Specimen Labeling

General Policy

Ideally, all specimens should be labeled with a Collection Manager/SunQuest label. If such labels are not available, then an APeX label is an acceptable alternative.  During computer downtimes, other adhesive labels will be accepted, provided they include the patient’s first and last names and the correct full unit number including the visit number. Do NOT use gummed paper labels which must be moistened to adhere, as they are prone to falling off, resulting in an unlabeled specimen.

Please see below for guidance on proper labeling of specimens.

Whoever obtains a specimen should label it. Do NOT give an unlabeled specimen to another individual to be labeled as this greatly increases the chance for mislabeling.

NOTE: THE LABEL ON A SPECIMEN FOR BLOOD TYPING OR CROSSMATCHING, ON A TISSUE BIOPSY OR ON AN INVASIVELY-COLLECTED SPECIMEN FROM A NORMALLY STERILE AREA (e.g., CSF, joint fluid, amniotic fluid, bone marrow) MUST DISPLAY THE LEGIBLE NAME OF THE INDIVIDUAL COLLECTING THE SPECIMEN AND THE DATE AND TIME OF SPECIMEN COLLECTION.

When multiple samples of the same type are collected at intervals (e.g. glucose tolerance test, provocative testing) or when multiple samples are collected from multiple sites (e.g. tumor localization) it is imperative to label each sample with a sample identification number or letter, the time it was drawn or the location from which it was taken. This avoids problems with sample mix-up in these situations.

Fetal sample labels must show the mother's first and last name and the mother's unit number. The label must have "FETAL" clearly written on it. In addition, the date and time the specimen is collected and the initials of the person doing the collection should be included on the label.

Donor Sample labels must show the donor's first and last name labeled "DONOR" and the recipient's first and last name and unit number labeled "RECIPIENT." In addition, the date and time the specimen is collected and the initials for the person doing the collection should be on the specimen.

Example: 

DONOR: Jones, Tom RECIPIENT: Smith, John 23456183   9/15/01   14:30 LR

Mislabeled or Unlabeled Specimens

At minimum, all labels must show at least the patient's first and last names and the correct unit number and have an associated order for the testing to be performed. Specimens with less information are inadequately identified, and will not be processed until the deficiencies are corrected. If an inadequately labeled specimen is brought to the laboratory by someone from the nursing unit or office, that individual will be asked to supply the missing information.

When the identification of a sample submitted for analysis is in any way questionable, the laboratory will recommend that, if feasible, a new specimen should be obtained.

If the laboratory is unable to determine from whom a sample has been collected with a reasonable degree of certainty, a new sample must be obtained. For example, if two unlabeled samples arrive from the same nursing unit at the same time, the samples must be recollected.

All specimens submitted to the Transfusion Service (for blood typing, crossmatch, etc.) must be properly labeled. Mislabeled, unlabeled or unsigned samples will NOT be accepted. 

When an unlabeled sample is received AND the sample can be identified with certainty we will allow the sample to be labeled by the person who obtained the specimen. The patient's physician must acknowledge in writing that the sample identity was questioned and the test result in the patient's chart will carry the notation that the sample was "REC'D MIS(UN)LABELED-RUN AT MD'S REQUEST"

When there is a mismatch between the name on the requisition and on the sample, the sample should be recollected. Similarly, if a sample is received and there are no apparent APeX orders for the name of the patient on the label the sample should be recollected as a potential mislabel. In cases where a mislabeled sample is irretrievable or where re-collection would jeopardize patient care (e.g. invasively collected samples, intra-operative samples, timed samples, etc.) AND the sample itself can be identified with reasonable certainty exceptions to the above policy may be made. These decisions will be the responsibility of a Laboratory Medicine resident on duty or a laboratory Medical Director. In cases where the sample is approved for testing the patient's physician must accept responsibility in writing for the specimen being processed. The test result in the patient's chart will carry a notation that sample was "REC'D MIS(UN)LABELED-RUN AT MD'S REQUEST”.

Labeling Guidance