Dear Mike, this is obviously a hot topic around the world. My view is
that there is a risk of tech's "mucking up" in many areas of specimen
preparation. Embedding punch bxies on their head, mixing lab. numbers
up, even losing specimens. The result is the same, a patients specimen
has not been handled as deserved. At the end of the day it doesn't
matter who made an error but that an error was made. We all know
mistakes are made, (not in your or my lab of course) but unfortunately
in our industry the consequences are or can be devastating. Mistakes are
not acceptable and systems must be put in place to prevent their
occurrence. The pathologist reporting the case is responsible for all
actions on that case, even if another pathologist/ technician made an
error in cut-up, the reporting pathologist's name goes on the bottom of
the report.
With regard to litigation, technical staff are covered by the fact that
pathologist's are the ones who sign out the report, unlike cyto
screeners who often have separate indemnity insurance.
Recently, we in Australia have been given guidelines for the performance
of the pathology surgical cut-up by NPAAC, (National Pathology
Accreditation Advisory Council). This body is made up of representatives
of, The Royal College of Pathologist of Australasia, The Australian
Institute on Medical Scientists and others. To read in full go to
http://www.health.gov.au/haf/pubs/pubs.htm and scroll down to NPAAC
publications. At the end of this list is the document I refer to.

I don't have any problem with well trained/ supervised technical staff
performing technical cut-up to a point. I guess this is where it gets
grey. Technical staff must be able to recognise when a specimen is not
the same as the others that came before it. This is why the above
document is very important along with the strict training/ monitoring it
requires. I'm sure debate will continue for a long time yet. David.

PS. One of the benefits of technical cut-up is that the blocks are
thinner, flatter and not jammed into the cassette, cos workmates won't
be as shy to peers as pathologist's.

David Taylor
Laboratory Manager
Drs King & Mower
Adelaide, Australia
 

-----Original Message-----
From: Mike Kirby [mailto:mikek@mail.saimr.wits.ac.za]
Sent: Friday, 28 September 2001 16:36
To: Histonet
Subject: Tech grossing - some thoughts



Rose Richardson asked how many Tech's are doing tissue grossing, as this
is
not allowed in her Path Dept.
And so it should be, because have any of the Tech's that are doing this
work, given any thought to the fact that they could face serious
litigation
should they make a "muck-up".
I have no doubt that there are Techs that are very good at it, but one
slip,
and you could be deep in the brown stuff.
Leave it to the Pathologists - that's what they trained to do and that's
what they are paid for.

Mike Kirby
Johannesburg
South Africa.