ADVANCE Outlook: Lab Professionals : Safety

Appreciation From a Frequent Flier

Matthew T. Patton — Mon, 19 Jan 2009 16:09:00 GMT

I travel pretty frequently for both work and pleasure. Last year, I logged more than 35,000 actual flight miles on USAirways alone.

Earlier this year, I chatted with a pilot enroute to Dallas who was traveling on American Airlines as a passenger. We were recounting the tragedy of Comair Flight 5191 in Lexington, Ky., where my distant cousin, Scarlett Parsley and her newlywed husband Jon Hooker were passengers. The pilot flew Airbus planes for USAirways, and he assured me USAirways pilots are among the best trained in the industry. Because the pilots were ultimately blamed for the crash in Lexington, he explained flight safety as a chain. All elements of a chain need to be strong -- among them, the pilot, air traffic control and the aircraft itself (and a long list of other links). If any link of the chain is broken or weak, it could lead to catastrophe. (Isn't lab work much like this?)

That's why I was glad to read about the level-headed, quick thinking of Chesley B. Sullenburger, the hero pilot of Flight 1549 who safely landed an Airbus A320 in the frigid Hudson river in New York City after the plane hit a flock of birds, cutting both engines.

Sullenburger's decision to ditch the plane in the water instead of attempting to land the ill-fated plane back at LaGuardia or Teterboro undoubtedly saved the lives of all 155 on board. As a frequent flier, I tip my hat to him (and the rest of the crew) in appreciation.

FDA Says LabCorp Violating Law

Amanda Koehler — Thu, 09 Oct 2008 14:16:00 GMT

Today the FDA told LabCorp, Burlington, NC, that it is violating the law by marketing its OvaSure test without regulatory approval.

The FDA said in a letter that if LabCorp did not stop selling the ovarian cancer test, it could face seizure, injunction or monetary fines. Click here for more information.

The OvaSure test had previously been under fire. In August, the Society of Gynecological Oncologists told the New York Times that the organization believed the test hadn't been validated enough for routine use. The FDA said the test had also not been proved to work.

OvaSure measures the six proteins in a woman's blood, and then calculates the probability the woman has ovarian cancer.

New Guidelines

Kerri Penno — Mon, 21 Jul 2008 13:36:00 GMT

In response to a disastrous mix-up wherein 400 breast cancer patients in Newfoundland were given inaccurate test results between 1997-2005, the Canadian Association of Pathologists has announced new guidelines for the country's laboratory services.

CTV.ca reports the new plan calls for:

mandatory certification for every prognostic and predictive test given by a medical laboratory;

test results from one lab to be verified by another, independent laboratory;

a national checklist for laboratories to follow to standardize operating procedures and equipment maintenance, test validation and staff training and evaluation;

creation of a national body, independent of the government, to accredit all medical laboratories in Canada; and

immediate and ongoing action from federal, provincial and territorial governments to address manpower and resource shortages in medical labs.

Immunity and the Avian Flu

Kerri Penno — Wed, 09 Jul 2008 21:55:00 GMT

"Bring out your dead." That was the call heard through the streets during the 1918 flu pandemic, when the deaths surpassed modern resources and casket shortages forced families to surrender their loved ones to a wagon piled with bodies. Not a pretty image. Now, we're faced with the likely possibility that another flu pandemic will arrive on the wings of infected birds.

According to Alysia Mihalakos, MPH, deputy chief of the Center for Emergency Preparedness and Response, part of the Rhode Island Department of Health, presenting at AMT, the risk is so great because we lack immunity. Because no one has been exposed to the H5N1 strain currently affecting Asian countries before, we don't have any antibodies or immunity to the strain, leaving us all susceptible. For the same reason, an H5N1 vaccine could kill more people than it would protect.

For Mihalakos and her colleagues, all they can do is plan and prepare as best as possible. Using the 1918 flu as a model, experts predict in Rhode Island, a state of about 1,000,000 people, 300,000 will be infected in a pandemic. Of those, about 7,000 will die. The majority, however, will live, and will require more beds, ventilators and caregivers than the small state has to offer. Figure on three times your typical patient load, with about a 40 percent reduction in staff, Mihalakos told attendees.

Rhode Island, like many states, is making efforts to close the gap between available and needed resources, by purchasing portable ventilators, creating videos to teach family members and others how to operate them, and making arrangements with local ice rinks to be used as temporary morgues.

