Specimen Rejection

Laboratory Alliance is committed to practicing the highest ethical standards to provide quality laboratory services to our customers and to comply with all Federal, State, and Local laws and regulations.

Laboratory Alliance of Central New York is licensed to operate by the New York State Department of Health. In addition, Laboratory Alliance is fully accredited by the Joint Commission. The four laboratory operations, which comprise Laboratory Alliance, undergo biannual inspections from both the New York State Department of Health and the Joint Commission.

Part 58-1.10 (e) of the New York Code of Rules and Regulations for Clinical Laboratories states: A specimen received by a laboratory shall not be tested or reported on if: 
      (1) the apparent condition of the specimen indicates that it is unsatisfactory for testing or that it
            is inappropriate for the test requested; 
      (2) it has been collected, labeled, preserved or otherwise handled in such a manner that it has
           become unsatisfactory or unreliable as a test specimen;
      (3) it is perishable and the time lapse between the collection of the specimen and its receipt by
           the laboratory is of such duration that the test finding may no longer be reliable; or
      (4) the date and, in the case of tests specified by the department, the hour when the specimen
           was taken by the physician or other authorized person is not furnished with the specimen.

Part 58.10 (f) of the New York Code of Rules and Regulations for Clinical Laboratories states: When a specimen is not tested for any of the reasons specified in subdivision (e) of this section the laboratory shall promptly notify the sender and give the reason therefore.

The purpose of the Joint Commission’s National Patient Safety Goals is to promote specific improvements in patient safety. The goals highlight problematic areas in health care and describe evidence and expert-based solutions to these problems. As with Joint Commission standards, accredited laboratories are evaluated for continuous compliance with the specific requirements associated with the National Patient Safety Goals.

Goal 1
Improve the accuracy of patient identification.

Requirement 1A – Use at least two patient identifiers when providing care, treatment, or services.

Rationale for Requirement 1A: Wrong patient errors occur in virtually all aspects of diagnosis and treatment. The intent of this goal is two-fold; first, to reliably identify the individual as the person for whom the service or treatment is intended; second to match the service or treatment to that individual.

Implementation Expectations for Requirement 1A: 
     1. Two patient identifiers are used when administering medications.
     2. Two patient identifiers are used when collecting blood samples and other specimens for clinical
        testing.
     3. Two patient identifiers are used when providing other treatments or procedures.
     4. The patient’s room number or physical location is not used as an identifier.
     5. Containers used for blood and other specimens are labeled in the presence of the patient. 
     6. Processes are established to maintain samples’ identify throughout the pre-analytical, analytical,
         and post-analytical processes.

Computer-generated labels with the barcode will sometimes have the first name truncated because of space limitations. Specimens with truncated names will not be accepted by Transfusion Services.

ONE-OF-A-KIND SPECIMENS

A one-of-a-kind specimen is any specimen not easily obtained (or re-obtained). This list includes, but is not limited to, bone marrow aspirate, bronchial lavage, cerebrospinal fluid and other body fluids, and surgical specimens.

If an improperly labeled one-of-a-kind specimen is received in the laboratory, the attending physician or his/her designee will be notified immediately. The specimen must be properly labeled by the attending physician or his/her designee prior to the laboratory taking any additional steps to process the specimen.

As the integrity of the test result has been compromised, documentation of the incident including the name of the person authorizing the testing will be entered into the laboratory information system.

SPECIMENS RECEIVED WITH NEEDLES ATTACHED

Hospital-Collected Specimens:

If a specimen is received in the laboratory with a needle attached, the patient’s nursing unit will be notified to recollect the specimen. If the specimen is a one-of-a-kind specimen, the nursing unit will be required to send someone to the laboratory to remove the needle. A hospital quality assurance tracking form will be submitted documenting the event.