80 to 100 27 to 31 31 to 36 11.5 to 14.5 150 to 350

The parameters that are marked with an asterisk (*) have failed the delta check. What can account for the variation in the patient's results in a 24-hour period? An investigation was begun. There are two likely possibilities. Is there a medical explanation for the change in results, or is this a preanalytic variable (mislabeling; i.e., wrong patient results)? The white blood cell count, red blood cell count, hemoglobin, and hematocrit have dramatically changed from Saturday to Sunday. A frequent explanation for this is blood transfusions being administered to the patient and causing an increment in red blood cell count, hemoglobin, and hematocrit. This patient had no transfusion history and the previous results do not indicate transfusion need; therefore, this is not considered a factor in the dramatically increased values. The technologist requested that the blood bank ABO type both samples. Both samples typed as O positive. No new information was obtained from this procedure. The laboratory then began another line of investigation. The floor was called and the laboratory was informed that the patient whose laboratory results were being called (the Sunday sample) had been discharged the previous day The sample in question (the Sunday sample) was incorrectly identified. How could the mislabeling take place? The patient's name had not been removed from the room or from the computer system. The labeling had not taken place at the bedside, with voice confirmation by the patient. Instead, the sample had been labeled based on the room number alone. Due to the diligence of the laboratory staff, the mistakes were identified and any further adverse complications were prevented. The sample that the laboratory has received was actually the blood from the new patient who now occupied the room.

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