Clinical consequences of specimen rejection: a College of American Pathologists Q-Probes analysis of 78 clinical laboratories

Archives of Pathology & Laboratory Medicine
Donald S Karcher, Christopher M Lehman


Clinical laboratory specimens may be rejected as unsuitable for analysis for a variety of reasons and specimen rejection may have significant clinical consequences. To quantify the clinical consequences of specimen rejection and determine the impact of laboratories' policies and practices on these consequences. Participants prospectively reviewed consecutive blood and urine specimens submitted to the chemistry and/or hematology laboratories to identify rejected specimens. For each rejected specimen, the patient's age, specimen type, testing priority, rejection reason, time from specimen receipt to receipt of recollected/relabeled specimen, recollection method, and test result time were recorded. Specimen/test abandonment was determined by failure to recollect or relabel a rejected specimen. Each laboratory's policy regarding relabeling of incorrectly labeled specimens was recorded, along with how many relabeled specimens were subsequently discovered to be mislabeled. Specimen rejection led to a (1) high rate of specimen recollection, (2) delay in result availability (median of 65 minutes), and (3) high rate of specimen/test abandonment. Longer test result delay was associated with higher hospital bed size; and higher test aband...Continue Reading


Nov 9, 2012·The New England Journal of Medicine·Dean F Sittig, Hardeep Singh

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