Responding to the message of
from "Cheasty, Sandra" :
We DO initiate an incident report when this happens. Unfortunately, many of our
cases come from outside our institution and the possibility of CJD is not always
recognized by the sender or evident in the report. We have had two cases come
through just this year where CJD was not suspected, but they turned up positive.
For known or suspected cases, we have a specific protocol set up. All samples
are processed by hand and cut under a hood set up specifically for CJD and other
prion diseases, using double gloves, gowns, goggles and so forth. All tools,
containers, etc,. used for processing, embedding, cutting and staining are
disposable. Blocks and slides on positive cases are filed separately from all
other blocks and slides in a closed contaioner.
While it is indeed unfortunate (and a real pain) when this happens.....there
WILL be times when a case "slips" through.
> I would certainly initiate an incident report re: the communication
> deficiency between attending physician/surgeon/O.R. and the pathology lab.
> Submitting departments must be held responsible for safely submitting all
> specimens to our labs. I recently received a breast biopsy with the
> localization wire and un-sheathed needle still attached. It was submitted
> fresh, in a ziplock specimen bag... Fortunately the nurse, courier,
> accessioner and grosser-de jour (myself) were not impaled.
> -----Original Message-----
> From: firstname.lastname@example.org [mailto:email@example.com]
> Sent: Tuesday, October 29, 2002 11:21
> To: Juanita.X.Brody@kp.org; firstname.lastname@example.org
> Subject: Re: CJD
> Responding to the message of
> from "Brody,Juanita X" :
> Hi Juanita,
> Unfortunately, you can not completely decontaminate. Best is to empty all
> containers on your processor into plastic waste bottles, double bag and wipe
> down outside with bleach. Fill empty containers with bleach (full strength)
> 1N NaOH and let sit overnight. Wipe down the microtome with bleach or 1N
> but be sure to rinse well as both are very corrosive. I have always changed
> the embedding center paraffin and wiped down all surfaces which may have been
> contaminated. If your water bath has a glass dish, soak that overnight in
> as well.
> All CJD waste must be incinerated. Also, here at least, the custodians and
> anyone else who may come into contact MUST be told that this is CJD waste and
> instructed on how to dispose of it. Under NO circumstances should it be put
> a landfill....autoclaved or not!!! We ran into this problem here, because
> Someone decided that we did not need incineration services anymore and
> contracted for autoclaving only and putting in landfill (DUMB!!!!). That is
> until we had a CJD case. THey actually had to track the trash pickup to
> state...and arrange for incineration. Really a mess!!! IF you have any other
> questions, feel free to contact me. We do most of the CJD cases for the
> Good luck.
> LuAnn Anderson HT(ASCP)
> University of MInnesota
> Neuropathology Lab
> > We processed a brain bopsy and was told 2 days later it was CJD. How do
> > you
> > decontaminate the micrtotome , processor , and embedding center?
> > Thanks
> > .
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