LABORATORY

SERVICE GUIDE

Version 1.02, Effec�ve Date: 1st May 2018

A supplementary to Pantai Premier Pathology Sdn Bhd
Price & Service Catalogue and Service Directories
 Table of Contents
Table of Contents 2
Introduc�on 4
Quality Statements 5
Consultant Pathologist 6
Opera�on Hours, Loca�on and Contact Numbers 7
24 hours Emergency Services 10
Outpa�ents Phlebotomy Services 10
Specimens Pick Up Services 10
Supplies 10
Pricing and Payment Policy 10
Feedback and Sugges�ons 11
Laboratory Requisi�ons 11
Test Requisi�on 11
Type of Request Forms 11
Test Order 11
Special Test 11
Urgent Test 11
Add Test 12
Specimens Collec�on and Handling 12
Types of Containers and An�coagulant 12
Order of Draw For Blood Specimens 12
Collec�on Of Specimens 12
General Principles in Handling Laboratory Specimens 13
Preven�on of Haemolysis 13
Packing and Storage of Specimens 13
General Specimen Storage 14
Transport of Specimen 14
Specimen Rejec�on 14
Specimens Rejec�on Criteria 14
Rejected Specimens 14
Prepara�on of Specimens 15
Collec�ng A Clean Catch Urine 15
Collec�ng 24 hours Urine 15
Oral Glucose Tolerance Test 16
Urea Breath Test 16
Blood Gases and pH 17
Semen Analysis 17

02
 Cytopathology Guidelines 17
Histopathology Guidelines 18
Handling of Specimen 18
Frozen Sec�on 18
Immunofluorescence (IMF) Stains 19
Special Stains & Immunohistochemistry (IHC) Stains 19
Radioac�ve Biological Specimen 19
Microbiology Guidelines 20
Molecular Oncology Guidelines 23
Molecular Infec�ous Disease Guidelines 24
Cytogene�cs Guidelines 26
Results Repor�ng 27
Repor�ng of Laboratory Results 27
Report From The External Referral Laboratories 27
Urgent Results 27
Turn Around Time 27
Cri�cal Panic Values 28
Appendix 1 30
Appendix 2 31
Appendix 3 32
Appendix 4 33
Appendix 5 34
Appendix 6 37

03
 INTRODUCTION

Pantai Premier Pathology Sdn Bhd has laboratories in the Pantai group of hospitals, Gleneagles
hospitals, and non-hospital based branches within Malaysia. Our reference core laboratory is located in
Pantai Hospital Ampang. We serve the needs of inpatients and outpatients at the hospitals we are
located, as well as other medical practitioners who practise within our area of service provision.

The Laboratory User Guide intends to communicate the important steps in laboratory tests requisition,
specimen requirement, specimen collection, handling and transportation. It also serves as a guide to
the laboratory services available.

We provide quality laboratory services in the following disciplines:

• Allergy Testing
• Clinical Chemistry
• Cytopathology
• Drugs of Abuse Screening
• Endocrinology
• Fluids & Excretion Analysis
• Haematology
• Histopathology
• Immunology & Serology
• Microbiology
• Molecular Diagnostics
• Therapeutic Drugs Monitoring
• Transfusion Medicine

• Specialized Testing

The scope of our services includes specimen handling, specimen processing and analysis, reporting of
test results, handling and delivery of supplies and test reports to our clients. Our internal quality audits,
quality assurance and quality control programmes ensure the achievement of our quality service
mission.

The integrity and reliability of the testing process have direct implication on the quality of the analytical
results produced. Besides the usual regular preventive and service maintenance on the instruments and
compliance to instrument calibration protocols, our laboratories also participate in many internal and
external quality assurance programmes to monitor the testing processes.

We have more than 18 residents/visiting consultant pathologists from various disciplines involve in the
reporting and managing the quality of our laboratories services. Under the active guidance of the
consultants and our management commitment towards service excellence with 8 major branches are
accredited with MS ISO 15189 by Department of Standard Malaysia.

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 QUALITY STATEMENTS
Mission, Vision, Core Values & Brand Promise
Our Mission
Delivering quality healthcare services that exceed your expectations with a
professional commitment to continuous improvement.

Our Vision
To be the trusted professionals of healthcare delivery.

Our Core Values

• Empathy
• Caring
• Progressive
• Professionalism
• Teamwork

Our Brand Promise

We are always there for you.
Because we care.

We serve. We heal. We deliver.

As individuals. And together.

We pioneer and innovate solutions.

We strive to be the finest in healthcare.

In the great cycle of life,

everyone will need medical attention sometime.

When we say that the patient comes first,

it is all about what we do best.

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 CONSULTANT PATHOLOGIST

Resident

No Consultants Discipline Posting

1 Dr Nik Azizah binti Wan Kadir • Histopathology Reference Specialised Lab, Bangsar
• Cytopathology Central Region
Reference Specialised Lab, Bangsar
Dr Shahrin Iskandar bin Abdul
2 • Histopathology Central Region
Wahab
• Cytopathology
• Histopathology Gleneagles Kuala Lumpur branch
Dato Dr. Sharifah Noor Akmal
3 • Cytopathology Reference Specialised Lab, Bangsar
binti Syed Husain Shahabuddin
• Cytogenetic & Molecular Central Region
Pathology
Gleneagles Kuala Lumpur branch
4 Dr Lee Bang Rom • Histopathology Reference Specialised Lab, Bangsar
• Cytopathology Central Region
5 Dr Krishnan Ramanathan • Histopathology Gleneagles Penang Branch
• Cytopathology Northern Region

6 Dr Chan Kai Soon • Histopathology Ipoh Branch

• Cytopathology Northern Region
7 Dr Rosli bin Ismail • Histopathology Ayer Keroh Branch
• Cytopathology Southern Region

Visiting
No Consultants Discipline Posting
1 Dr Peh Suat Cheng • Histopathology Reference Specialised Lab, Bangsar
• Cytopathology Central Region
2 Gleneagles Kuala Lumpur branch
Dr Julia Munchar binti
• Histopathology Reference Specialised Lab, Bangsar
Munchar Jaluli • Cytopathology Central Region
3 Dr Ahmad Toha Bin
• Histopathology Gleneagles Kota Kinabalu branch.
Samsudin
• Cytopathology
4 Dr Poh Bee Hoon • Histopathology Ipoh Branch
• Cytopathology Northern Region
5 Dr Noraidah binti Masir • Histopathology Reference Specialised Lab, Bangsar
• Cytopathology
• Cytogenetic & Molecular Central Region
Pathology
6 Dr Sabariah binti Abdul • Histopathology Reference Specialised Lab, Bangsar
Rahman • Cytopathology Central Region
7 Dr Reena Rahayu binti Md • Histopathology Reference Specialised Lab, Bangsar
Zin • Cytopathology Central Region
8 Dr Leslie Charles Lai Chin • Chemical Pathology Gleneagles Kuala Lumpur Branch
Loy
9 Dr Zubaidah binti Zakaria • Cytogenetic & Molecular Reference Specialised Lab, Bangsar
Pathology Central Region
10 Dr Ariza binti Adnan • Microbiology Pathology Reference Specialised Lab, Bangsar
Central Region
Gleneagles Medini Branch
Southern Region
11 Dr Rohani binti Md Yasin • Microbiology Pathology Gleneagles Kuala Lumpur Branch
Central Region
• Molecular Pathology Reference Specialised Lab, Bangsar
Central Region
12 Dr Amir Hamzah bin Dato’ • Clinical Immunology & Allergy Bangsar Branch, Central Region
Abdul Latiff

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 13 Dato' Dr Vijaya Sangkar • Haematology & Immuno- Bangsar Branch, Central Region
Jaganathan Naidu Haematology Pathology

14 Dr Rudy Yeoh Seok Ching • Haematology Pathology Gleneagles Kuala Lumpur Branch,
Central Region

15 Dr Eow Geok Im • Haematology Pathology Ipoh Branch, Northern Region

16 Dr Guan Yong Khee • Haematology Ayer Keroh Branch, Southern Region

17 Dr Wan Aswani binti Wan • Haematology Pathology Ayer Keroh Branch, Southern Region
Yusof

18 Dr Indhira Subbiah • Haematology Pathology Gleneagles Medini branch, Southern

Region

19 Dr Yabitha a/p Vasan • Histopathology Gleneagles Medini branch, Southern

• Cytopathology Region

For pathologist advisory services kindly contact the respective laboratories.

