Evaluation of Pre-analytical Biopsy Specimen Errors in the Pathology Laboratory of Hamadan School of Dentistry (2009-2010)

Statement of Problem: Oral biopsy is important in the definite diagnosis of oral and maxillofacial lesions. This procedure as well as other laboratory services is prone to errors affecting the patient's safety. The purpose of this study was to evaluate pre-analytical biopsy specimen errors in the Oral Pathology Laboratory of Hamedan School of Dentistry, west of Iran. Ninety-one oral biopsy samples, obtained from departments of oral and maxillofacial surgery (34 samples, 37.3%), oral medicine (22 samples, 24.3%) and periodontics (10 samples, 10.9%), as well as private offices (16 samples, 17.6%) and hospitals (9 samples, 9.9%) were received and evaluated in the Oral Pathology Laboratory of Hamedan School of Dentistry considering pre-analytical errors. The errors in the request forms included unmentioned names of patients (7.7%), age (3.3%), clinical history (4.4%), site of biopsy (10.9%), differential diagnosis (18.7%) and the name of the requesting clinician (8.8%), as well as lack of radiographs (4.4%) and previous biopsy results (2.2%). Use of inappropriate fixative (5%), and specimen-containers with non-proportional volume (3%), and their small size inlets (3%) was also reported. Non-standard containers were seen in 19% of the cases,and mislabeling errors (31 missed, 2incomplete defects, and 1 incorrect) in 34% of the cases. Of 105 specimens, 6.67% were small in size, 1.90% superficially removed, and 0.95% had been traumatized. Out of the 5 containers with more than one specimen, 4 containers did not have any markers. Considering the biopsy errors in the study specimens, training and surveillance to reduce the frequency of such errors seems necessary.