Specimen Identification Errors in Breast Biopsies: Age Matters. Report of Two Near-Miss Events and Review of the Literature.

The consequences of patient identification errors due to specimen mislabeling can be deleterious. We describe two near-miss events involving mislabeled breast specimens from two patients who sought treatment at our institution. In both cases, microscopic review of the slides identified inconsistenci...

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Publicado en:Breast Journal Vol. 23; no. 5; pp. 583 - 589
Autores principales: Tozbikian, Gary, Gemignani, Mary L., Brogi, Edi
Formato: case study pictorial Journal Article
Publicado: Wiley-Blackwell Sep2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2017
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Specimen Identification Errors in Breast Biopsies: Age Matters. Report of Two Near-Miss Events and Review of the Literature.
      aug:
        au:
          Tozbikian, Gary
          Gemignani, Mary L.
          Brogi, Edi
        affil: Department of Pathology, Wexler Medical Center at The Ohio State University, Columbus Ohio
      sug:
        subj:
          Biopsy
          Specimen Handling
          Diagnostic Errors
          Quality Assurance
          Patient Safety
          Patient Identification
          Laboratories
      ab: The consequences of patient identification errors due to specimen mislabeling can be deleterious. We describe two near-miss events involving mislabeled breast specimens from two patients who sought treatment at our institution. In both cases, microscopic review of the slides identified inconsistencies between the histologic findings and patient age, unveiling specimen identification errors. By correlating the clinical information with the microscopic findings, we identified mistakes that had occurred at the time of specimen accessioning at the original laboratories. In both cases, thanks to a timely reassignment of the specimens, the patients suffered no harm. These cases highlight the importance of routine clinical and pathologic correlation as a critical component of quality assurance and patient safety. A review of possible specimen identification errors in the anatomic pathology setting is presented.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        Journal Article
      ougenre: Article
    language: English
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