[Histonet] Re: release of pathology specimens


 Tiffany Price (where?) asks:
>>Does anyone have a policy/procedure for the release of pathology specimens to patients? (placenta, extremities, etc)<<

I've never seen a policy written, though there probably needs to be.

Extremities: Requests for amputated legs for burial in the family cemetery are fairly common where I practice in rural southern Appalachia. Expect such requests from highly observant Jews also. Get the help of the family funeral director - this is a situation they're comfortable with.

Mastectomy specimens: I've never encountered this situation, but apparently some women want to bury them. Once again, you need a funeral director.

Souvenir gallstones: This used to be very common - in one hospital we had to wash and bottle all the gallstones before we left for the day, in case a surgeon demanded them - but this practice seems to have been banned by the infection control people. Souvenir tonsils went the same way.

Placentas: you don't want to know. Some lay accoucheurs require their patients to EAT their placentas (rather, their babies' placentas) like animals do. Several years ago while doing a locum in rural southern Misery I had an indignant call from a lay midwife in a distant town. Seems she'd had a delivery with a retained placenta, gotten an OB-GYN to remove it, and sent it to us for examination. What she was indignant about was that the hospital had put the placenta in formalin, and in that condition autoplacentophagy was impossible. 

Reference: Ober, William B. [of blest memory] A modest proposal for preventing choriocarcinoma among innocent mothers. Obstetrics and Gynecology 1968;31:866-9.

Hope you're not reading Histonet over lunch!

Bob Richmond
Samurai Pathologist
Knoxville TN

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