But it's not all bleak. Seven thousand deaths means 293,000 will survive the first wave, Mihalakos stressed--293,000 who have now been exposed and are immune.

Rudimentary Precautions

Kerri Penno — Tue, 24 Jun 2008 19:57:00 GMT

The Atlanta Journal-Constitution recently reported some disturbing news about the CDC's infectious disease lab in Atlanta. Researches studying Q fever, a disease caused by Coxiella burnetii, were working in a room with a containment door sealed with duct tape. The taping occurred a year ago, when a malfunction with the ventilation system pulled potentially contaminated air out of the lab. Nine workers tested negative for exposure in the incident, but the tape remains. Two quotes from the article appear below:

"It's an enhancement," said Patrick Stockton, CDC safety and occupational health manager, as he and four other agency officials took a reporter to see the door Wednesday. "We could take it off."

"I do not believe the CDC would approve this arrangement in a laboratory other than their own," Richard Ebright, a microbiologist and biosafety expert at Rutgers University in New Jersey, said of the taped Q fever lab door.

What do you think? What would the Joint Commission have to say if inspectors found duct tape a part of your universal precautions?

Joint Commission's 2009 Safety Goals

Frank Fraser — Thu, 19 Jun 2008 19:24:00 GMT

The Joint Commission announced on June 17 the 2009 National Patient Safety Goals and related requirements for its accreditation programs and Disease-Specific Care Certification Program

Of the Joint Commission's 16 total goals-three of which have been retired since the requirements were incorporated into the standards-the following four apply to the Laboratory Accreditation Program:

Goal 1: Improve the accuracy of patient identification
Goal 2: Improve the effectiveness of communication among caregivers
Goal 7: Reduce the risk of healthcare associate infections
Goal 13: Encourage patients' active involvement in their own care as a patient safety strategy.

Each year, the Sentinel Event Advisory Group works with the Joint Commission to review literature and databases to identify potential new goals and requirements.

Find a complete list of goals and related requirements for the Laboratory Accreditation Program here.

Frank Fraser is an editorial intern at ADVANCE.

Artificial Blood Risks

Kerri Penno — Tue, 29 Apr 2008 19:28:00 GMT

The FDA is under fire today, in the wake of a report released in JAMA yesterday, detailing the organization approved artificial blood substitute trials even after studies showed the products increased risk of heart attack and death.

"It's hard to understand," said Charles Natanson, MD, an NIH senior investigator who lead the analysis, in a Washington Post article. "They already had data that these products could cause heart attacks and evidence that they could kill."

The meta-analysis examined five blood substitutes:

HemAssist, Baxter Healthcare Corp., Deerfield, IL;
Hemopure, Biopure Corp., Cambridge, MA;
Hemolink, Hemosal BioPharma Inc., Ontario, Canada;
PolyHeme, Northfield Laboratories Inc., Evanston, IL; and
Hemospan, Sangart Inc., San Diego.

According to the Washington Post article, the review, released yesterday, combined data from more than 3,711 patients participating in 16 studies testing, and found the products "nearly tripled the risk of heart attacks and boosted the chances of dying by 30 percent."

Not only does the oversight pose a significant risk to patients treated with these substances, but the lack of clear communication can hamper future efforts to produce a viable blood substitute, Dr. Natanson noted. "Keeping data from being public represents real risks to patients. If secret science is allowed, other companies can't build on the successes and failures and [outside reviewers] won't be able to fully assess the risk."

CLMA ThinkLab Update

Amanda Koehler — Mon, 17 Mar 2008 18:51:00 GMT

We asked CLMA to update us on the status of ThinkLab '08, to be held March 29-April 1 in Atlanta, where a recent tornado did some damage to the Georgia World Congress Center. Here's what they said:

"CLMA is closely monitoring the situation in Atlanta as a result of the tornado that hit the downtown area on Friday, March 14. We are in communication with the Georgia World Congress Center and area hotels as they assess the damage to their facilities. Contractors are assessing the damage to the Georgia World Congress Center today and will contact us with further updates.

As of Monday, March 17, ThinkLab '08 will continue as scheduled without interruption for March 29-April 1. In the event that we run into any issues that prevent access to hotels, or the Georgia World Congress Center, we will notify you immediately. We will provide further updates to you as soon as something more definitive is known.

