The State of California Department of Health has modified testing and reports requirements for lead and other heavy metal testing to include patient demographic information. In order for Laboratory Services at Cedars-Sinai to comply with the state law, which mandates the testing laboratory include this information with the test results, we are requesting your cooperation in providing the required information on the requisition. Furthermore, should a request for this type of testing be received without the required information, testing will not be performed until the required information is obtained. If the information is not received before sample stability is compromised, the test request will be cancelled.

Repeat determinations are routinely performed as part of our ongoing quality assurance program. If the variation between samples exceeds precision criteria, assays are repeated in duplicate. Any results higher than the highest standard are repeated after dilution. For most assays, specimens will be retained for seven days. In the event a test result is questioned, a physician may request a repeat at no charge by contacting customer service representatives at (310) 423-2200 or (800) 898-2757 (press "2").

Test results are called if noted on the requisition. If analysis is completed by 8 p.m., results are called that evening. Results of analysis completed after 8 p.m. are called before 10 a.m. the next day. Exceptions to this would be any results exceeding the laboratories critical limits. These critical values are called around the clock as soon as they are obtained and regardless of a request to call. STAT test results are called as test results are completed. However, if STAT test results are completed after 10 p.m. and result is not defined as a critical value, results will be phoned the next day before 10 a.m.

Additional testing can be arranged if sufficient volume remains after initial tests are completed and specimen stability has not been exceeded for the test requested. Contact our customer service representatives at (310) 423-2200 or (800) 898-2757 (press "2") to request test additions.

Cancellations received while specimens are in transit will be accepted at no charge. Cancellation requests received after test setup cannot be accepted. A report and appropriate charges will be issued. Contact our customer service representatives to cancel a test request at (310) 423-2200 or (800) 898-2757 (press "2").

• Unlabeled specimen
• Mislabeled specimen
• Improperly/incompletely labeled specimen
• Inadequate or insufficient information on requisition
• Specimen collected in wrong tube, container or preservative
• Specimen inappropriately handled with respect to temperature, timing or storage requirements
• Quantity not sufficient for test requested
• Specimens submitted in syringes with needles attached
• Cracked or leaking containers with external contamination
• Specimens submitted in tissue paper, diaper, foil, plastic wrap, etc.
• Hemolysis
• Lipemia

The time required for analysis (expected report time) is listed in the test menu section. Please allow additional time when repeat testing is requested or required as for confirmatory testing.

Because of improper collection or in-transit degradation, some samples cannot be analyzed. You will be notified on the next business day of rejected or problem samples. Specimen rejection may be avoided by ensuring the following conditions are correct:

• Patient/specimen identification matches with requisition
• Pertinent patient information included
• Specimen type (plasma, serum, whole blood, etc.) and volume
• Specimen container (sterile, metal-free, etc.)
• Temperature (ambient, refrigerated or frozen)
• Urine pH
• Transport medium
• Lack of hemolysis

In order to provide quality test results, specimens received after-hours on Friday that are either unlabeled, mislabeled or cannot be resolved within 24 hours will no longer be processed for testing. Our customer service representatives will inform clients of the outcome within a reasonable time. Stability on culture requests will be verified for each type of media received. Unresolved problems will be credited, and the client will be notified on the next business day.

Written authorization is required of all phone orders for a collection or add-on testing. When submitting written orders as a follow-up to phone orders, please write clearly Add-on or Follow-up to phone orders of (date). To avoid delays we will process your phone order at the time it is made. However, the written request must follow immediately by fax to (310) 423-0358.