Can you provide examples of common reasons for sample rejection in the laboratory?

Laboratories may reject blood samples for various reasons to maintain the quality and accuracy of test results. Common reasons for sample rejection include:

Clotted Specimen:

Blood that has clotted before proper separation into serum or plasma may be rejected. Clotting can interfere with many laboratory tests and affect the accuracy of results.

Hemolyzed Specimen:

Hemolysis, the rupture of red blood cells, can release intracellular components and impact test results. Hemolyzed samples are often rejected, as they can lead to inaccurate readings in various assays.

Insufficient Sample Volume:

Some tests require a minimum volume of blood for accurate analysis. If the collected sample volume is insufficient, it may be rejected to prevent potential errors.

Wrong Tube Type or Additive:

Different tests require specific blood collection tubes with appropriate additives or anticoagulants. Using the wrong tube type or additive can lead to inaccurate results, and samples may be rejected.

Expired Collection Tubes:

Collection tubes have expiration dates, and if used after the expiration date, they may not function as intended. Expired tubes can lead to sample rejection.

Incorrect Labeling:

Samples that are not properly labeled or mislabeled may be rejected to prevent confusion in patient identification and ensure accurate result reporting.

Contaminated Specimen:

Contamination of the blood sample with substances such as cleaning agents, disinfectants, or other contaminants can lead to sample rejection.

Improper Sample Handling:

Failure to follow proper sample handling procedures, including inadequate mixing of tubes or prolonged storage before processing, can result in sample rejection.

Transportation Issues:

Samples that are inadequately packaged or improperly transported can be rejected due to the risk of deterioration or contamination during transit.

Lipemic Specimen:

Lipemia, an excessive amount of lipids or fats in the blood, can interfere with certain laboratory tests. Lipemic samples may be rejected to avoid inaccurate results.

Post-Prandial Specimen:

Samples collected shortly after a meal (post-prandial) may contain elevated levels of certain analytes, affecting test results. Fasting requirements for specific tests should be followed.

Unsuitable Sample Condition:

Samples exposed to extreme temperatures, freeze-thaw cycles, or other adverse conditions may be rejected due to the potential impact on sample stability and test results.

Unlabeled or Inadequately Labeled Tubes:

Tubes without proper patient identification or tubes with incomplete information may be rejected to prevent errors in result reporting.

Expired Reagents or Calibrators:

Laboratory reagents and calibrators have expiration dates. If expired materials are used, it can compromise the accuracy of test results, leading to sample rejection.

Specimen from an Improper Collection Site:

Some tests require specific collection sites (e.g., arterial blood gases). If the specimen is collected from an improper site, it may be rejected.

These are examples of common reasons for sample rejection, but the specific criteria for rejection may vary between laboratories and depend on the type of tests being performed. Regular training of healthcare professionals, adherence to standard operating procedures, and quality control measures contribute to minimizing sample rejection and ensuring accurate laboratory results.

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