| R. Lewis Dark:
Primum non nocere, or: First, Do No Harm!
"FIRST, DO NO HARM!" IS KNOWN TO EVERY HEALTHCARE PROFESSIONAL. However, I
was surprised to learn that this famous phrase is not from the Hippocratic Oath!
In checking wikipedia.com as I wrote the headline above, I learned that "the
phrase expresses one of the principal precepts allmedical students are taught in
medical school and is a fundamental principle for the emergencymedical services."
Wikipedia has an interesting discussion of early references to this sentence
and its use in medicine, but does note that, by around 1900, it was in common
use within the medical community here in the United States.
I wanted to call your attention to this precept of "First, do no harm!" in
the context of the disclosure by Quest Diagnostics Incorporated that it had,
for 18 months during 2007 and 2008, reported inaccurate Vitamin 25(OH)
D results to tens of thousands of patients and had instituted a voluntary
notification and retest program for patients who had received inaccurate test
results. In speaking to THE DARK REPORT (which was first to break this
important story) and the national press, Quest Diagnostics is downplaying
the potential negative consequences to patients. One Quest pathologist even
told a reporter that he doubted that patients would have suffered any harm
from the problem! A written Quest statement read on a television news
broadcast declared that, following its notification campaign, "we have not
been made aware of any adverse impact to patients."
I personally find this a disappointing public face to the problems created by
the inaccurate test results Quest Diagnostics sent to patients and their physicians.
The New York Times reporter quoted one doctor who said, "There was a patient
we put on vitamin D and all of a sudden, for the first time ever, the patient came
back with what seemed to be a toxic level of vitamin D. "When the patient had his
Vitamin D tested by another laboratory, the "value was considerably lower." On
disease-specific bulletin boards and discussion groups, it is not difficult to find
postings dating back two years by concerned patients who are upset by odd or
discordant values on their Vitamin D tests performed by Quest.
By repeatedly stating "no harm to any patients (that we know of)," Quest
shows a lack of respect for the turmoil it has caused to patients and physicians.
Of course, lawyers have a hand in these public statements. Still, I come from the
old-fashioned school of values, where admitting amistake is the right thing to do
and the first step to rebuilding trust withmy customers andmy friends.
Inaccurate Results + Quest
Dominates News Cycle
From the New York Times to CNN News,
Quest's Inaccurate Vitamin D testing is a big story
CEO SUMMARY: Most laboratory professionals don't know it
yet, but significant changes occurred to the entire lab industry last
week. After Quest Diagnostics Incorporated acknowledged that it
was retesting tens of thousands of patients because 7% of the
Vitamin D results it reported during an 18-month period were
inaccurate, a blitz of newspaper headlines and television news
coverage of the story alerted Americans to the problem.
Labs Need to Respond To Inaccurate Results
In 2004, ongoing failures in HCV, HIV testing
at a Baltimore hospital lab became national news
CEO SUMMARY: What does a lab do when it discovers that
it has reported inaccurate test results? In 2004, a turnaround
team arrived at the laboratory of Maryland General Hospital in
Baltimore to deal with the consequences of a failed infectious
disease testing program. For about two years, the lab had
reported inaccurate HCV and HIV results. One member of that
turnaround team shares lessons learned that pathologists can
use to develop effective contingency plans for their own labs.
Dennis Monahan of ARUP Dies on Christmas Eve
He was ARUP's first sales representative and
contributed to the lab's growth for 24 years
Lab Conserves Blood When Drawing Patients
Rhode Island hospital laboratory has lead role in encouraging adoption of transfusion-free medicine
CEO SUMMARY: New attention on both the risks associated
with blood transfusions and the cost of blood products is
triggering action by the nation's hospitals. At the 719-bed
Rhode Island Hospital, the laboratory is on the front line of the
hospital's blood management initiative. One change in longstanding
practices is to encourage phlebotomists to draw only
the minimum amount of blood required for lab testing.
However, smaller specimens require changes to lab operations.
ASCP Awarded PEPFAR II Funds for Lab Assistance
ASCP members now serving 15 PEPFAR
countries to help improve lab testing services
CEO SUMMARY: With new Congressional authorization
and funding of $48 billion, PEPFAR II-a second five-year initiative
to help targeted countries battle HIV, AIDs, tuberculosis,
and malaria—is about to get under way. To better support
diagnosis and management of HIV/AIDs patients, some
PEPFAR funds are designated to expand laboratory testing
services in countries with high prevalence rates of HIV/AIDS.
ASCP's funding award will support laboratory training events
and technical assistance to labs in 12 PEPFAR countries.
INTELLIGENCE: Late & Latent
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