Specimen Rejection

Flow Cytometry Specimen Rejection Approval Requests:

Specimen processing of rejected specimens requre flow cytometry pathologist approval.

 Flow Cytometry Specimen Rejection Examples: 

  1. Unlabeled or mislabeled specimens will not be processed until the specimen label is corrected by knowledgeable staff in person. 

  2. Specimens arriving after 1 p.m. may be held until the next day (if collected the same day received) or may be rejected if the schedule is full (or if the specimen was collected before the day received).

  3. Improper collection or handling during transport (often detected during the gross specimen examination):

  4. Specimens with very low cellular content due to cell loss or disease conditions.

  5. Fixed Specimen / Specimen in FixativeCells derived from blood, bone marrow, fluids and tissue must be viable for flow cytometry testing. Any specimen with fixative added for any length of time i.e. formalin, B5 fixative, alcohol, etc. will be rejected for flow cytometry testing. Fixation is not reversible. In addition, lithium heparin should not be used as it is toxic to cells. 

  6. Low Viability / Non-Viable cells:  Viability less than 60% may be rejected. Cells derived from blood, bone marrow, fluids and tissue must be viable for flow cytometry testing. Cell death may be due to excessive age of specimen, poor handling, or patient therapy.

 Specimen Handling of Rejected Specimens:

  1. The Flow Cytometry laboratory director or alternate will contact the clinician for recollection of rejected specimens.
  2. The rejected specimen will be accessioned and finalized. 

  3. In addition, the clinician will be notified and the specimen will be held at room temperature for retrieval by the sending service i.e. Hematopathology, Cytopathology or clinical group for alternate testing. 

  4. Specimens remaining in the Flow Cytometry lab will be discarded the following work week.