All specimens, packages or shipments sent from, or received in, the Laboratory of Pathology (LP) must comply with all applicable local, state, and Federal laws and regulations governing packing, labeling, and transportation.
As a Federal facility, LP staff members must be vigilant about receiving packages via mail or courier services. The following Web resources are available for procedures for handling suspicious packages:
Specimens within NIH are transported by personnel from Patient Escort Services (301-496-9295) who are trained in the appropriate safety and packaging procedures suitable to specimen type and distance transported. All specimens must be properly labeled to meet the NIH requirements for transportation of biohazards. Escort Services has a tracking system to ensure that all specimens submitted to the laboratory are actually received. Electronic orders are placed in the Clinic Research Informatics System (CRIS) or are FAXed to the individual laboratories and individual laboratory sections/units record specimen receipt in either a logbook or the Laboratory Information System (LIS). These systems can be used to track specimens when needed.
The nurses transporting specimens to the Frozen Section Room from the Operating Room enter these into a logbook. Histology personnel review the logbook and initial each entry when specimens are transported from the Frozen Section Room to the Histology Laboratory. They confirm that all specimens are properly labeled and placed in sealed containers prior to transporting materials on a laboratory cart.
Specimens transported to the Laboratory of Pathology from clinics and nursing units follow strict labeling and packaging guidelines established in M95-3, Transport of Patients, Specimens, Blood Products, and Medications within the NIH Clinical Center. All specimens will be submitted in appropriately labeled and well-constructed containers with secure lids (or sealed bags) to prevent leakage during transport. Specimens are transported in clearly labeled carriers or bags that indicate that the contents are biohazardous diagnostic specimens.
All specimens must be properly packaged and labeled to indicate the general nature of the materials transported.
Occasionally, specimens may be hand-carried by personnel from other buildings, (e.g., Suburban Hospital or the National Military Medical Center). When doing so, make sure the packages are double bagged (or placed in a secondary sealed container) to prevent any potential leakage. A Nalgene leakproof, sealable, puncture-proof container available through most catalogs to transport materials between buildings is recommended. Specimens should be labeled “Diagnostic Specimen.” Hand-carried materials must have sufficient absorbent material to absorb all specimens, if the primary container breaks or leaks. If using a courier, follow the packing instructions provided by the courier. If the specimen is known to be infectious, then it becomes a regulated dangerous good and must be packaged following the guidelines for Shipping Diagnostic and Potentially Biohazardous Specimens Outside the NIH (see Freight Forwarding Section instructions for more details or contact the LP Clinical Manager).
If it is necessary to transport a deceased patient for autopsy, contact Admissions (301-496-3315) to arrange transportation using a licensed funeral home or service.
The majority of the material sent from the Laboratory of Pathology to outside facilities are in the form of non-infectious, non-hazardous tissue slides or blocks. These materials are packaged and processed for transport by commercial US carriers such as FedEx. USPS, DHL, and UPS. Refer to the general surgical pathology send outs policy for guidance on packaging and shipping of slides or blocks. LP staff who package and ship diagnostic material complete a Department of Transportation approved packaging and shipping training course.
Biohazardous material shipped from LP to non-NIH facilities must go through the NIH Freight Forwarding Section (FFS), to be packaged and shipped by trained and credentialed staff.
Freight Forwarding Section staff will ensure:
Diagnostic packages (UN 650) must be packaged by a trained and certified shipper using approved packing materials.
The LP shipper must complete NIH form 1884, Request for Shipment, to include identifying:
The package should be taken to the Freight Forwarding Section 
in Building 13, Room 1759 while adhering to the NIH Shipping Policies and Procedures. Freight Forwarding Section can be reached at (301) 496-5921. The Freight Forwarding Section will provide any stickers and labels that are needed to correctly mark and label the package as a diagnostic specimen. They will also complete the shipping manifest. The laboratory sample may never arrive at its destination if it is improperly packaged, labeled or declared.
On a rare occasion, diagnostic or infectious material may need to be transferred from the Laboratory of Pathology by LP staff who are trained in biological materials packaging and shipping.
Transport personnel responsible for packaging and shipping biohazardous specimens or chemicals are trained in packaging and shipping infectious substances. Training include issues such as adherence to regulations for transport of biohazards, use of rigid containers where appropriate, temperature control, and notification procedures in case of accident or spills.
LP personnel can either attend NIH DOHS Biological Materials Shipper Training course, or complete the CDC National Laboratory Training Network (NLTN), Packaging and Shipping Division 6.2 Materials: What the Laboratorian Should Know 2016.
The NIH Biological Material Shipper Training is a one-day certification course from an outside vendor for all personnel involved in the shipping of infectious substances, diagnostic specimens, biological specimens and dry ice classified as "dangerous goods." The course provides personnel with the knowledge and certification to be a shipper of categories A and B infectious substances, biological substances, exempt human and animal specimens, genetically modified organisms (GMOs) and dry ice. An awareness of existing regulations and their legal aspects for the transportation of Dangerous Goods as specified in the Code of Federal Regulations (49 CFR) is provided. The course will use, as its core reference, the latest Edition of the International Air Transport Association Dangerous Goods Regulations (IATA DGR). This course provides hands-on activities to enhance knowledge retention. A certificate of training is awarded upon demonstration of a student's knowledge and understanding of the regulations.
Training must be completed prior to staff packaging and shipping infectious material, and every 3 years.
Radioactive tissues are not processed and embedded in paraffin blocks unless radiation is below background level; therefore, no additional precautions are required. Call Radiation Safety at 301-496-3277 if additional information is required.