[Histonet] RE: Histonet Digest, Return of Body Parts for religious reasons

Wed Nov 26 16:00:50 CST 2008

There are laws here in Texas that regulate all body parts as hazardous waste.  If it isn't going to a funeral home the body part must go to a licensed hazardous waste handler.

Our legal department has indicated they don't feel that under Texas law there is an exception for releasing body parts even with a subpoena.  We had to have that discussion once.

Ross M Stapf
Histopathology Manager
Baylor University Medical Center
3500 Gaston Ave.
Dallas, TX 75246
214-820-2465
214-820-4110 fax
RossS <@t> baylorhealth.edu

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu [mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Tony Henwood
Sent: Wednesday, November 26, 2008 3:50 PM
To: Terri Braud; histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] RE: Histonet Digest, Return of Body Parts for religious reasons

Amazing how different areas have different regs (or lack of)
I thought I would attach our policy, seems to work and, drafted with the best intentions, hopefully prevents litigation and meets the needs of
patients:

BIOPSY SPECIMENS: RETURNED TO PATIENTS
PROCEDURE (c)
Background
At present, very few patients request the return of resected organs or other samples. When patients are specifically informed of what happens to such specimens, it is likely that such requests will increase in frequency, especially in relation to larger samples including whole organs, the disposal or retention of which may have emotional implications. Laboratories should have established protocols to permit compliance with such requests while minimising any risk to the patient or others from infection or toxic chemicals. Procedure
1.      Contact the Histopathology Department, ensure that patient
details and patient representative (usually a parent) details (including contact number) are supplied.
2.      Request is received and action approved by the Pathologist
involved with the case.
3.      Specimens are not usually released until one month after the
report has been verified.
4.      Histopathology staff will then liaise with the patient's
representative and undertake the following procedure.
i.      The specimen is washed in gentle running water for one hour
(minimum).
ii.     The biopsy is blotted dry and sealed in a biodegradable plastic
bag
iii.    The bag is labelled with "The Children's Hospital at Westmead",
patient's name and the biopsy specimen laboratory accession number.
iv.     The specimen is placed in a small esky or similar container.
v.      A copy of the 10% formalin MSDS form is attached to the
container.
vi.     The details of the specimen transfer from Histopathology to the
family representative are recorded on the release form (Attachment 1), a copy is given to the parents and the original is attached to the specimen report.
vii.    Explanation is given to the parents regarding the possible
hazardous nature of the specimen. That is:
o       If the specimen is for burial, ensure a deep hole.
o       Ensure that the specimen is kept away from children or pets.
o       Stress that the danger does not necessarily only lie with the
possible infectious nature of the tissue but also the hazardous nature of the preservative.
o       Remind the parents to be familiar with the MSDS form and if
concerned contact the laboratory (phone number included on the MSDS). The above information is included on the Release Form

References:
1.      Royal College of Pathologists (2001) "Transitional guidelines to
facilitate changes in procedures for handling 'surplus' and archival material from human biological samples " http://www.rcpath.org/index.php?PageID=208

Regards

Tony Henwood JP, MSc, BAppSc, GradDipSysAnalys, CT(ASC) Laboratory Manager & Senior Scientist
Tel: 612 9845 3306
Fax: 612 9845 3318
the children's hospital at westmead
Cnr Hawkesbury Road and Hainsworth Street, Westmead
Locked Bag 4001, Westmead NSW 2145, AUSTRALIA

-----Original Message-----
From: histonet-bounces <@t> lists.utsouthwestern.edu
[mailto:histonet-bounces <@t> lists.utsouthwestern.edu] On Behalf Of Terri Braud
Sent: Thursday, 27 November 2008 2:43 AM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] RE: Histonet Digest,Return of Body Parts for religious reasons

You might want to check with local regulations concerning burial.  Here, and at other facilities that I've been a part of, we receive these requests regularly, usually associated with amputated limbs, however, we make it a policy to release no "soft tissue" to a patient, but instead we ask that they make arrangements with a funeral home (since this is supposed to be for purposes of burial, eventually) and it is only to the funeral home that we will release the part.  What happens to the part after that, is between the patient and their funeral home representative, which is much more familiar with regulations and practices for these situations. This is the only way to complete way protect the hospital from liability of having a body part "stored in the attic".

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital and Medical Center
1648 Huntingdon Pike
Meadowbrook, PA 19046
(215) 938-3676 phone
(215) 938-3689 fax

The premise I've been given is so that, upon death, the patient may be stored with her body parts.

My facility has concerns about providing it to her in formalin (for obvious
reasons) or alcohol. The patient admits this is a family practice with momma's appendix already being stored in the attic.

It can get a bit toasty warm here in the South so attic storage of a specimen in alcohol may not be prudent and I can't be absolutely certain it wouldn't burn the house down, another potential liability for my institution.

I'm tempted to give it to her in food grade vinegar, to avoid the potential liabilities from using anything that could be considered hazardous. Assuming that returning her gall bladder is a given, what do you think of using vinegar for this purpose?

Vinnie Della Speranza

Manager for Anatomic Pathology Services

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