[Histonet] Specimens lost during processing.

[STEVEN PINHEIRO]

All,
Looking for help in analyzing the entire scope of the process. There is not much published data (that I can find) and I am hoping this group can lend some expertise.
Our rate is higher than we would like it to be. There is no consistent size at risk although GI and Derm biopsies are the biggest involved group. We have broken it down into steps.

1. Can be lost at grossing- either never loaded into the cassette at all, or cassette was discarded. Thus we hold on to our waste and can search for misdirected cassettes if need be.

2. Lost in the processor itself. Most are wrapped. If large enough not to be wrapped, we would not expect the processor to eat them, so assume cassette lid not properly closed. Frankly the highest number of losses we're seeing is no tissue found in cassette by embedders.

3. I am being told that we can't use micromesh cassettes in our microwave processors (Milestone Pathos) and want to know if anyone is.

4. Tissue not seen at embedding. Again no way to tell when the tissue disappeared. We know that tiny tissue can spring out during the opening at embedding but I don't know how else to examine or limit this step.

5. Tissue can be exhausted during microtomy. Rare but noteworthy.
I am hoping people can tell me about their procedures for dealing with "specimens that don't survive processing", what safeguards they have in place, and to some extent what your own lab percentage or experience is.
Apologies in advance for the length of the message, but could really use your help.


Steven Pinheiro, MBA, MLS(ASCP)DLMCM
Manager Anatomic Pathology and Cytology
Loyola University Medical Center
2160 S First Ave, Bldg 110 Rm 2214
Maywood, IL 60153
708-327-2642 (O)
708-327-2620 (F)
***@lumc.edu<mailto:***@lumc.edu>

"You must do the thing you think you cannot do"
E. Roosevelt


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[Foshey, Annette]

In reference to the first point - we had a grossing log and matched what was written on the log by the P.A. or pathologist to what was actually in the processing baskets that way the person setting up the processors knew right away if something was written incorrectly on the log or what other troubleshooting you had to perform.


-----Original Message-----
From: STEVEN PINHEIRO [mailto:***@lumc.edu]
Sent: Monday, July 06, 2015 1:28 PM
To: ***@lists.utsouthwestern.edu
Subject: [Histonet] Specimens lost during processing.

All,
Looking for help in analyzing the entire scope of the process. There is not much published data (that I can find) and I am hoping this group can lend some expertise.
Our rate is higher than we would like it to be. There is no consistent size at risk although GI and Derm biopsies are the biggest involved group. We have broken it down into steps.

1. Can be lost at grossing- either never loaded into the cassette at all, or cassette was discarded. Thus we hold on to our waste and can search for misdirected cassettes if need be.

2. Lost in the processor itself. Most are wrapped. If large enough not to be wrapped, we would not expect the processor to eat them, so assume cassette lid not properly closed. Frankly the highest number of losses we're seeing is no tissue found in cassette by embedders.

3. I am being told that we can't use micromesh cassettes in our microwave processors (Milestone Pathos) and want to know if anyone is.

4. Tissue not seen at embedding. Again no way to tell when the tissue disappeared. We know that tiny tissue can spring out during the opening at embedding but I don't know how else to examine or limit this step.

5. Tissue can be exhausted during microtomy. Rare but noteworthy.
I am hoping people can tell me about their procedures for dealing with "specimens that don't survive processing", what safeguards they have in place, and to some extent what your own lab percentage or experience is.
Apologies in advance for the length of the message, but could really use your help.


Steven Pinheiro, MBA, MLS(ASCP)DLMCM
Manager Anatomic Pathology and Cytology
Loyola University Medical Center
2160 S First Ave, Bldg 110 Rm 2214
Maywood, IL 60153
708-327-2642 (O)
708-327-2620 (F)
***@lumc.edu<mailto:***@lumc.edu>

"You must do the thing you think you cannot do"
E. Roosevelt


Confidentiality Notice:
This e-mail, including any attachments is the property of Trinity Health and is intended for the sole use of the intended recipient(s). It may contain information that is privileged and confidential. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please delete this message, and reply to the sender regarding the error in a separate email.