving? • Now in the chaos of deconstructing and decoupling from the global supply chain – what options do we have? A J A Z | I N S I G H T S 2 2
  • 23.
    Should the pharmaceutical industryadopt a harm reduction stance? I raised this question in my report: "Chaos to Continual Improvement: Path to Harmonization" (CPhI Annual Industry Report 2019). What do you think? 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 3
  • 24.
    Learning from experience [FD&CAct, “scientific training and experience” to make “effectiveness” decisions “fairly and responsibly.”] 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 4 2012: Chemometrics, Pharmacometrics and Econometrics Dimensions of Quality by Design | PPT
  • 25.
    New Prior Knowledgeand Continued Process Verification 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 5 Process Validation: General Principles and Practices (2011)| FDA ASTM E2709: Standard Practice for Demonstrating Capability to Comply with an Acceptance Procedure & ASTM E2281: Standard Practice for Process and Measurement Capability Indices. Karthik Iyer, April 1st , 2014, ISPE PV
  • 26.
    Minding the gap:What we know vs. practice 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 6 Welcome to the Experience Economy (hbr.org) (1998) To-Err-is-Human-1999—report. (IOM) A Design Thinking, Systems Approach to Well-Being Within Education and Practice | The National Academies Press
  • 27.
    In Over OurHeads: The Mental Demands of Modern Life, Robert Kegan (1994) 5 / 7 / 2 0 2 5 • As experts, we are self-authored in our tiny compartment • Much of the sector is suck in 3rd order of consciousness • Often imperialist rule • In chaos, we get stuck in “fight/flight” mode A J A Z | I N S I G H T S 2 7
  • 28.
    The Experience Economy & Scientific Responsibility "Experienceis not what happens to you; it’s what you do with what happens to you." — Aldous Huxley. 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 2 8
  • 29.
    5 / 7/ 2 0 2 5 A J A Z | I N S I G H T S 2 9 FD&C Act, “scientific training and experience” to make “effectiveness” decisions “fairly and responsibly.”
  • 30.
    The moment weare in 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 3 0 Outsourced Pharma Guest Column | April 15, 2025
  • 31.
    SMART Shepherding inTurbulent Times • Shepherding = guiding others while tending your [own] awareness. • It’s an internal feedback loop. • From insight to flow • This is how systems mature 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 3 1
  • 32.
    Final Reflection 5 /7 / 2 0 2 5 • SMART isn't just a tool. It’s a mindset for transforming how we know, lead, and flow. A J A Z | I N S I G H T S 3 2
  • 33.
    From Intermittent to Flow •Correcting repeatedly, continual improvement with continuous [P] development → Prevention [Procrustean Profiteer, Patient, Professional…Pharmaceutical systems] • Adaptive learning or learning from experience, without fear, with passion [FD&C Act, “scientific training and experience” to make “effectiveness” decisions “fairly and responsibly.”] • A case study, a framework, a [SMART] practice to achieve and sustain the flow state, the peak state of human consciousness, where engagement and performance are unrivaled SMART Shepherding Practices, a LinkedIn Newsletter (#188) 5 / 7 / 2 0 2 5 A J A Z | I N S I G H T S 3 3