OPERATION HOURS, LOCATION AND CONTACT NUMBERS

Corporate Office Customer Service Hotline

4th Floor, Pantai Hospital Ampang (T) +603 4280 9115 (F) +603 4297 4911
Jalan Perubatan 1, info@premierpathology.com.my
55100 Pandan Indah, Kuala Lumpur
(T) +603 4297 9911 (F) +603 4296 5901 Dispatch Hotline
Core Laboratory
(T) +603 4280 2911 / +603 4280 5911
Bangsar
(T) +603 2282 2108

Table 1: Operation Hours, Location and Contact Numbers

LIST OF LABORATORIES TEL NO. FAX NO. OFFICE HOURS
CORE LABORATORY (PANDAN INDAH) +603 4280 9115 +603 4296 4095 Mon - Fri : 8.30am - 5pm
LG Floor, Bangunan MOB, Pantai Hospital Sat : 8.30am - 1pm
Ampang, Jalan Perubatan 3,
55100 Pandan Indah, Kuala Lumpur

BANGSAR, KUALA LUMPUR +603 2282 875 +603 2287 2622 Mon - Fri : 9am - 5.30pm
Level 2, Block A, Pantai Hospital Kuala Sat : 9am - 1pm
Lumpur, No 8, Jalan Bukit Pantai,
59100 Bangsar, Kuala Lumpur

REFERENCE SPECIALISED LAB, +603 2282 8795 +603 2287 2622 Mon - Fri : 9am - 5.30pm
BANGSAR, KUALA LUMPUR Ext. Sat : 9am - 1pm
Level 8, Block A, Pantai Hospital Kuala 171 (CMDL),
Lumpur, No 8, Jalan Bukit Pantai, 176 (Cyto),
59100 Bangsar, Kuala Lumpur. 134 (Histo)

CHERAS, KUALA LUMPUR +603 9131 7147 +603 9131 7141 Mon - Fri : 8.30am – 5.00pm
Basement, Pantai Hospital Cheras, Sat : 8.30am - 1pm
No. 1, Jalan 1/96A, Taman Cheras Makmur,
56100 Cheras, Kuala Lumpur.

07
 KLANG, SELANGOR +603 3373 6252 +603 3373 6271 Mon - Fri : 9am - 5pm
Ground Floor, Pantai Hospital Klang, Sat : 9am - 1pm
Lot 5921, Persiaran Raja Muda Musa,
41200 Klang, Selangor.

KLANG OFF SITE, SELANGOR +603 3370 1315 +603 3370 1329 Mon - Fri : 9am - 5pm
No.125, Ground Floor, Sat : 9am - 1pm
Lebuh Turi Off Persiaran Raja Muda Musa,
41200 Klang, Selangor.

GLENEAGLES, KUALA LUMPUR +603 4141 3064 +603 4141 3065 Mon - Fri : 8.30am - 5pm
2nd Floor, Gleneagles K.L. (Hosp. Block), Sat : 8.30am - 1pm
No 286, Jalan Ampang,
50450 Kuala Lumpur.

SUNGAI PETANI, KEDAH +604 441 2994 +604 441 3012 Sun - Thu : 8.30am - 5pm
Ground Floor, Pantai Hospital Sungai Petani, Fri : 8.30am - 1pm
No. 1, Persiaran Cempaka,
Bandar Amanjaya, 08000 Sungai Petani,
Kedah.
PENANG +604 646 5505 +604 646 6606 Mon - Fri : 8.30am - 5pm
3rd Floor, Pantai Hospital Penang, Sat : 8.30am - 1pm
No. 82 , Jalan Tengah,
11900 Bayan Baru, Penang.

GLENEAGLES, PENANG (Histo & Cyto) +604 220 0838 +604 210 6006 Mon - Fri : 9am - 5.30pm
6th Floor, Gleneagles Penang, +604 210 8202 Sat : 9am - 1pm
No. 1, Jalan Pangkor,
10050 Georgetown, Penang

IPOH, PERAK +605 548 1279 +605 548 8044 Mon - Fri : 8.30am - 5pm
4th Floor, Pantai Hospital Ipoh, Sat : 8.30am - 1pm
No. 126, Jalan Tambun,
31400 Ipoh, Perak.

PERAK COMMUNITY SPECIALIST +605 241 9000 - Mon-Fri : 8am-6pm

HOSPITAL (SATALLITE LABORATORY – Sat : 8am-1pm
IPOH BRANCH)
277, Jalan Raja Permaisuri Bainun,
30250 Ipoh, Perak.
SERI MANJUNG, PERAK +605 688 6608 +605 688 8058 Mon - Fri : 8.30am - 5pm
1st Floor, Pantai Hospital Manjung, Jalan Sat : 8.30am - 1pm
PPMP 1,
Pusat Perniagaan Manjung Point,
32040 Seri Manjung, Perak.
SEREMBAN, NEGERI SEMBILAN +606 601 6466 +606 601 6467 Mon - Fri : 9am - 5.30pm
Ground Floor, Oakland Commerce Square, Sat : 9am - 1pm
No.55 Jalan Haruan 5/2,
70300 Seremban, Negeri Sembilan.

AYER KEROH, MELAKA +606 231 7977 +603 4141 3065 Mon - Fri : 8.30am - 5pm
Ground Floor, Pantai Hospital Ayer Keroh, No. Sat : 8.30am - 1pm
2418-1, Km 8, Lebuh Ayer Keroh, 75450 Ayer
Keroh, Melaka.

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AYER KEROH OFF SITE, MELAKA +606-2313232 +606-2312277 Mon - Fri : 8.30am - 5pm
B7, B7-1, B8, B8-1 & B9-1, Sat : 8.30am - 1pm
Jalan PKCAK 1,
Pusat Komersial Cendana Ayer Keroh
Hang Tuah Jaya, 75450 Melaka
MUAR (SATELLITE LABORATORY – +606-951 6095 +606-951 6139 Mon - Fri : 9am - 5.30pm
AYER KEROH BRANCH) Sat : 9am - 1pm
No. 6, Tingkat 1,Jalan Perniagaan Jaya
Pusat Perniagaan Mas Jaya, Jalan Salleh
84000 Muar, Johor.
BATU PAHAT, JOHOR +607 432 8855 +607 432 5885 Sun - Thu : 8.30am - 5pm
3rd Floor, Pantai Hospital Batu Pahat, No. 9S, Fri : 8.30am - 1pm
Jalan Bintang Satu,
Taman Koperasi Bahagia,
83000 Batu Pahat, Johor.
KUANTAN, PAHANG +609 513 0886 +609 513 0885 Mon - Fri : 9am - 5.30pm
Ground Floor, No. A29, Sat : 9am - 1pm
Lorong Tun Ismail 10, Sri Dagangan,
25000 Kuantan, Pahang.

KOTA BHARU, KELANTAN +609 743 3535 +609 743 3530 Sat - Thu : 8.30am - 5.30pm
Kota Bharu Medical Centre Sdn Bhd
PT179-184, Jalan Sultan Yahya Petra
Lundang,
15200 Kota Bharu, Kelantan.
KERTIH, TERENGGANU +609 826 2187 +609 826 1730 Sat - Thu : 8.30am -
1st Floor, Lot 50058, 5.30pm
Jalan Kemaman-Dungun,
24300 Kertih, Terengganu.

GLENEAGLES, KOTA KINABALU +6088 518908 - Mon - Fri : 7.30am - 5pm

2nd Floor, Riverson@Sembulan, Sat : 7.30am - 1pm
Block A-1, Lorong Riverson, Sembulan,
88100 Kota Kinabalu, Sabah.
GLENEAGLES MEDINI, JOHOR BAHRU +607-5601042 +607-5601050 Mon - Fri : 9 am – 5.30pm
Level 1, No.2, Jalan Medini Utara 4, Sat : 9 am - 1pm
Medini Iskandar,
79250 Iskandar Puteri,
Johor.
PENGERANG (SATELLITE LABORATORY +607-8244881 +607-8244882 Mon - Fri : 9 am – 5.30pm
– GLENEAGLES MEDINI, JOHOR BAHRU) Sat : 9 am - 1pm
Central Medical Facility (CMF)
Plot 113, Petronas RAPID Project Pengerang,
81900 Kota Tinggi, Johor.
BANDAR PENAWAR (SATELLITE +607 – 8861880 - Mon - Fri : 9 am – 5.30pm
LABORATORY – GLENEAGLES MEDINI, Sat : 9 am - 1pm
JOHOR BAHRU)
49A, Jalan Jelutong 1
Taman Desaru Utama
81930 Bandar Penawar, Johor.

