Mislabeled and Unacceptable Blood Bank Specimens: A 3-Year Single-Institution Retrospective Review

Abstract

Our study aims to identify the main causes of specimen rejection and mislabeling for specimens received in the Danbury Hospital Department of Pathology & Laboratory Medicine Blood Bank from 2015 to 2017 and compare these data to national benchmarks. We performed a retrospective review of all mislabeled and unacceptable blood samples that were received by the Danbury Hospital Blood Bank from January 2015 to December 2017. A spreadsheet of mislabeled and unacceptable blood samples was reviewed. The spreadsheet included patient location, problem code (hemolysis, incomplete patient name, medical record number or date of birth, absent or incorrect date of collection, lack of phlebotomist identification, wrong patient name on tube, specimen collected in wrong tube, specimen mislabeled), test type, specimen collected by, action taken, and outcome. Specimens were categorized based on the reason for mislabeling and rejection. Annually, 11,000 specimens on average are received in the DH Blood Bank; 588 mislabeled/unacceptable specimens were documented from 2015 to 2017. Of these, 391 were hemolyzed, 104 were documented to lack phlebotomist identification, 77 were categorized as “other” (mislabeling category option not applicable), 6 were unlabeled, 4 had an incomplete or misspelled patient name, 3 were found to have wrong name on tube, 2 had incorrect specimen in tube, and 1 lacked collection date. The rate of mislabeled and unacceptable specimens collected for our study was 1.8% (588/33,000). Regarding our hemolyzed specimens, national benchmarks prove that improper specimen collection/handling is the most common lab specimen error (86%). This applied for our study as well with a rate of 391 of 588 (66%) mislabeled/unacceptable specimens being due to hemolysis. We plan to further investigate the cause of hemolyzed specimens as well as absence of phlebotomist identification on specimens in future studies.

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