Hospital laboratory errors can lead to the wrong diagnosis, a delay in diagnosis, or an incorrect treatment. Sometimes, they mean the difference between life and death.
Medical researchers have studied the role of lab tests and how they impact medical decision-making by physicians. What they came up with is:
• 35% of hospitalized patients have at least one laboratory test ordered
• For those admitted to the hospital, that number jumps to 98% of patients
• In the ER, 56% of patients have one ore more lab test ordered
• For outpatients, 29% of patients have at least one laboratory test
There are all kinds of problems that can occur between the time a doctor orders a laboratory study and when the results are communicated back. We’ll address some of the common ones here.
Delay in getting the sample. When doctors order lab work, they should specify how quickly they need the results. “Stat,” for example, means as soon as possible. Some hospitals use “super stat” to mean immediately. If the ordering physician doesn’t specify otherwise, hospital staff will collect the sample on a routine basis, which often takes hours.
There are also occasions when a lab order falls through the cracks. The order goes from a doctor to a nurse or nurses’ station clerk to the laboratory. For some lab work, nurses collect the sample. For other tests, lab personnel do that. Nurses are required to communicate the order to the laboratory and follow-up, as needed, to make sure things are getting timely done.
Poor training of phlebotomists and other staff. Phlebotomists are health care workers with special training on taking blood samples. Poorly-trained phlebotomists can impact the quality of the sample drawn and, in turn, the accuracy of the lab test that’s done. For example, some patients pump their fists when giving blood—phlebotomists should make sure that this is avoided because it can give an inaccurate result.
Contamination. When hospital personnel collecting, processing, or testing the sample don’t follow best practices, the sample can become contaminated and useless. This happened in a wrongful death medical malpractice case that I’m handling, where a nursing home employee took a urine sample from a bedpan instead of in a sterile fashion. This led to a multiple-day delay in diagnosing and treating a urinary tract infection, ultimately leading to the patient’s death.
Misinterpretation. When lab personnel misinterpret a study, it renders the lab work useless to the ordering physician. That, of course, can misdirect treatment decisions.
Delay in communicating the result. Just like there can be a communication breakdown when the order goes from the doctor to the nurse to the lab, there can be a failure to communicate lab results.
Lab personnel are responsible for communicating test results back to the nursing staff. This is often done through the electronic medical records system without any direct provider to provider communication. The nursing staff is responsible for following up with the laboratory if the results aren’t available when expected. Unfortunately, floors can be under-staffed, and this doesn’t always happen.
When there’s a critical finding (either high or low), though, the standard of care requires the laboratory to pick up the phone and notify a nurse or the ordering physician, and to document the same in the medical record.
One of the saddest things for a family to discover is that a loved one was seriously injured or passed away because of lab results that fell through the cracks and that would’ve made a difference if they had been timely acted on. If you’ve suffered because of this type of medical error, then contact a top-rated experienced Houston, Texas medical malpractice lawyer for advice on your legal options.