09
 CHERAS, KUALA LUMPUR (UKMSC) +603-9171 1748/ +603-9171 1629 Mon - Fri : 8.30 am – 9 pm
7th Floor, Clinical Block, 1749 Sat : 9 am – 5 pm
UKM Medical Centre,
Jalan Yaacob Latif,
Bandar Tun Razak,
56000 Cheras, Kuala Lumpur.

ALOR SETAR, KEDAH +604-730 8110 +604-730 8110 Sun - Thu : 8.30am - 5pm
Ground Floor, INS Medical Centre, Fri : 8.30am - 1pm
639-D, Jalan Pintu Sepuluh,
05100 Alor Setar, Kedah.

24 HOURS EMERGENCY SERVICES

The hospital based laboratory provides 24 hours emergency services to the Pantai Hospital
inpatients and outpatients for the essential tests while others test are only done during office hours.
All specimens sent to for testing outside the normal office hours are subject to additional charges.

OUTPATIENT PHLEBOTOMY SERVICES

Phlebotomy services are available during the outpatient operating hours at our laboratories.
Referring clinics shall issue a Laboratory Request Form for patients to bring along to our outpatient
department to ensure correct and adequate specimens are collected. Please refer to page 7, 8 & 9
for the operating hours. We are close on public holidays.

SPECIMENS PICK UP SERVICES

Kindly call up our service call line provided for specimen pick up services.
Specimen pick up service is available during the below operating hours (except for Kota Bharu,
Kertih, Sungai Petani & Batu Pahat):

• Monday to Friday 9.00 am to 5.30 pm

• Saturdays 9.00 am to 1.00 pm
• Sundays & Public Holidays Closed

For further details, please refer to Table 1: Operation Hours, Location and Contact Numbers.
Extended hours are also available in some areas. Please enquire with your local branch for details.

SUPPLIES
We provide the following consumables within 2 working days upon receiving the Supply Request
form from the client clinics:
• Request Forms
• Specimen Containers
• Sterile Swabs
• Cervical Smear Kit (Conventional and Liquid Based)
• Histopathology Specimen Containers
• Specimen Carrier Bags

Requisition of consumable supply with Supply Request form shall be submitted to the laboratory
personnel during office hour 1 day in advance of the expected date of supply.

The collection of supply is strictly during normal office hours only.

PRICING & PAYMENT POLICY

• All prices are quoted in Ringgit Malaysia and subject to the implementation of the Goods and
Services Tax.
• All cheque payment shall be payable to “Pantai Premier Pathology Sdn Bhd” only.

10
Our Marketing and Despatch personnel are authorised to collect the cheques on behalf of the
company

FEEDBACK AND SUGGESTIONS

We value and welcome your feedback in relation to our services. If you have any comment or
suggestion, please contact our Customer Service +603 4280 9115 or our respective branch or
email to info@premierpathology.com.my

LABORATORY REQUISITION

TEST REQUISITION
All specimens shall be accompanied by a request form filled with the following particulars:
• Patient’s Full Name & second identifier (Government ID or Passport No/Medical Record Number)
• Patient’s age, date of birth & gender
• Date & time of specimen collection
• Diagnosis or Clinical History (Where Applicable)
• Name and signature of requesting doctor, clinic stamp and telephone number
• Billing mode (Cash, Clinic, Hospital and Employer/GL)
• Special attention if required (Urgent/Overtime/Phone/Fax No.)
• Nature / source of specimen
• Specimen Status (Fasting or non-fasting)
• Examination required

TYPE OF REQUEST FORMS

• Blood Bank/Transfusion Request Form
• Clinical Request Form
• Histopathology & Cytopathology Request Form
• Allergy Diagnostic Request Form
• PMCare Request Form
• Prudential Request Form
• Specialized Testing Request Form
• Microbiology Request Form

TEST ORDER
Tick at the column next to the test(s) to indicate the test(s) requested or name the test under the “OTHER
TEST” column if it is not included on the printed test list.

“SPECIAL” TEST
Certain special test e.g. blood transfusion, HIV, Cytogenetic, DNA testing requires informed consent. It
is the responsibility of the requester to ensure that consent is taken prior to testing. This consent should
be kept in the patient’s case note.

URGENT TEST
Tick on the URGENT box.
• Send specimen in URGENT Specimen Carrier Bag.
• Tick on phone/ fax and provide phone/fax number on the request form if verbal/faxing of report is
required.

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 ADD TEST
• Adding test to old specimen is subject to specimen availability, adequacy and nature of specimen
• Overnight specimens are not suitable for biochemistry, haematology testing and microbiology.
• Please check with laboratory staff before adding new tests on same specimen. Do enquire with the
local branch on the test listing with allowable time limits for requesting additional examinations or
further examinations on the same primary sample.
• Verbal order of adding test is not acceptable. Additional tests shall be added upon receiving the
supplementary request form.

SPECIMENS COLLECTION AND HANDLING

Proper specimen collection and handling is an integral part of obtaining a valid and timely laboratory
test result. Specimens must be obtained using proper phlebotomy techniques, collected in the proper
container, correctly. It is the policy of the laboratory to reject specimens when there is failure to follow
these guidelines. All specimens should be handled with universal precautions, as if they are hazardous
and infectious.

TYPES OF CONTAINERS AND ANTICOAGULANT

Name Cap Type of Testing

Sodium Citrate Blue Coagulation
Plain Red Chemistry, Serology, Immunology, Endocrinology
Lithium Heparin Green Chemistry, Therapeutic Drugs
Sodium Heparin Green Karyotyping and FISH
EDTA Purple Haematology/ Blood banking & Crossmatch
Fluoride Oxalate Grey Glucose, Lactate

Refer to Appendix 1: BD Tube Guide

ORDER OF DRAW FOR BLOOD SPECIMENS

Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives
between tubes. The recommended order of draw for plastic vacutainer tubes is:

1. Blood culture tubes (applying full aseptic technique)

2. Citrate Tube (Blue cap)
3. Plain Tube (Red cap)
4. Heparin Tube (Green cap)
5. EDTA Tube(Purple cap)
6. Fluoride Tube (Grey cap)

NOTE: Tubes with additives must be thoroughly mixed. Erroneous test results may be obtained when
the blood is not thoroughly mixed with the additive.
Please refer to BD Vacutainer Order of Draw for Multiple Tube Collections (Appendix 2)

COLLECTION OF SPECIMENS
• Correct patient identification before specimen collection is extremely important. Identify the patient
prior to specimen collection, using at least two patient identifiers and label at the specimen container.
• Avoid drawing blood below or from the infusion side to prevent dilution of blood specimen.
• Select specimen containers according to the tests requested (Refer to Price and Service Catalogue)
• Label specimen with water proof ink at the point of specimen collection.
• Indicate the source of specimens on containers for anatomical pathology and microbiology
specimens.
• Do not pre-label the empty specimen containers before attend to the patient.

12
• Blood bank specimen must be labelled clearly and accurately at patient's bedside immediately after
blood taking. DO NOT share blood bank specimen with other tests. Use only hand written label and
never use pre-printed label or labelling specimen. The label should include at least 2 identifications
e.g. the patient's full name, MRN, NRIC or DOB. The date and time of collection and the
initial/signature of the person taking the blood.
• Label Glucose Tolerant Test specimens according to collection time.
• Fill up the citrate and EDTA specimens to the volume mark available on the tube to ensure the correct
anticoagulant to specimen ratio.
• Do not send specimen in syringes, regardless of whether the needles are attached or not.
• Place specimens in the inner pocket of the specimen carrier bag and seal the zip.
• Place the request form at the outer pocket of the specimen carrier bag.
• For collection of urine specimen for drug abuse testing, collection site must be secure in order to
eliminate the possibility of specimen tampering or adulteration.

