Corporate labs take us down tricky path in pathology

August 8, 2010

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RE “MISTAKES that matter: 2 biopsy errors result in an unnecessary surgery and delayed treatment’’ (Metro, Aug. 2): The biopsy identification error that led to Thomas Cloutman’s delay in diagnosis is something that all pathologists dread, and that we go to great lengths to avoid in our hospital-based practices.

All specimens are double-labeled with a unique accession number and the patient’s name, to decrease the possibility of misidentification. Further, we routinely avoid processing specimens of the same type sequentially; for example, a prostate biopsy would be followed by a colon biopsy or skin biopsy, never by another prostate biopsy. Our modest volume and variety of biopsy types allow us to take precautions to avoid mix-ups.

Increasingly, however, outpatient biopsies are being aggressively pursued by corporate labs such as the one cited in the story, which often process large numbers of similar specimens such as prostate biopsies. The high-volume, profit-driven business also may increase the workload of technical support staff. I believe it was inevitable that this so-called corporatization of the medical specialty of pathology would lead to errors of the type that affected Cloutman.

Dr. Donald G. Ross
North Andover
The writer is chief of the department of pathology at Holy Family Hospital and immediate past president of the Massachusetts Society of Pathologists. His views are his own.

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