Special Handling 

Blood & Body Fluid Specimen Delivery Precautions

1. General Precautions
   Extraordinary care must be taken to avoid accidental wounds from sharp instruments contaminated with potentially infectious material and to avoid contact of an open skin lesion with material from these patients.
2. Handling
   Disposable gloves should be worn when handling blood specimens, blood soiled items, body fluids, excretions and secretions as well as surfaces, material and objects exposed to them. Hands should be washed after removal of disposable gloves.
3. All specimen tubes should be spun with the cork in position in a sealed container to guard against aerosol formation each time the specimen is spun. Transfer of specimens should be done with DispoPipettes – no mouth pipetting.
4. Specimen Handling
   After proper collection and processing, each specimen should be put in a zip lock transport bag with the requisition folded and put in the outside pocket of the bag with the patient's name facing out.
5. Transportation
   All couriers must comply with Federal Regulations which specify how specimens must be packaged for transport. Couriers may not transport improperly packaged specimens. Couriers will refuse to transport specimens which are not correctly packaged at time of pickup.
   1. Personnel other than an SSM Health St. Mary's Hospital - Madison lab services messenger (cab, physician, client employee, volunteer) Transportation via cab.
      1. Place specimen in a plastic container with a leak proof cap.
      2. Place plastic container in a zip top plastic bag with a biohazard label. (If needed, place ice inside the bag also, taking care not to overfill it.) Ensure that the bag is securely closed.
      3. Place bagged specimen in a rigid container, such as a Styrofoam box or plastic specimen container ("cottage cheese" type) and seal.
      4. If desired, place inside a brown paper bag for ease of carrying. The outer most container (brown bag or rigid container if paper bag not used) must have a label identifying the contents:
         1. If a biological specimen, use biohazard symbol
         2. If a pathology specimen in formalin, use formaldehyde warning label
   2. US Mail (primarily tissue specimens) - The US Postal Service requires the following packaging:
      1. Place specimen in a plastic pre-filled formalin container with a leak proof cap. Note warning label and handle with care.
      2. Label specimen container with patient name and type/site of tissue. Wrap container in sufficient absorbent material to completely absorb the contents in case of leakage.
      3. Place wrapped plastic container in a zip top plastic bag. Ensure that bag is securely closed. Paperwork should be placed in the outer pocket of the bag.
      4. Place bagged specimen in a Styrofoam box and seal with tape.
      5. Place Styrofoam box inside addressed cardboard mailing sleeve. The outside mailing box must be labeled with a formaldehyde warning.
   3. Overnight Courier (primarily flow cytometry specimens)
      1. Fresh tissue specimens must be shipped by overnight courier.
      2. Place fresh tissue specimens in a plastic container with a leak proof cap. The container must contain tissue culture media (RPMI 1640 or similar media), in order to retain the specimen integrity. Media is available upon request. Make sure that the volume of media is at least twice the volume of the tissue. Place container in a zip top plastic bag.
      3. If specimen is whole blood or bone marrow, place the container in a zip top plastic bag. Ensure that the bag is securely closed.
      4. Place the bagged specimen and enough absorbent material to absorb the liquid in the container. Place paperwork in a mailing cylinder or box, and seal it with tape.
      5. Place the overnight courier label and a biohazard label on the outermost container.
      6. Call the flow cytometry lab (608-258-6309) and inform them the specimen will arrive the next day. This will ensure that the specimen is processed as soon as it arrives.
      7. During excessively cold weather conditions, please contact the flow cytometry lab for further instructions. ***

Confidentiality

Any and all resident records, charts or reports produced by SSM Health St. Mary's Hospital – Madison laboratory services are and remain the property of SSM Health St. Mary's Hospital – Madison laboratory services. Any and all resident records, charts or reports produced by client are and remain the property of client. If either party has access to such resident records, it must handle such records in accordance with applicable law and regulations relating to patient confidentiality. The parties agree to execute any documents and take any action required by the Health Insurance Portability and Accountability Act of 1996 with respect to the reports, records and supporting documentation prepared in connection with this Agreement.

Certification & Compliance

SSM Health St. Mary's Hospital – Madison laboratory services is and shall remain at all times in compliance with all applicable laws and regulations in connection with its provisions of laboratory services and billing for services. SSM Health St. Mary's Hospital – Madison laboratory services is and shall remain at all times during the term of this Agreement licensed to provide all types of clinical laboratory testing by the State of Wisconsin, the United States Department of Health and Social Services, Medicare and Wisconsin Medical Assistance. If SSM Health St. Mary's Hospital – Madison laboratory services CLIA certification is suspended or revoked, Client will receive written notification of such and have the option of termination of their agreement immediately.