GENERAL PRINCIPLES IN HANDLING LABORATORY SPECIMENS

Known factors significantly affect the performance of the examination or interpretation of the results as
below:

• Secure all specimen containers’ caps to prevent leakage and cross contamination.
• Mix plasma specimen gently by inverting the specimen tubes. Avoid vigorous shaking to prevent
blood specimen haemolysis.
• Unless indicated, specimens should be stored at room temperature (air condition) and avoid exposing
specimens to extreme heat or cold.
• Place specimens in the inner pocket of the specimen carrier bag and seal the zip.
• Place the request form at the outer pocket of the specimen carrier bag.
• Send specimen(s) together with request form to the laboratory for testing as soon as possible.
• Do not keep specimens overnight as these specimens may give erroneous and misleading results.
To ensure the integrity of specimens.
• Do not use expired collection container for specimen collection. Expired supplies shall be returned
to us or being disposed at your end. Please give us a call for the arrangement.
• Fill up the citrate and EDTA specimens to the volume mark available on the tube to ensure the correct
anticoagulant to specimen ratio.
• Ensure correct type specimens in used.
• Avoid drawing blood below or from the infusion side to prevent dilution of blood specimen.

PREVENTION OF HAEMOLYSIS
Allow alcohol on venepuncture site to dry before inserting needle into the vein.
A 21-gauge needle is recommended for collection of blood using non-vacutainer tubes. There is a
greater likelihood of haemolysis with smaller gauge needles.

During venepuncture for collection of blood using non-vacutainer tubes, the plunger of the syringe should
be drawn back slowly and the blood should flow freely.

After venepuncture for collection of blood using non-vacutainer tubes, remove the needle before
allocating blood into the blood tubes and expel blood gently into the correct collection container.

After collecting blood into the blood tube containing anticoagulant, immediately invert the capped blood
tube gently for several times to allow blood mixing with anticoagulant thoroughly to prevent clotting. Do
not shake the blood tube vigorously as this may cause haemolysis.

PACKING & STORAGE OF SPECIMENS

• Avoid exposing specimens to extreme heat or cold.
• Place specimen in the inner pocket of the specimen carrier bag and seal the zip.
• Request form shall be placed at the outer pocket of the specimen carrier bag.
• Send specimens with Request Form attached.
13
 GENERAL SPECIMEN STORAGE
• All specimen collected or obtained, except for a few that require other specific instructions as indicated
in the specimen types, are to be left at room temperature in the clinics while awaiting for pick-up by
the despatchers.
• Do not keep the specimens overnight in the clinics as these specimens may give erroneous and
misleading analytical results to some tests reported. Examples are falsely elevated potassium level,
falsely low glucose result, etc.

TRANSPORT OF SPECIMENS
For clinic and wards situated within the hospital, the Pneumatic Tube System (if applicable) can be used
to send blood, urine and swab specimens to the laboratory. Blood culture, surgical tissue, body fluids,
bone marrow specimens and amniotic fluid for cytogenetic examination shall NEVER be transported to
laboratory via Pneumatic Tube Systems.

SPECIMEN REJECTION
SPECIMENS REJECTION CRITERIA
To ensure the quality of the analytical results provided are not compromised due to the quality of the
specimens, our laboratory personnel will inspect the appropriateness of the specimens and test
requests upon receiving in the laboratory. Inappropriate or inadequate specimens or test requests will
be rejected according to the following Specimen Rejection Criteria:

• Broken / Leaking / Spilt Containers

• Clotted EDTA/Citrate specimen
• Discrepancies between specimen and request form
• Haemolysed specimen
• Incorrect / Insufficient / Overfilled Specimen
• Insufficient clinical information
• No request form attached
• No requesting doctor’s name
• Overnight / Delayed specimen
• Test required not fully specified
• Unlabelled specimen
• Wrong usage or expired container
• Test not available
• Microbiology specimens without proper transport medium
• Microbiology specimens collected in non-sterile container
• Collection swab has dried out for microbiology specimens.
• Histopathology and microbiology not labelled with specimen source.
• Tissue block specimen contain less than 10% of tumour for Molecular Oncology testing.

REJECTED SPECIMENS
• Specimen rejection will be informed to the referring party by phone, followed by a Follow Up
Specimen Request Form fax/send to the referring party.
• Corrective action to be taken will be suggested upon the notification of specimen rejection.
• Provide analysis or perform specialized tests which require special skills or instrumentation that are
beyond the capacity of the in-house laboratory
• Provide analysis or perform tests that are requested infrequently
• Provide second opinion for histopathology, cytopathology and related disciplines
• Provide backup service for unscheduled or unanticipated situation

The laboratory will not be held responsible for tests sent to a laboratory at the specific request of a
requesting clinician if the respective referral laboratory:
• Is not an approved Outsource Referral Laboratory by Pantai Premier Pathology Sdn. Bhd.

14
 PREPARATION OF SPECIMENS
Preparation of specimens consists of the following:
1. Collecting A Clean Catch Urine
2. Collecting 24 hour Urine
3. Oral Glucose Tolerance Test
4. Urea Breath Test
5. Blood Gases pH
6. Semen Analysis
7. Cytopathology Guidelines
8. Histopathology Guidelines
9. Microbiology Guidelines

COLLECTING A CLEAN CATCH URINE

Clean-catch urine specimens are collected in a sterile specimen cup or container. Instruction shall be
provided to the patient prior to the specimen collection to facilitate a proper collection procedure.

Instruct the patient to wash hand thoroughly. The lid of the specimen container shall be removed and
avoid touching the inside of the specimen container or lid. For a female patient, she shall spread her
labia apart with one hand, keeping the folds separated for the rest of the procedure. Using disposable
wipes, clean the area between the labia and around the urethra thoroughly from front to back. Use a
new wipe for each stroke. If water is used in the cleaning, the same area shall be pat dry with clean
paper towel. Men follow the same instructions, but cleanse the outside of the penis before starting the
urine stream. If the patient is not circumcised, he shall pull back the foreskin before starting the cleaning
procedure.

The patient shall urinate a small amount into the toilet, and start collecting the urine in the specimen
container after 2 or 3 seconds. The patient shall avoid placing the container onto the perineal skin. A
collection of about 30 ml of urine is sufficient for urinalysis and bacterial culture procedure. The lid of
the container shall be secured before passing the urine specimen to the nurse.

A specimen that contains stool, vaginal discharge, or menstrual blood cannot be used.

COLLECTING 24 HOUR URINE

Instruction for 24 Hours Urine Collection
1. Note time before collecting urine.
2. Empty bladder completely.
3. Discard this urine specimen.
4. Collect all subsequent urine specimens passed during the next 24 hours in the container provided
with the suitable preservative in it. (Urinate into a small container and transfer it into the 24 hours
urine container provided).
5. Mix the contents thoroughly after each addition of urine if a preservative is used.
6. At the end of the collection period (approximately the same time the following day), empty bladder
completely.
7. Include the last urine specimen in the total collection.
8. Send the specimen immediately to the laboratory / Consultant suite.
9. Please do not urinate directly into the bottles as it contains preservative that are caustic and harmful
to the skin.

Note: Please include the height and weight of patient if creatinine clearance is being done.

Patient Preparation for urine VMA

Many Laboratory restrict food. Such as coffee, tea, bananas and others foods. Some ask for no drugs
use (except for digitals) for 2 weeks before the test. Aspirin, Peroxidane, Levodopa, Amoxicilin,
Cardidopa, Reserpine and Disulfiram commonly interfere.
Monoamine oxidase inhibitor decrease VMA excretion.
For an infant, thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag
with an adhesive paper on one end), and place it on the infant. For males, place the entire penis in the

15
 bag and attach the adhesive to the skin. For females, place the bag over the labia. Diaper as usual over
the secured bag.
This procedure may take a couple of attempts -- lively infants can move the bag, causing the urine to
be absorbed by the diaper. The infant should be checked frequently and the bag changed after the
infant has urinated into the bag. Drain the urine from the bag into the container provided by your health
care provider.
Deliver it to the laboratory or your health care provider as soon as possible upon completion.

ORAL GLUCOSE TOLERANCE TEST

The oral glucose tolerant test (OGTT) is used for the diagnosis of gestational diabetes mellitus, type 1
and type 2 diabetes mellitus.

