Unsatisfactory Samples

NSO endeavors to test every blood sample we receive. Sometimes, a baby may require a repeat newborn screen, as the first sample was unsatisfactory. This means that the sample could not be tested properly. A sample could be unsatisfactory for various reasons:

• The quality of the blood sample was poor,
• The newborn screening card was not filled out properly or the sample was mislabeled,
• The sample was collected less than 24 hours of age,
• The sample was received greater than 14 days after collection,
• Instrument failure in the lab

Repeat samples are requested for all unsatisfactory specimens. It is the submitter’s responsibility to obtain a repeat sample once notified of an unsatisfactory specimen. The submitter should attempt to communicate the need for a repeat specimen directly to the infant’s family or health care provider.

NSO procedure for tracking repeat specimen requests

1. NSO informs the submitter of the unsatisfactory specimen and a need for a repeat specimen by faxing a report on the day of sample receipt.
2. If a repeat specimen is not received 3 weeks following notification, NSO sends a repeat request letter to the submitter.
   • Communication attempts to the family and/or health care provider by the submitter regarding the need for a repeat sample should be documented on the repeat request letter, which is faxed back to NSO.
   • The repeat request letter permits NSO to clearly identify whether or not the family and/or health care provider has been informed of the need for a repeat. 
3. After an additional 3 weeks, a letter is sent to parents if a submitter indicates they have been unable to contact the infant’s family OR if the infant’s health care provider has been contacted but no repeat specimen has be received. A copy of this letter is cc’d to the submitting institution and the infant’s HCP (if known).