A result that does not fit

A complete blood count is ready for review, but the red cell count and hematocrit are low while hemoglobin is unremarkable. The MCHC is 45.6 g/dL and the analyzer displays an RBC agglutination flag. That relationship is observed discordance, not proof of either a specimen or method error and not a result to release.

Place the order on hold under local procedure; review the result relationships and analyzer information, then inspect the specimen and original smear. A discordance can be biological, preanalytical, or analytical. The flag, histogram, specimen appearance, and film determine the next evidence rather than assigning a cause at the outset.

If evidence remains unresolved, suppress release, request recollection when indicated, and consult or escalate through the local pathway. A delta check compares the current result with a prior result using locally validated limits; it can add urgency but does not identify the cause or replace this review.