Patient shall be advised to resume normal diet intake (containing at least 150g of carbohydrate daily)
and usual physical activity for at least 3 days prior to the test. The patient must fast overnight (8-
14 hours) with only plain water is allowed. Smoking is not permitted during the test and the presence of
factors that influence interpretation of the results shall be recorded (for example: medications, inactivity,
infection, etc.).
A fasting venous blood specimen will be taken prior to the consumption of 75g anhydrous glucose.
Paediatric patient will be given 1.75 g/kg body weight up to 75g for the glucose load. Patient shall be
remained seated and consume nothing but water throughout the test. The test shall be abandoned if the
patient vomits during the test.

For general patients who are not pregnant, a fasting and 2-hour post glucose load venous blood
specimen shall be obtained for blood glucose testing; for OGTT performed on pregnant ladies, an
additional 1-hour post glucose load specimen is required besides the fasting and 2-hour post glucose
load specimens (Recommendation on the diagnosis and classification of hyperglycaemia in pregnancy
by International Association of Diabetes).

Specimens for OGTT shall be clearly labelled with the time of collection to allow the laboratory to
differentiate between the fasting and post glucose load specimens and report accordingly.

UREA BREATH TEST

PYtest Administration & Analysis in 3 Easy Steps
The patient should have fasted for 4 hours prior to completing the test. The patient should not have
taken antibiotics and bismuth containing products for 1 month, proton pump inhibitors for 1 week and
cyto-protective medicines such as sucralfate for 2 weeks prior to the test. This is because such
medications will decrease the DPM readings and may give false-negative results.

Step 1
The PYtest® Kit should be opened up and all components laid out.
PYtest Kit Includes:
• 2 paper cups
• PYtest® balloon
• PYtest® capsule
• A straw
• A courier/mail box for the balloon should the breath specimen need to be posted or air-freighted

Step 2
The Patient swallows a PYtest® capsule (containing a small amount of 14C-labelled urea) with 30mls
of water using paper cup provided. Wait 3 minutes then swallow the second cup of water and wait for
another 7 minutes before proceeding to Step-3. When the 14C-urea comes into contact with H.pylori in
the stomach, it is hydrolyzed into 14C-carbon dioxide and ammonia. The 14C-carbon dioxide (14CO2)
enters the bloodstream and is carried to the lungs via the circulatory system and is exhaled by the
patient.

16
Step 3

Ten minutes after ingesting the capsule, a breath specimen is collected in a special metalised mylar
balloon. The balloon containing the breath specimen may be analysed on-site or sent to a pathology
laboratory for analysis.

BLOOD GASES AND pH

The measurement of blood gases and pH are used to evaluate oxygen and carbon dioxide exchange,
respiratory function, and acid-base balance. Arterial blood is preferred for these determinations due to
its superior uniformity throughout the body, but venous pH is extremely similar in most situations and is
more easily obtained.

The blood gases specimen shall be collected by using heparinized syringe. While collecting the blood
gases specimen, be sure that no air bubbles are aspirated into the syringe. After adequate specimen
volume is obtained, quickly remove the needle and apply pressure on the puncture site.

The specimen shall be sealed immediately and placed on ice. It is important to keep the specimen air
tight and water tight and immediately transport the specimen to the Intensive Care Unit for testing. The
testing shall be performed within 10 – 15 minutes from the time of specimen collection.
Mode of oxygen delivery (whether the patient is breathing room air, oxygen, or ventilated) and patient’s
temperature must be indicated. Fever and assisted oxygen or breathing alters test interpretation.

The cause of specimen rejection includes clots in specimens, specimen left at room temperature for
more than 15 minutes and specimen is not properly sealed before analysing.

SEMEN ANALYSIS
1. Refrain from sexual intercourse or masturbation for between 3 to 5 days.
2. Produce the specimen by masturbation without artificial lubricants. Do not use condom, as condoms
contain spermicidal agents.
3. Collect the specimen into the clean, wide mouth container supplied. It is important that the whole
ejaculate is collected. If not, the specimen should be labelled as incomplete.
4. The specimen must be delivered to the lab within 1 hour once been collected. Keep the specimen
warm at body temperature during the transportation.

CYTOPATHOLOGY GUIDELINES

Table 2: Specimen Collection and Handling for Cytopathology Specimens

SPECIMEN TYPE COLLECTION & HANDLING GUIDELINES
BRONCHIAL • Roll brush over clean, dry slide.
BRUSHINGS • Fix immediately the labelled slides with spray fixative or 95% ethyl alcohol.
• The brush used to prepare bronchial brushing slides may be swished in a
container of Cytolyte solution to dislodge remaining specimen.
• Label containers/ slides with at least 2 identifiers (e.g. patient’s name, IC,
passport number or MRN)
• Submit to the laboratory using one request form.
FINE NEEDLE • Advanced booking is required for FNA by Consultant Cytopathologist as well
ASPIRATION as when assistance is required by MLT.
(FNA) • Fix 2 to 3 slides immediately (within a few seconds) using Cytopathology spray
fixative or immerse in 95% ethyl alcohol for 15-30 minutes.
• Provide another 2 to 3 air dry slide without fixative.
• Fluid obtained with a needle pass shall be expressed into a sterile container.
• Label containers with at least 2 identifiers (e.g. patient’s name, IC, passport
number or MRN) and indicate nature of the specimen.
• Label slides to indicate air dried or alcohol fixed smears.
• Submit to the Laboratory using one request form.

17
 FLUIDS • Including CSF, bronchial washing, colonic washing, pelvic washing, effusion,
etc.
• Collect in a sterile container, label with at least 2 identifiers (e.g. patient’s
name, IC, passport number or MRN) and indicate nature of the specimen, and
send immediately to the laboratory.
GYNAECOLOGY • Ideal sampling date is two weeks after the first day of the last menstrual period.
SMEAR Avoid sampling during normal menses.
• Avoid use of vaginal medication, vaginal contraceptives, or douches for 48
hours prior to examination.

Liquid Based (ThinPrep)

• To obtain an adequate sample from the cervix, insert the central bristles of the
broom into the endocervical canal deep enough to allow the shorter bristles to
fully contact the ectocervix. Push gently and rotate the broom in a clockwise
direction 5 times.
• Rinse the broom in the PreserveCyt® solution vial by pushing the broom into
the bottom of the vial 10times, forcing the bristles apart. Swirl the broom
vigorously to further release the material. Discard the broom.
• Tighten the cap so that the torque line on the cap passes the torque line on
the vial.
• Label the test vial with at least 2 identifiers (e.g. patient’s name, IC, passport
number or MRN).
• Submit to the laboratory using one request form.
• Refer to Appendix 3: ThinPrep® quick reference guide.

Conventional
• Label the slide with at least 2 identifiers (e.g. patient’s name, IC, passport
number or MRN).
• Smear preparations shall be fixed immediately after collection:
Fixative Duration
95% ethyl alcohol 15 – 30 minutes
spray fixatives 10 minutes
• Fixed smears should be allowed to dry for 10 minutes prior to placing into slide
carrier for dispatch to the laboratory.
• Submit to the laboratory using one request form.

HISTOPATHOLOGY GUIDELINES

HANDLING OF SPECIMEN
• Routine specimens should be fixed in 10% buffered formalin unless otherwise stated.
• Unfixed biopsy specimens for special immunofluorescence stains shall be sent to laboratory
immediately.
• Unfixed and fresh specimen for frozen sections shall be delivered to laboratory immediately.
• All specimens shall be labelled with patient’s 2 unique identifiers and nature of specimens.
• All histopathology specimens shall be sent in containers with proper labelling.
• Large specimen shall be sent in double-bagged plastic bag to prevent leakage.
• Multiple small specimens, such as gastrointestinal biopsies, shall be mounted on a piece of filter
paper and properly labelled.
• For specimens where orientation is important, mark or tag the specimen e.g. axillary tail of
mastectomy specimens, surgical margin.
• Specimens from different anatomical sites should be sent in separate containers, labelled and
itemized in the same Histopathology Request Form.
• Specimens will be charged according to the number, size and nature of specimens, complexity and
not depending on the size of containers.

