Specimen Identification Errors in Breast Biopsies: Age Matters. Report of Two Near‐Miss Events and Review of the Literature. Issue 5 (16th March 2017)

• Record Type: Journal Article
• Authors: Tozbikian, Gary; Gemignani, Mary L.; Brogi, Edi
• Is Part Of: Breast journal. Volume 23:Issue 5(2017:Sep./Oct.)
• Page Start: 583
• Page End: 588
• Publication Date: 2017-03-16
• Subjects: biopsy -- breast -- laboratory error -- lactating adenoma -- Monckeberg medial calcific sclerosis -- needle core -- specimen misidentification; Breast -- Diseases -- Periodicals; Breast -- Cancer -- Periodicals; 618.19
• DOI: 10.1111/tbj.12797
• Languages: English
• ISSNs: 1075-122X

Abstract

Abstract: The consequences of patient identification errors due to specimen mislabeling can be deleterious. We describe two near‐miss events involving mislabeled breast specimens from two patients who sought treatment at our institution. In both cases, microscopic review of the slides identified inconsistencies between the histologic findings and patient age, unveiling specimen identification errors. By correlating the clinical information with the microscopic findings, we identified mistakes that had occurred at the time of specimen accessioning at the original laboratories. In both cases, thanks to a timely reassignment of the specimens, the patients suffered no harm. These cases highlight the importance of routine clinical and pathologic correlation as a critical component of quality assurance and patient safety. A review of possible specimen identification errors in the anatomic pathology setting is presented.