In this episode of our advanced cGMP case study series, we take a detailed, practical journey through the FDA’s Investigations Operations Manual—the IOM. Often overlooked outside of regulatory circles, the IOM is in fact the FDA’s own blueprint for how inspections are prepared, conducted, and assessed. We unpack key sections, especially Chapters 5 and 8, revealing how investigators assess risk, structure inspections, and make observations that lead to Form 483s and, potentially, warning letters. With the recent transition from the Office of Regulatory Affairs (ORA) to the new Office of Inspections and Investigations (OII), we also examine how these organizational shifts are amplifying the focus on inspectional rigor. Whether you’re in Quality Assurance, Regulatory Affairs, or site leadership, understanding how the FDA thinks—before, during, and after inspections—can be a game changer.

We walk through the pre-inspection intelligence-gathering process, the facility tour, document review, and personnel interviews—every phase driven by objective evidence and risk prioritization. You’ll hear composite case studies of two fictional companies: one who internalized the IOM to their advantage, and one who ignored it to their detriment. The episode closes with tactical guidance on preparing your team, training SMEs, organizing documents, and simulating real inspections to reduce surprises. More than just theory, this conversation provides concrete strategies to align your internal quality systems with FDA expectations and to proactively manage inspection readiness. By the end, you’ll see the IOM not as a regulatory black box, but as a powerful, public guide to building a stronger, inspection-ready organization.