Compromising the Specimen

Compromising the Specimen

Most people think that when a lab messes up a specimen, they either lose the specimen or mix it up with another specimen. These are the mistakes that get the most press and cause the most lawsuits. But these mistakes are rare and zealously guarded against. Bad publicity costs money, after all.

One of the most common mistakes a lab makes that compromises a specimen is to fail to preserve it properly. Most specimens must be preserved until testing, most commonly by refrigeration. Some must be frozen or must use a chemical preservative. When that doesn’t happen, and the test is run anyway and results reported out, and no comment added regarding the failure to preserve it properly, then potentially false results are given to the doctor and nobody has any idea that they might be bad results. These results are taken as gospel and treatment and diagnoses are based on them.

By far the most common error in the medical lab is just waiting too long to process and test the specimen. The specimen must be delivered from the point of collection, most often a doctor’s office, to the lab. Then it must be received, and identified. Then it must be accessioned, entered into the lab’s computer system. If many specimens are received at once, some may wait quite a while to be accessioned. Then the specimens sit around until someone can take them to the department that will do the testing. They need labels printed and usually they need to be added to a work list. Then they sit around waiting in line for the lab technologist to get to them and do the test. All of this takes time, often too much time. And as above, no one tells the doctor or patient if a particular specimen has been delayed long enough to compromise the results. No one finds out.

Mostly this is all a result of the Lab not hiring enough people to do the work in a timely manner. This is a way to increase profits by not spending money on personnel. The Lab gets away with this because no one is aware that it is going on, except the employees, who are not going to rat them out, usually because they are afraid they would be fired.

What you don’t know can hurt you.

Procedural Drift

At our lab, procedural drift is more like a torrent than a drift. Some people even have to remind the Supervisor to look at the Standard Operating Procedure (SOP) to remind him of the proper procedure. Reasons for this are manifold.

Most of the SOPs are out of date, some by years, if not decades. And this is because the supervisors have all they can do to satisfy Corporate bureaucratic red tape and paperwork that they have no time to update procedures.

Technologists are few in number and overworked. We never seem to have a full staff. This means training new people is rushed and slipshod, and leaves the new people to figure things out for themselves a lot of the time. It also means that Technologists can't take the time to look up procedures when they are not sure, and so they sometimes make it up as they go along.

Busy supervisors mean they do not have the time to monitor the work of the technologists and enforce proper procedures. Mostly, monitoring consists of correcting mistakes when someone complains about them. Otherwise some mistakes just go unnoticed.

Procedures are not indexed, not in a central location and not easy to find.

All these reasons, and probably more, are attributable to the mega corporation who owns the lab having profit as their bottom line, not patient care or client service. This seems to keep coming around and biting them in their behinds.

Labcorp Loses Out to Rival Quest

Labcorp suffers a setback when it loses the Aetna contract to Quest.

Read the article here.