Laboratory Professionals Member Community

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  • 1.  Preanalytical errors

    ASCP Ambassador
    Posted 10-31-2025 18:27

    Good evening all

    After a bit of a lull due to my insane schedule, I am trying to finish my book (The Costs and Causes of Preanalytical Errors in an Anatomical Pathology Laboratory).

    With that brief intro, I have a question that I would like all the information you can share:

    What kinds of accessioning errors do you encounter?

    What kinds of facility errors do you encounter?

    How do you correct the errors?

    Do you have a threshold for the number of errors?

    Any additional information you can share?

    Thanks

    Dr. Michael Mazzotta



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    Michael Mazzotta Administrative Laboratory Director/Manager
    Brunswick GA
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  • 2.  RE: Preanalytical errors

    ASCP Ambassador
    Posted 11-01-2025 08:25
    Edited by Bodhraj Acharya 11-01-2025 08:26

    Please refer to this CAP publication for sugical Pathology 

    https://cap.objects.frb.io/documents/practical-guide-specimen-handling.pdf

    • Accessioning errors: patient/specimen ID mismatches; requisition–container discrepancies; wrong site/laterality; block/slide mislabeling; LIS/order mistakes; sub-optimal specimens (leaking, wrong fixative, underfilled).
    • Facility-origin errors: point-of-care labeling/collection mistakes; transport/chain-of-custody gaps; fixation issues (cold ischemia, wrong/insufficient formalin); missing clinical details or fragment counts.
    • Corrections/prevention: "stop-the-line" acceptance policy; two-identifier verification + barcoding from container → cassette → slide; clarify site/laterality at grossin
    • Thresholds/KPIs: zero tolerance for wrong patient/specimen; aim ≤1 labeling error per 1,000; track surgical specimen ID errors; target ≥90–95% compliance with fixation windows for breast biomarkers.

    Disclaimer - AI was used to make this idea presentable. 

    Bodhraj Acharya, PhD, HCLD(ABB), MLS(ASCP), FADLM



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    Bodhraj Acharya Department Director (technical)
    Chittenango NY
    (315)415-1598
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  • 3.  RE: Preanalytical errors

    ASCP Ambassador
    Posted 30 days ago

    Good afternoon

    Yes, I know of the information from the CAP, but I was asking how do you handle issues at your facility.

    Example:

    You receive a four-part GI biopsy case (esophagus, stomach, small bowel, and large bowel) with all four bottles completely blank. There is no name or any other information. What do you do at your facility?

    Best

    Dr. Mazzotta



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    Michael Mazzotta Administrative Laboratory Director/Manager
    Brunswick GA
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  • 4.  RE: Preanalytical errors

    Posted 30 days ago

    This would be treated as an irretrievable specimen. We would ask the provider who collected to come to the lab and label the specimen with all of the pertinent information and then fill out a form so there is record of this.

     

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  • 5.  RE: Preanalytical errors

    Posted 29 days ago

    In my first hospital system, if within the hospital, the specimen was refused at attempted drop-off. Staff returned to the clinical team for proper labeling & identification before again attempting delivery to the lab.

    If outside delivery to the reference location, an affidavit stating what was received, when, & by whom, was sent to the collecting team/facility. As much detail as possible was provided (assumed source, measurements, container description, etc). The clinical team/facility provided proper patient & specimen identification with an attestation by the RN or Dr as to identity of specimen source (patient & site). This had to be completed before processing began.



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    Deidra Bruton Technologist/Scientist, non-supervisor (CT,MLS,MT)
    Sumter SC
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  • 6.  RE: Preanalytical errors

    Posted 27 days ago
    Interesting!

    Well, in my hospital if I get a GI Biopsy without labels, just because it's a biopsy I will do the following:
    1. Check the expected list for a similar expected specimen.
    2. Call the RN or Provider on that patient 
    3. Get the RN or someone from the care team to come with patient identifier to the lab and properly label the specimen.
    4. Biopsies are not just rejected but if it was a blood specimen, I will call the nurse for a redraw with proper labels.





  • 7.  RE: Preanalytical errors

    Posted 26 days ago
    The samples should be rejected. There's no assurance which sample is what and from whom.  Staff should be given a warning since the retrieval of the specimens was evasive. 

    One CANNOT confirm that the right test, on the right sample, at the right time, is truly being performed. 







  • 8.  RE: Preanalytical errors

    Posted 11-01-2025 09:45

    I am not buying a copy.



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    Katelyn Woodford Not employed
    Kalamazoo MI
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  • 9.  RE: Preanalytical errors

    ASCP Ambassador
    Posted 11-01-2025 10:21

    No it's free

    https://cap.objects.frb.io/documents/practical-guide-specimen-handling.pdf 



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    Bodhraj Acharya Department Director (technical)
    Chittenango NY
    (315)415-1598
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  • 10.  RE: Preanalytical errors

    Posted 23 days ago

    Read a paper that addressed this topic recently

    https://pubmed.ncbi.nlm.nih.gov/38738289/



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    William Schryver
    Saint Louis MO
    (314)805-9674
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