FROZEN SECTION
• At least one day advance booking is required.
• Contact Histopathology section for enquiry.
• Specimen for frozen sections will be done without fixative.
• An additional 100% surcharge will be imposed for frozen section request done after office hours.
• Courier service charge for waiting and pickup specimen.
18
IMMUNOFLUORESCENCE (IMF) STAINS
• At least one day advance booking is required.
• Fresh unfixed specimen for Renal and Skin biopsy shall place on filter paper soaked with saline and
another specimen in 10% buffered formalin.

SPECIAL STAINS & IMMUNOHISTOCHEMISTRY (IHC) STAINS

• Special stains employ staining techniques to identify suspected pathogens or demonstrate specific
cellular components that aid pathologist in the evaluation of disease states.
• Immunohistochemistry stains (IHC):
- To give clear picture of cancer invasion & metastasis
- To decide appropriate line of therapy
- In prognosis and response to treatment
- In patient selection for targeted therapies
• Attending clinician will be informed of the additional test (Special stain or Immunohistochemistry
stain) and charge will occur for further staining, kindly contact Histopathology laboratory for
quotation.

RADIOACTIVE BIOLOGICAL SPECIMEN

• All biological specimens obtained from patients who have recently received radioactive material for
the purposes of therapy or diagnosis are regarded as hazardous.
• All radioactive specimens should be sealed into containers and labelled with:
- Radioactive label: “Caution Radioactive Material”
- Type of radioisotope
- Date and time the patient received radioisotope
• The requesting clinician must ensure to state that the specimen is radioactive and specify the
radionuclide in the request form.
• Ensure double packaging of the radioactive specimens to prevent any potential leakage and do not
use Pneumatic delivery system for radioactive specimens.

Table 3: Histopathology Specimen and Code

CODE SPECIMEN

BX (Biopsy specimen) 1. Antral biopsy

2. Gastric biopsy
3. Stomach biopsy
4. Tru-cut biopsy (breast, prostate-1 site)
5. Liver biopsy
6. Cervical biopsy (TRO CIN)
7. PNS/NPC
8. Endometrial curettings
9. Endometrial sampling/pipelle
10. Skin bx, skin lesion
11. Brain tumour <10mm
12. POC (<30mm)
13. Endocervical polyps

MUS (Medium uncomplicated specimen) 1. Fallopian tubes – Rt & Lt. (even in 2

containers)
2. Appendix
3. Ovary (1 side- <30mm)
4. Lipoma (small) <30mm
5. Sebaceous cyst (<30mm)
6. Tonsil ( 1 side)

19
 LS (Large specimen) 1. Thyroid lobe (1 side)
2. Appendix(>50mm)
3. Breast lump (big container) <30mm
4. Lipoma (big container)>30mm
5. Omentum
6. Axillary tail
7. LLETZ
8. Prostatic chips <30mm
9. Gallbladder
10. Lymph node
11. Axillary Lymph Node
12. Mole with skin
13. Tonsil (Rt & Lt in 1 container)
14. Ovary (40-50mm)
15. Fibroid (<50mm)
16. Molar/Ectopic pregnancy >30mm
17. Skin with tumor
18. Doughnut (rectum)

LCS (Large complicated specimen) 1. Segment of colon

2. Ovary (>50mm)
3. Fibroid (>50mm)
4. Breast WLE <50mm
5. Prostatic chips >30mm
6. Cervix (Cone)

CC (Complex complicated) 1. Uterus with appendages (TAHBSO)

2. Mastectomy specimen/ WLE >50mm
3. Hemicolectomy specimen
4. Gastrectomy
5. Laryngectomy
6. Total prostate
7. Bladder
8. Kidney
9. Radical neck
10. Total thyroidectomy
11. Femur
Immunofluorescence(IF)+(Routine HPE) Skin in-house
Renal- send away to referral lab
Photo Charge to histopathology specimen with photo
2nd opinion (H218) In-house pathologist
IHC (Immunohistochemistry) *Package IHC stain for 2-3 IHC stain
SIHC (Single Immunohistochemistry) *Breast marker IHC stain and other single stain
SS1 (Special stain) *Histochemical stain, e.g.: PAS,DPAS, Giemsa

Note: Please contact histopathology lab for assistance.

MICROBIOLOGY GUIDELINES

GENERAL PRINCIPLES
• Whenever possible, specimens shall be collected before antibiotic therapy is commenced.
• Avoid contaminating the specimen. Maintain aseptic or sterile techniques.
• Specimens for bacterial culture should be representative of the disease process.
• Sufficient specimen must be collected to ensure an accurate examination.
• Transport specimens quickly to the laboratory to prevent desiccation of the specimen and death of the
microorganisms.
• Submit fluid specimens collected. Do not submit fluids on swabs.
• Patient’s recent antimicrobial therapy and brief clinical history shall be provided.

20
SPECIAL PRECAUTIONS
• Specify specimen collection site in the test order to ensure optimal recovery of micro-organisms.
• Specimen for urine culture shall be sent to the laboratory immediately after collection. Otherwise it
shall be refrigerated.
• CSF specimens shall be transported to the laboratory immediately after collection. Refrigeration is
strictly prohibited as fastidious bacteria do not withstand refrigeration.

Table 5: Specimen Collection, Handling and Rejection Criteria for Microbiology Specimens
Specimen Container and Storage and Precaution Rejection
Type Amount Transport Criteria
Abscess Sterile leak- Transport as soon Avoid sampling the surface Dried up
proof container as possible at area. (Aspirate, if possible or specimen in
- needle ambient pass a swab deep into the container
aspiration temperature. lesion and firmly sample the
lesion’s advancing edge) Swab without
Swab in Amies If > 24 hours, transport
- Drained transport media refrigerate at 4 to Remove surface exudates by medium
abscess 8°C wiping with sterile saline
- Swab before collection.
Skin Sterile leak- Ambient Cleanse the area with sterile Specimen
scraping/ proof container temperature. saline. submitted in
Biopsy, formalin.
Bone or If > 24 hours, For skin scrapping, scrape
Tissue refrigerate at 4 to area at the active margin of
8°C the lesion. Do not draw
blood.
Submit specimen in sterile
Skin scrapping: container without formalin.
transport to the
laboratory in a Specimen may be kept moist
cardboard mailer. with 0.85% sterile saline
Blood Blood Culture Transport upright An aseptic technique is Broken blood
Culture Bottle in a rack in critical to proper blood culture
transport box. culture collection. bottles.
Adult:
Ambient Refer to Appendix 5 Wrong
6-10 ml Aerobic temperature if container
blood culture able to reach the Do not keep Blood culture
bottle and lab within 24 bottles in the refrigerator.
8-10 ml hours. Use Aerobic Blood culture
Anaerobic blood bottles (6-10ml) for isolation
culture bottle of yeast/ fungal.
Children or
infants:
1-4 ml Paeds
bottle
Faecal Clean, dry leak- at 4 to 8°C For rectal swab - pass the tip Leaked
Specimen or proof screw cap of a sterile swab specimens
Rectal Swab containers approximately one inch
beyond the anal sphincter. Insufficient
or Carefully rotate the swabs to specimen
Appropriate specimen the anal crypts for
bacteriology at least 10 seconds before
transport media withdrawing the swab.
or For bacterial isolation, need
to process within 1 to 2 days
Swab in Amies of collection.
transport
media(rectal
swab)
5ml liquid

21
 (a teaspoonful)
or 5g solid
(peanut sized)
Nail Clean, dry leak- Ambient Wipe nail with sterile saline. NA
proof screw cap temperature
containers Clip away the affected areas
and collect material under
the nail
Pernasal/ Swab in Ambient NA Swabs not in
transport temperature transport
nasopharyn medium medium
geal Swab
Calcium alginate
swab in
transport
medium (for
pertussis)
Swab must be
fully immerse in
the transport
medium
Sputum Plain sterile Transport in Instruct patient to gargle or >25
container sealed container rinse mouth with water. ephithelial
Bronchial as soon as cells/ Low
Lavage Sufficient possible Instruct patient to cough power field.
(BAL) amount deeply to produce a
depending the Bacteria – specimen from the lower
Tracheal number of test Ambient respiratory tract and not
aspirate requested temperature. saliva.
Nasopharyn If > 24 hours,
geal refrigerate at 4 to
aspirate 8°C
Sterile Body Plain sterile Ambient Clinician obtain specimen via Insufficient
Fluids container temperature. percutaneous needles specimen
aspiration or surgery.
If > 24 hours,
refrigerate at 4 to Fluid specimens are
Blood culture 8°C preferable than swab
bottles culture.
Sufficient
amount
depending the
number of test
requested
Wound Swab with Ambient Disinfect surface of the Swab without
swab / pus transport temperature. wound with sterile saline. transport
medium medium
If > 24 hours, If swab is used, obtain
Swab must be refrigerate at 4 to specimen at the time of
fully immerse in 8°C incision or drainage of wound.
the transport Avoid sampling of the surface
medium area as it may contaminate
the specimen with flora not
involved in the infection.
Throat Swab Swab with Ambient Depress tongue with a sterile Swab without
transport temperature. tongue depressor. transport
medium medium
If > 24 hours, Specimen inflamed area,
Swab must be refrigerate at 4 to exudates and/or lesions with
fully immerse in 8°C the suitable swab for the test.
the transport
medium

