Module overview
Section 5 of 6 · Open sections

Required section · Section 5 of 6

Five case cards, five dispositions

Work each card the same way: run the four-question risk screen, choose a disposition, state the required comment or communication, and flag whether the event also needs nonconforming-event review. A nonconforming-event program responds to departures from established policy, process, or procedure and tracks them through data assessment and management review; not every rejection is a nonconforming event, but a departure from the written procedure usually is.

Card A: a coagulation tube arrives at 60% fill for a test that requires a defined citrate-to-blood ratio. Card B: cerebrospinal fluid for cell count and protein arrives with no visible defect but the order form lists only one patient identifier where two are required locally. Card C: a chemistry tube separated four hours late but the requested analytes are validated stable at room temperature for six hours. Card D: a potassium sample arrives grossly hemolyzed with an H-index far above the local action limit. A late separation remains a processing departure even when an analyte has validated six-hour stability; result acceptability and process review are separate decisions.

A delayed separation that remains within a validated stability window can support a procedure-based result disposition, but it is still a processing departure requiring the required review or investigation. An underfilled specimen is not repaired after receipt: proceeding, prioritizing, recollecting, rejecting, or holding/releasing are dispositions under the current procedure. A compromised patient collection, such as the wrong identity or an unsuitable additive, cannot be repaired by centrifuging, aliquoting, or writing a comment.

For each card, also identify the responsible next step: who approves an exception, who is notified, and what gets logged. Those specific roles, recipients, and comment wording are controlled by local policy; the pattern of the decision matters, not a universal script naming the exact people or words.

Write down the disposition and the reasoning together, because a reader coming back to the record needs to see why, not only what was decided.

Illustrative drawing — this picture was drawn rather than captured.

Specimen exception record form with fields for deficiency observed, tests affected, disposition chosen, approving authority, clinician notified, report comment used, and whether a nonconforming-event log applies.
Figure 1The fields a qualified exception record needs to capture.

Ordering exercise

Card C: a chemistry tube separated four hours late, within the validated six-hour room-temperature stability window for the ordered analytes. Put the steps of the disposition workflow in the order a laboratory professional actually performs them.

  1. 1. Document the timing and the decision

    Record the collection time, the separation time, and the stability basis for proceeding, so the record shows the reasoning, not just the result.

  2. 2. Release the result without a qualifying comment

    Because the specimen meets the validated stability criterion, the result is released as a standard result rather than as a qualified exception.

  3. 3. Run the four-question risk screen

    Confirm identity is intact, the delay does not make the collection irreplaceable, the issue is a processing timing issue, and note the order's urgency.

  4. 4. Classify as correctable, not a rejection

    Because the delay is within the validated window, this is a documented processing correction rather than a compromised collection.

  5. 5. Check the analyte-specific stability window

    Compare the four-hour delay against the validated stability data for the specific analytes ordered, not a single generic time limit.

Knowledge checks

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Knowledge check 1

Card D describes grossly hemolyzed potassium from a difficult pediatric draw where recollection is not currently possible. Which statement best reflects how irreplaceable specimens are handled?

Choose one option.

Knowledge check 2

Which of these are examples of a correctable processing issue rather than a compromised patient collection? Select all that apply.

Choose at least 2 options.

Knowledge check 3

Card E describes a properly collected tube delivered in a leaking, contaminated transport bag. Beyond the specimen disposition, what else does this event call for?

Choose one option.

Section status

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