Who is Responsible?
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Problem Identified
Who is Responsible
  Technologist
Lab Management

Hospital Management

1. The wrong control samples were used when the proper controls were deemed "too expensive"
2. Chemical reagents for a variety of routine tests were used after they had passed their expiration date.
3. Questionable test results for HIV, hepatitis B and C, sexually transmitted diseases such as Chlamydia and gonorrhea were reported.
4. The laboratory department was "poorly staffed, poorly trained, overworked and moral was low.
5. When two tests on the same sample provided opposite results, the cause was not investigated.
6. Test conducted for Legionella bacterial on five patients at a Northwest Baltimore nursing home were mishandled but test results were issued despite being invalid.
7. Filters in cervical cancer test kits were reused in lab, when those filters should have been thrown out.
8. Required controlled testing on equipment and materials to certify that they worked properly not conducted.
9. Specimen-labeling problems not followed up on.
10. When supervisors were warened of problems in testing, they were admonished for thier complaints.
11. An untrained clerk was "ordered to perform high complexity testing and verify patient results."
12. Technicians were required to report out test results even thought they were "fearful of the accuracy."
13. Lab workers were threatened with the loss of their jobs if they reported problems to state inspectors.
14. Basic testing procedure manuals contained incomplete and sometimes inaccurate instructions.
15. The hospital charged more that it should for some tests.
16. Competency checks of employees not completed
17. Records of transfusion reations not reviewed in a timely manner.
18. No system to document and remedy problems reported to the lab.
19. Continuing education for pathologists and cytotechnologists not documented.
20. Proper documentation of quality control tests was not provided.
21. Electronic systems for assessing lab quality and reporting problems flawed.
22. The lab did not report sexually transmitted disease cases to local health departments, nor report cervical cancer cases to a state registry.

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