22
 Vaginal And Swab in Ambient Avoid collection from the Swab without
transport temperature. areas of normal flora. transport
Urethral medium medium
Swab If > 24 hours, Please notify if Neisseria
Swab must be refrigerate at 4 to gonorrhoea is suspected.
fully immerse in 8°C
the transport
medium
CSF Plain sterile Transport in Do not refrigerate Insufficient
bottle sealed containers specimen specimen
as soon as
Minimum 0.5ml possible.
each in 3
different bottles Bacteria –
Ambient
temperature.
If > 24 hours,
keep at 37ºC
(incubator)
Urine Clean, screw- Transport to Avoid overnight specimens. Insufficient
top specimen laboratory within specimen
transport 2-3 hours or store
container at 4 to 8°C not
more than 24
Minimum 1ml hours

Urine from Clean, screw- Transport to Disinfect the catheter Foley

indwelling top specimen laboratory within collection port with 70% catheter tips
catheter transport 2-3 hours or store alcohol.
container at 4 to 8°C not
Use a needle and syringe to
more than 24
aseptically collect 5-10ml of
hours
urine.
Transfer the urine to a sterile
container

Our routine Culture & Sensitivity of Bacterial Pathogen procedure identify and report the susceptibility
pattern of the following bacterial species:
• Enterobacteriaceae
• Haemophilus and Pasteurella
• Neisseria and Moraxella
• Pseudomonas and other aerobic Gram Negative Bacilli
• Staphylococcus
• Streptococcus and Enterococcus

Our routine Stool Culture procedure identifies and reports the susceptibility pattern of Salmonella,
Shigella and Vibrio species.

For others special request please indicate on the request form if less common pathogens are sought
or anaerobic culture is required.

MOLECULAR ONCOLOGY GUIDELINES

SAMPLE REQUIREMENTS FOR REAL TIME PCR OR SEQUENCING

• Tissue should be fixed in formalin and not exposed to decalcification solution.

• The paraffin block should contain no less than 3 mm or at least 10% area of tumor.
• The laboratory accepts tissue sections. At least ten (10) paraffin sections are required for each
test and to be kept in a microcentrifuge tube or mount on unstained slides.
• One H&E slide should be provided.

23
 • Block or slide/ tube should be properly labeled with a block ID that matches the surgical pathology
specimen number on the surgical pathology report.
• Block or slide/ tube should be sent at room temperature in proper storage containers (e.g plastic
slide boxes) to protect them during transport/shipment.
• A surgical pathology report and completed request form must accompany all specimens.

SAMPLE REQUIREMENTS FOR TISSUE FISH

• The recommended sample fixation for FISH is 6-48 hours in 10% Neutral Buffered Formalin.
• The laboratory accepts tissue sections. The optimal thickness for all sections is 3-4μm. Please
clean microtome blade and water bath thoroughly before cutting sections to avoid cross-
contamination and false positive results.
• The first few sections should always be reserved for FISH testing. Sections should be mounted on
positively charged slides.
• Please label all slides clearly with AT LEAST TWO unique patient identifiers, e.g. name and
pathology number (Block ID).
• For paraffin sections, send five (5) slides per FISH test requested in a protected container
together with a completed request form, corresponding H&E slide with the relevant area marked
(even if 100% is tumour tissue) and your own Histopathology report.
• If you prefer to send FFPE block, this will need to be cut and the sections marked by a
histopathologist prior to testing.

Slides and blocks should be posted at room temperature packaged in a cushioned and sturdy outer
package. A fine absorbent pad should be used to protect tissue face of the paraffin block from
damage during transportation.

WHOLE BLOOD FOR LIQUID BIOPSY (Refer Appendix 6)

• Whole blood in two (2) 10 mL Cell-Free DNA (cfDNA) BCT Tubes provided or please contact
Pantai Premier Pathology at +603 2280 0187 ext 171/173 for further information. (TUBES MUST
BE IDENTIFIED WITH THE SAME NUMBER AS THAT REGISTERED IN THE ATTACHED
REQUEST FORM AND MUST BE SENT TO THE LAB AS SOON AS POSSIBLE AT AMBIENT
TEMPERATURE)After collection, immediately and gently invert the tubes 10 times. Inadequate or
delayed in mixing may result in inaccurate test result.
• After 10 times inverted, store at room temperature (2°C to 30°C).
• Specimen must be reached at RSL, Pantai Premier Pathology Sdn Bhd. Within 3 days.
• Please contact Pantai Premier Pathology Sdn Bhd. for collection of specimens.

MOLECULAR INFECTIOUS DISEASE GUIDELINES

GENERAL PRINCIPLES

• Avoid contaminating the specimen.

• Sufficient specimen must be collected to ensure an accurate examination.
• Transport specimens quickly to the laboratory with ice packs.

SPECIAL PRECAUTIONS

• Specify specimen collection site in the request form.

• Urine specimen shall be sent to the laboratory immediately after collection. Otherwise it shall be
refrigerated.
• CSF specimens shall be transported to the laboratory immediately after collection. Refrigeration is
strictly prohibited.

24
 Storage and Rejection
Specimen Type Container Transport Precaution Criteria
Cotton/Dry/Rayon-
Nasal/Nasopharyngeal Dacron Swab, in NA NA
2°C-8°C
/Throat Swab Viral Transport
Medium (VTM)
Sputum, Bronchial
Alveolar Lavage, Instruct patient
Bronchial Lavage, to cough deeply
Bronchial Aspirate, Sterile Leak-Proof to produce a
2°C-8°C
Bronchial Washing, Container specimen from
Nasopharyngeal the lower
Aspirate, ETT respiratory tract
Secretion and not saliva. Salivary sample
Do not scoop
specimen from
Sterile Leak-Proof the toilet bowl
Stool 2°C-8°C NA
Container
Do not freeze
specimen prior
to testing
Refrigerate
serum/plasma at
2°C-8°C for 3
Plain Serum/Edta 2x Plain Tube/EDTA
days. Freeze
Plasma Tube
serum/plasma in - NA Lysed specimen
20°C or cooler if
more than 3 days
Sterile Leak-Proof
Urine 2°C-8°C Ensure to collect NA
Container
1st void urine
Avoid collection
Urethral/Vaginal/Anal Dry/Cotton/Gel
2°C-8°C from the areas NA
Swab Swab
of normal flora.
Thinprep, Surepath
Liquid Base Cytology 2°C-8°C NA NA
Or Pathtezt
Ambient
temperature
FFPE Block/Cell
Container Avoid high
Block/FNAC/EUSFNA
temperature NA NA
during
transportation
Body Fluid; Pleural,
Peritoneal, Pus,
Sterile Leak-Proof
Abscess, Ascitic, 2°C-8°C NA NA
Container
Gastric Lavage,
Pericardial Fluid

Sterile Leak-Proof Ambient Do not

CSF
Container temperature refrigerate NA

25
 CYTOGENETICS GUIDELINES

PERIPHERAL BLOOD (KARYOTYPE)