Thank you for your understanding and we look forward to seeing you in Atlanta!"

Neither Rain, Nor Sleet, Nor Snow ...

Amanda Koehler — Wed, 27 Feb 2008 19:34:00 GMT

Being that it's the end of February, we've been getting some nasty weather here in Pennsylvania. "Wintry mix" seems to be the favorite phrase of weathermen (and women) in our area.

At our company, editorial staff members have the option to work from home if there is bad weather. I did this last week, and it was great knowing I didn't have to combat the elements, especially because I have an hour and 10 minute commute.

However, it made me think that you laboratorians never have this option. No matter if it's snow, tornadoes, hurricanes or any other force of Mother Nature, you need to get to work for the sake of your patients.

Then I started wondering about what you do in these conditions. Do you have some sort of system set up in your lab? Do you carpool with coworkers?

We'd love to hear your stories about bearing the elements to get to your lab.

National Health Observances

Matthew T. Patton — Fri, 07 Dec 2007 20:11:00 GMT

Every month has special health observances. HHS posts these on its Web site, saying: "Health professionals, teachers, community groups, employers, and others can use these special times to sponsor health promotion events, stimulate awareness of health risks, or focus on disease prevention. Individuals can take advantage of the latest health promotion or disease prevention information available about the topic of a health observance to improve their own health or the health of family members as well as volunteer to support locally sponsored events."

Here's what December has (or had, considering a few of these have already happened) in store.

For more information on 2008, check out this site: http://www.healthfinder.gov/library/nho/.

Entire Month
Safe Toys and Gifts Month
Prevent Blindness America
211 West Wacker Drive, Suite 1700
Chicago, IL 60606
800-331-2020
info@preventblindness.org
www.preventblindness.org

December 1 - 7
National Aplastic Anemia and MDS Awareness Week
Aplastic Anemia & MDS International Foundation, Inc.
P.O. Box 613
Annapolis, MD 21404-0613
800-747-2820
410-867-0242
Fax: 410-867-0240
help@aamds.org
www.aamds.org

December 1
World AIDS Day
Joint United Nations Programme on HIV/AIDS
unaids@unaids.org
www.unaids.org/en/default.asp

December 2 - 8
National Handwashing Awareness Week
Henry the Hand Foundation
11714 U.S. Route 42
Cincinnati, OH 45241
513-769-3660
dr.will@henrythehand.com
www.henrythehand.com

MA Town Practices Emergency Vaccinations

Kerri Penno — Tue, 04 Dec 2007 14:34:00 GMT

You expect to hear stories about major medical centers and large cities practicing disaster preparedness. You hope smaller hospitals and local governments are working on their emergency plans, and that no matter where a natural or manmade disaster or pandemic strikes, we will be ready.

Yet I was surprised to hear my small hometown of North Attleboro, MA, had a pandemic flu drill over the weekend. Town officials asked residents looking to get a flu shot to come to the high school for a vaccination clinic.

Organizers hoped to flood the high school with 1,000 Massachusetts residents and see exactly how long it takes to vaccinate hundreds of people. More than 800 people, including my parents, turned out to get their shots.

The exercise turned up a couple minor problems with the plan, such as a bottleneck at the front doors, where paperwork stations set up too closely to the entrance had people waiting outside. These discoveries where what officials were looking for, and will give them insight on how to tweak the pandemic vaccination plan, just in case.

It's good to hear the town is working on emergency preparedness. Have you seen anything similar in your home town? Find more information on emergency preparedness in our Safety Standards column.

Taking Responsibility

Amanda Koehler — Thu, 29 Nov 2007 14:50:00 GMT

The CDC recently announced none of the airplane passengers who flew with TB-infected lawyer Andrew Speaker have contracted the disease.

This should be a sigh of relief, knowing the 250 people who boarded a flight from Atlanta to Paris in May are safe from the disease.

However, it is still infuriating to know Speaker, who was advised by health officials not to fly to Europe for his wedding because of his condition, went against what educated professionals told him.

People must be responsible for their own health and illness diagnoses, especially when it comes to something that can be easily spread to others. If you can avoid potentially passing diseases on to others, you should. This seems like an obvious statement, but it's one Speaker did not seem to understand. He selfishly put lives at risk when he decided to put his own needs before the health of people around him.