Clinical pathology

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Author: Mikael Häggström, M.D. [note 1]

Topics with own articles


Lab management

Lab management is essentially about handling each of the extremely various situations that arise, and can generally be achieved by:

  • Common sense
  • Gathering enough information before a decision
  • Identifying what questions needs answering
  • Asking proper expertise and/or looking up relevant information in proper sources (see learning pathology), which may include local protocols as well as policies of accrediting organizations of the department (which are generally more stringent than the national or regional laws).

Test question

Retention time

(You may skip this question if you don't expect to ever be part of laboratory management in the US.)

You work in a pathology department in the United States, which is accredited by the College of American Pathologists (CAP). Your local procedure manual states that non-forensic paraffin-embedded blocks must be retained for at least 10 years before being thrown away. In order to save storage space, one suggestion that gets brought up is to reduce the retention time to 5 years. You look up the issue, and find that the U.S. law (the Clinical Laboratory Improvement Amendments; CLIA) states that such blocks must be retained for at least 2 years. Is it acceptable to finish the look-up here, and agree to reduce the retention time of non-forensic paraffin-embedded blocks to 5 years in this department?

  • Answer: This pathology department is accredited by CAP, whose requirements commonly exceed those of the U.S. law, in this case stating at least 10 years for non-forensic paraffin-embedded blocks. Therefore, is not acceptable to relax minimum retention times without first having had a look at CAP requirements, if the lab is accredited by it (don't assume it isn't without checking). Thus, the answer to this question is: no.

For quick look-up in the future, the following are the most relevant retention times, as given by U.S. law[1] as well as by CAP[2] (more comprehensive lists are available in their sources):

Microscopy slides Histology and non-forensic autopsy 10 years[1]
Forensic autopsy Indefinitely[1]
Cytology, fine needle aspiration 10 years[2]
Cytology, apart from fine needle aspiration 5 years[1]
Paraffin-embedded blocks Non-forensic 2[1] or 10 years[2]
Forensic Indefinitely[1]
Requisition forms and test reports Pathology reports 10 years[1]
Other 2 years[1]
Blood bank records Quality control records 5 years[2]
Donor and recipient records 10 years[2]
Records of indefinitely deferred donors Indefinitely[2]
Wet tissues Until report is completed[1] or 2 weeks thereafter[2]
Proficiency testing records and quality management/quality control records (except for blood bank) 2 years[1]
Discontinued procedures 2 years[1]
Blood smears and other body fluid smears, microbiology slides (including Gram stains) 7 days[2]
Flow cytometry plots 10 years[2]

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 . 42 CFR § 493.1105 - Standard: Retention requirements.. Cornell Law School. [68 FR 3703, Jan. 24, 2003; 68 FR 50723, Aug. 22, 2003]
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 . CAP Policy Manual - Policy PP. Minimum Period of Retention of Laboratory Records and Materials. CAP.org. Adopted August 1995. Revised September 2020

Image sources