[Histonet] cross contamination[Scanned]

[Kemlo Rogerson]

Do you log it as an incident using IR1?

-----Original Message-----
From: Marshall Terry Dr,Consultant Histopathologist
[mailto:Terry.Marshall <@t> rothgen.nhs.uk] 
Sent: 14 January 2005 16:36
To: Scholz, Stephen J.; Histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] cross contamination[Scanned]

This is my practise. It is not held out to be perfect, but is honest.

If it's very obvious, as in a case yesterday with a colonic gland sticking
onto the surface of a piece of skin, I ignore it in all respects.

If less than an expert might misconceive it, I mention it. E.g. "a fragment
of endometrium, which is clearly a cross-over from another patient is
noted."

The crunch comes when you suspect it might be from another patient but you
can't know it. There is no easy way out of this one - you have to tell it as
it is.  Then wait for the "can't you do a test?" - "would immunochemistry
help?" - "can you do DNA testing" - "what do I tell the patient" and dozens
more possible witless comments or questions.

As to the language, cross-over or cross contaminant seems to cover any of
cutting board, processing and water bath contamination. 
If you can see it in the block you can be more specific, but there is little
point to being so.

Luckily, the bad scenario happens infrequently.
The worst scenario, where the cross-over is not recognised or suspected
seems even less frequent, and of course, can only be suspected in
retrospect.


Dr Terry L Marshall, B.A.(Law), M.B.,Ch.B.,F.R.C.Path
 Consultant Pathologist
 Rotherham General Hospital
 South Yorkshire
 England
        terry.marshall <@t> rothgen.nhs.uk

-----Original Message-----
From: Scholz, Stephen J. [mailto:Stephen.J.Scholz <@t> osfhealthcare.org]
Sent: 14 January 2005 15:41
To: Histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] cross contamination


Hello all;

I have a question for the masses regarding cross contamination in surgical
specimens.  I would like know how others are handling situations when a
small fragment from one specimen gets embedded with a different case.
(probably stuck on  forceps)  When it is obvious upon reading the slide that
the fragment doesn't belong does the Histologist remove it?  Does the
Pathologist comment in the Path Report and what is the common language used
(debris, cross-contaminate, ect)?  What is done from the Pathologist
perspective when the contaminate tissue is similar but logic dictates that
it doesn't belong with that case. Again, is it mentioned in the report and
what language is used to state the Pathologist believes there is incorrect
tissue fragments with the case?

I eagerly await your replies,


Stephen J. Scholz HT(ASCP)
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