RE: [Histonet] Fetal Remains
At my former hospital in Maryland, we required a disposal form separate
for fetuses before we would accession the specimen. The only exception
was if the family was planning a funeral. Now occasionally we would get
a case where the family said they were having a funeral home pick it up
and they didn't. Those would usually sit for at least a year before a
Pathologist would give permission to dispose of it.
Here under Texas law all specimens must be disposed of as Pathological
waste or by a licensed funeral home. We have people ask for things all
the time, but I just quote the Texas Law (25 Tex. Admin. Code 1.132
Section 1.133). Currently we do not have a separate disposal form for
fetuses. We are creating one because the hospital is supposed to start
funding funeral home pick up of fetuses and scattering of ashes on an
area of ground in a local cemetery. The new form will give 3 choices
for fetal disposal: their own funeral home, the hospital funded
cremation and scattering of ashes, or disposal as Pathological Waste
(although the chaplains are going to find a nicer term for it).
Your legal or risk management department should be able to at least
assist you in creating a form that lessen the chance of another lawsuit.
Ross M Stapf
Baylor University Medical Center
3500 Gaston Ave.
Dallas, TX 75246
[mailto:firstname.lastname@example.org] On Behalf Of Jackie M
Sent: Tuesday, December 28, 2004 12:44 PM
To: Bell, Lynne
Subject: Re: [Histonet] Fetal Remains
In my experience, for any products of conception, it is customary and
responsibility of the 'generating' department, i.e., nursing floor, ER,
OB, OR - to obtain a waiver/release or other documentation allowing the
hospital to dispose of fetal remains OR surgically obtained specimens.
This goes for non-OB specimens as well. I once had a motorcyclist ask
the bones from his severed toes (from a wreck) so he could make a
necklace. We said no - he signed the release.
I worked in a hospital where the Mom changed her mind after a couple of
weeks, and wanted to have a service for her fetus. We did everything we
could to find the already discarded specimen - even though she had
the release, and we were not legally responsible to retrieve it. We did
find it, and were able to return it. People need closure, sometimes.
Sent by: email@example.com
12/28/2004 12:23 PM
Subject: [Histonet] Fetal Remains
I am interested how other hospital handle and/or dispose of fetal
remains. In particular, I am interested in "products of conception"
where there is an actual formed fetus. How long do you retain this
specimen, how do you dispose of it, do you have the mother sign a
"release of remains". In the state of Vermont, a fetal death is 20
weeks and over OR 400 grams and over and we require an autopsy permit
for this. If it is smaller than 400 grams or less than 20 weeks, it is
considered a surgical specimen.
Of course, the reason I am asking is our hospital was recently sued for
disposing of a 200 gram fetus after following our Histology policy of
disposing of surgical specimens six weeks from accession date. We are
naturally "gun-shy" at this point to even discard any "products of
conception". Your wisdom and guidance will be truly appreciated.
Lynne A. Bell, HT (ASCP)
Central Vermont Hospital
P. O. Box 547
Barre, VT 05641
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