In accordance with 45 CFR 46, in addition to the Office for Human Research Protections...

If IRB/IEC approval is suspended or terminated, reporting is required to protect oversight and accountability.

45 CFR 46.113:“An IRB shall notify theinstitutional officials, the department or agency head, and OHRP(when applicable) of any suspension or termination of IRB approval.”

This ensures transparency and institutional responsibility for compliance. Internal hospital committees or directors (A, C, D) are not mandated reporting entities.

Thus, the correct answer isB (Appropriate institutional officials).