Slide retention by the referral laboratory?

[cellmatrix]

When other community pathology practices outsource their consults to another specialty referral lab by sending the paraffin block for initial diagnosis, what precisely are we obligated to return to these clients? Is it not per CLIA or CAP slide retention policy for us to retain in our archives those slides, eg, immunohistochemical stains, that the subspecialty referral lab had set up and performed to render their expert consultative diagnoses? Would the secondary referral lab not be exposed to legal risk by returning, on a routine basis for ALL cases, all slides to the original community pathology client? What if, for example, there is a lawsuit, and slides were returned to the client, and the client lost the slides? This places the referral lab in a precarious position, if all slides are sent back to the community pathology practice and said community practice loses slides, wouldn’t this be a risk in the setting of potential lawsuit? And why would the community practice feel a need to double check diagnoses and document agreements, as they are general community practice sending to the sub specialty referral lab for the first time, primary diagnosis. They aren’t capable of rendering the primary, often complicated lymphoma diagnosis, for example, to begin with, that is why they are sending the samples in the first place. Usually concordance reviews are documented at the originating client lab on an internal basis and if the originating lab had rendered a diagnosis, and the case was then sent out to another referral lab for a second opinion or report, not the other way around. I don’t think it is common practice for the larger national reference labs e.g. NeoGenomics, Quest, Integrated Oncology, Mayo, ARUP, or academic centers, eg NIH, Mass General, for example, to return to the original referral clients slides all of the slides or especially those slides unique to their institution and which they setup and prepared, is it?

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[cellmatrix]

When other community pathology practices outsource their consults to another specialty referral lab by send us the paraffin block, what precisely are we obligated to return to these clients? Is it not per CLIA or CAP slide retention policy for us to retain in our archives those slides, eg, immunohistochemical stains that the subspecialty referral lab had set up and performed to render the expert consultative diagnoses? Does the secondary referral lab not incur exposure to legal risk by returning, on a routine basis for ALL cases, all slides to the original community pathology client? What if, for example, there is a lawsuit, and slides were returned to the client, and they lose the slides? it is difficult to make any guarantee for optimal archiving and specimen stewardship if we send back everything to the community pathology practice. And why would the community practice feel a need to double check diagnoses and document agreements, they are general community practice sending to the sub specialty referral lab for the first time, primary diagnosis. They aren’t capable of rendering the primary, often complicated lymphoma diagnosis, for example, to begin with, that is why they are sending the samples in the first place. I don’t think it is common practice for the larger national reference labs e.g. NeoGenomics, Quest, Integrated Oncology, Mayo, ARUP, or academic centers, eg NIH, Mass General, for example, to return to the original referral clients slides all of the slides or especially those slides unique to their institution and which they setup and prepared, is it?

I also see the following NY State guideline;

Title: Section 58-1.13 - General requirements for performance of anatomic pathology and cytopathology procedures | New York Codes, Rules and Regulations

regs.health.ny.gov

“3) Stained slides and paraffin blocks shall be retained for a minimum of 20 years from the date of examination.”

Im not sure it is sufficiently explicit. If referral client is requesting that ALL stains be returned by the specialty referral lab to the community Pathology practice that initiated the original referral request, the New York State guidance only suggests slides must be retained for 20 years, but it does give a precise language stipulating retention by WHOM

 

[Guest8]

When we send out a consult to the local academic centers with a block we only expect to get our original slides and the remaining block back. The consult center keeps any slides they made off the block. But if we did any H&E or IHC slides that we sent to them we do expect those slides back for our files.