Sample Labeling & Identification

The laboratory reserves the right to refuse improperly labeled specimens. Specimens collected for laboratory testing must be labelled with a permanently attached label in the form of a computer generated label or written legibly in indelible ink. The label must include, at minimum, the patient's legal name (last name and first name), and a second unique identifier that can be traced directly back to the patient, specifically their Personal Health Number (PHN) or Medical Record Number (MRN). The label should match the requisition accordingly.

Refer to Acceptance of Laboratory Samples and Test Requests Policy and Appendix A for information about the required information on specimen labels.

For instructions for applying pre-printed labels, refer to Laboratory Specimen Label Placement.

Consistent practices for specimen rejection are employed across APL. The laboratory takes measures to maintain specimen integrity during the process of following up on the receipt of an improperly identified specimen. The laboratory recognizes that, in certain cases where the specimen is less common, involves an invasive procedure or could not otherwise be easily recollected, it may be acceptable to apply an exception to specimen rejection. Exceptions are applied using strict and explicit criteria in accordance with established procedures.

General Rejection Criteria

Unlabeled Specimens

• Unlabeled specimens are considered to be Major Deficiencies.
• Common specimen types (blood, urine, swabs, sputum, stool, etc.) which can be easily recollected and cannot with certainty be identified, will require recollection.
• Specimens which are less common and more difficult to recollect (CSF, fluids, tissues, etc.) will require the person who collected them to identify the specimen and sign a waiver assuming responsibility for the identification of the specimen.
• If the person responsible for collecting the specimen is unable with certainty to identify the specimen, the appropriate Clinical Leader or designate and ordering physician will be notified.

Incorrectly Labeled (Mislabeled) Specimens

• Mislabeled specimens may be Major or Minor Deficiencies.
• Specimens which are labelled with the wrong patient's name compared to that of the accompanying requisition or with a different patient's ID number, the same criteria as for Unlabeled Specimens apply.
• Minor deficiencies may be accepted and procedures ordered will be performed (the exception is requests for blood products for transfusion, which must be recollected) however major deficiencies may be rejected.

Incorrect Container or Preservative

• Specimens received in an incorrect container, or without appropriate preservative, which would invalidate the results, will require recollection. The collection site or nursing unit will be informed. In the case of a Patient Service Centre, the patient will be contacted to arrange for recollection of certain specimens.

Insufficient Specimen for Procedure(s)

• If insufficient specimen is received for all procedures requested and the specimen is easily able to be recollected (urine, stool, sputum, blood, etc.), a repeat collection will be requested. Procedure(s) for which there is sufficient specimen will be performed.
• If the specimen is not easily able to be recollected (CSF, fluids, etc.), the ordering physician will be contacted to establish a priority order of tests to be performed.

Unsuitable Specimen for Procedure(s)

• Specimens which are received and are unsuitable for the procedure requested (saliva for sputum test, urine for blood tests) or if the specimen has been in transit too long for a valid result, the specimen will be rejected. The nursing unit or collection site will be informed so a proper specimen can be collected.

Anatomical Pathology samples must be labeled with the following information:

• Exact anatomical site of tissue origin.
• Multiple specimens on the same patient with the same collection date must have an alpha designation (A, B, C, etc.). The information on the specimen container must match the information on the requisition.
• Specimens from patients with known or suspected infectious diseases should be marked as infectious. Processing of specimens may be delayed if the container lid is not properly secured and the contents are leaking

Microbiology samples must be labeled with the following information:

• When multiple samples are submitted to the laboratory at the same time for the same patient, include:
  • Exact site (source/type) of sample
  • Date and time of collection
• Multiple specimens requiring individual diagnosis should be placed in separate collection containers