A pink tube and a flagged potassium

A basic metabolic panel and magnesium arrive from the emergency department. The plasma is visibly pink. The analyzer reports the panel along with a hemolysis index of 82 arbitrary units (AU) on this instrument, and the local chemistry procedure flags potassium as potentially positively biased at 50 AU or greater. Sodium, creatinine, and magnesium carry no interference flag at this index on this method. The order is time-sensitive.

The identity label is correct, the tube and additive are right for the panel, the volume clears the minimum, and there is no clot. Nothing about the collection itself is wrong. The only problem is a specimen-quality index that says one analyte, potassium, may not be trustworthy as measured.

The defensible next action, when a specimen is imperfect in one respect but fine in every other, is not obvious: reject the whole specimen? Release everything anyway? Withhold only the affected result? Call for an exception?

A repeatable four-question risk screen distinguishes a mandatory rejection from a conditionally acceptable defect and supports writing the disposition, the comment, and the notification this case actually requires.

A specimen defect is a question about one or more specific results, not an automatic verdict on the whole tube.