• Proper specimen collection and sterile handling are absolutely critical for cytogenetic studies.
• Draw 5-10 mL (paediatric: 2-5 mL) peripheral blood in a green-top (sodium heparin) collection
tube.
• Collection containers must be closed tightly to prevent leakage of sample during transportation to
the laboratory.
• Label specimen tube with patient’s name and a second identifier (ex: DOB, MRN).
• All requests should be accompanied with the request form signed by the respective medical
officers / consultants.
• The REFERRAL REASON(S) for the test (compulsory requirement). A history and/or intended
purpose of the investigation allows us to select the exact culture regime or mode of analysis most
appropriate for the clinical scenario.
• The culture procedures were made everyday afternoon (except Sunday & Public Holiday) at about
5 pm (usually). Any changes of culture time need to adjust timing for thymidine and harvest
process.
• Specimens should be received by the laboratory as soon as possible (ideally within 24 hours). It is
generally recommended that specimens be maintained at ambient temperature during transit.
Extreme temperatures should be avoided. Never freeze, add fixative or preservative.
• If it is not possible to process samples as soon as they arrive, they should be stored at 4°C.
However, since delays affect quality, cultures should be initiated as soon as possible.
• Only the specimen collect with sodium heparin media will attempted for cytogenetic studies.
• Specimens that are clotted, haemolysed and/or added in wrong anticoagulant tube will be rejected
and informed to the ward or clinic immediately.
• Suboptimal specimens;
- In blood which is partially clotted, particularly haemolysed, or in which the log time before
receipt by laboratory of sample is more than 24 hours, studies may be attempted,
although are considered suboptimal specimens and are less likely to be successful.
- Metaphase spreads may obtain from the sample collected in lithium heparin, however,
sodium heparin is preferred since lithium heparin may cause toxicity to cells.
• Do not use expired collection containers or transport media for specimen collection.

BONE MARROW (KARYOTYPING)

• Proper specimen collection and sterile handling are absolutely critical for cytogenetic studies.
• Aspirate 1-5 mLs of a first draw of bone marrow aspirate into a sodium heparin tube and mix well
to prevent clotting.
• Collection containers must be closed tightly to prevent leakage of sample during transportation to
the laboratory.
• Label specimen tube with patient’s name and a second identifier (ex: DOB, MRN).
• All requests should be accompanied with the request form signed by the respective medical
officers / consultants.
• The REFERRAL REASON(S) for the test (compulsory requirement). A history and/or intended
purpose of the investigation allows us to select the exact culture regime or mode of analysis most
appropriate for the clinical scenario.
• The culture procedures were made everyday afternoon (except Sunday & Public Holiday) at about
5 pm (usually). Any changes of culture time need to adjust timing for blocking, releasing and
harvest process.
• Specimens should be received by the laboratory as soon as possible (ideally within 24 hours). It is
generally recommended that specimens be maintained at ambient temperature during transit.
Extreme temperatures should be avoided. Never freeze, add fixative or preservative.
• If it is not possible to process samples as soon as they arrive, they should be stored at 4°C.
However, since delays affect quality, cultures should be initiated as soon as possible.
• Only the specimen collect with sodium heparin media will attempted for cytogenetic studies.
• Specimens that are clotted, haemolysed and/or added in wrong anticoagulant tube will be rejected
and informed to the ward or clinic immediately.

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• Suboptimal specimens;
- In bone marrow which is partially clotted, particularly haemolysed, or in which the log time
before receipt by laboratory of sample is more than 24 hours, studies may be attempted,
although are considered suboptimal specimens and are less likely to be successful.
- Metaphase spreads may obtain from the sample collected in lithium heparin, however,
sodium heparin is preferred since lithium heparin may cause toxicity to cells.
• Do not use expired collection containers or transport media for specimen collection.

FLUORESCENCE IN SITU HYBRIDIZATION (FISH)

• If FISH is done in conjunction with chromosome analysis, no additional specimen is required.

• Requirement for type of specimen to be sent:
- 3ml bone marrow or peripheral blood in sodium heparin tube (green top). (Only FISH test is
requested).
- Label specimen tube with patient’s name and a second identifier (ex: DOB, MRN).
- Maintain at room temperature and transport to the Lab as soon as possible.
- These studies may also be performed on paraffin embedded tissue.

RESULTS REPORTING
REPORTING OF LABORATORY RESULTS
• Quantitative results will be reported together with reference ranges.
• Comments will be included for all results with poor specimen quality that may interfere with the
accuracy of the testing.
• Preliminary reports which are crucial to patient management will be issued to requesting clinician.
• Completed reports will be delivered or printed to the requesting clinician and not to patient.
• All laboratory personnel are strictly adhering to Personal Data Protection Act and code of ethics of
private and confidentiality of result.

REPORTS FROM THE EXTERNAL REFERRAL LABORATORIES

The laboratory is responsible to channel the entire original report from the outsource referral laboratory
to the requesting clinician without alteration.
If transcription is required the transcribed results shall be legible without mistake and verified by key
personnel.

URGENT RESULTS
Urgent results will be reported to the requesting doctor via fax/phone provided the fax/phone number is
provided on the request form. However faxing of urgent reports are recommended instead of verbal
reports to ensure the accuracy of results conveyed.

TURNAROUND TIME
Laboratory reports are usually completed within 24hours upon receipt of the specimen except for the
tests that are outsourced, requires long period of incubation (e.g. Bacteria culture), run in batches and
involved clinical interpretation (e.g. Histopathology and Cytopathology)
Occasionally, the laboratory may not be able to meet the defined turnaround time for test that are
routinely performed in-house e.g. equipment breakdown, LIS/Server down or where the second opinion
required. If there is a delay in reporting results which may compromise patient care, lab will notify
affected requesting doctor/client accordingly.

Further inquiries regarding Turnaround Time, can be made by calling respective Pantai Premier
Pathology Branch and/marketing personnel.

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 CRITICAL / PANIC VALUES
Critical or panic values are life threatening results that indicates an imminent life threatening condition
whereby therapy of immediate actions is required promptly.

Test results which fall within the critical value will be informed to the requesting doctor with record
maintained. The doctor shall read back the patient’s identity and critical value informed before the end
of the conversation as a precautionary step to ensure correct information had been conveyed and
received.

Table 6: Critical Values

HAEMATOLOGY CRITICAL VALUE EXCEPTION

APTT ≥ 80 sec Nil

Blood Parasite Seen Previously reported

Fibrinogen ≤ 1 g/L (Adult) Nil

≤0.7g/L(Paediatric)

< 8.0 g/dL or ≥19.0 g/dL (Adult)

Haemoglobin Nil
< 8.0 g/dL or ≥ 20.0 g/dL (Paediatric)

< 8.0 g/dL or ≥ 22.0 g/dL (Neonatal)

Total White Cell (WBC) ≤2.0 x 109 /L or ≥50.0 x 109 /L Nil

(Paediatric)
Platelets Count ≤80 x 109 /L or ≥1000 x 109 /L Previously reported

Prothrombin Time (PT) ≥ 40 sec Nil

BIOCHEMISTRY CRITICAL VALUE EXCEPTION

Bilirubin ≥ 256 µmol/L (Neonatal) Nil

≤1.5 mmol/L or ≥3.00 mmol/L (Adult)

Calcium Dialysis Patient
≤1.7mmol/L or ≥3.10mmol/L (Paediatric)

Creatine Kinase (CK) ≥ 600 IU/L Nil

Creatinine ≥330µ mol/L (Paediatric) Dialysis Patient

Glucose ≤2.8 mmol/L or ≥20.0 mmol/L (Adult) Nil

≤1.6 mmol/L (Paediatric, CSF)

≤0.4 mmol/L or ≥2.00mmol/L (Adult)

Magnesium Nil
≤0.5 mmol/L or ≥1.8 mmol/L (Paediatric)

≤0.32 mmol/L or ≥2.87 mmol/L (Adult)

Phosphate Nil
≤0.40mmol/L or ≥2.80mmol (Paediatric)

Potassium (> 18 years old) ≤2.8 mmol/L or > 6.0 mmol/L Nil

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 Sodium ≤ 125 or > 155 mmol/L Nil
>50ng/L(Trop T)
Troponin Nil
>0.07 mg/ml (Trop I)

Immunology/Serology CRITICAL VALUE EXCEPTION

HIV All reactive Nil

Cytopathology

High grade squamous intraepithelial lesion (HSIL)

High grade squamous intraepithelial lesion (HSIL) with suspicious of invasion
Squamous cell carcinoma (SCC)
Atypical glandular cell – non otherwise specified (AGC-NOS)
Atypical glandular cell (AGC) favour neoplastic
Adenocarcinoma in-situ (AIS)
Adenocarcinoma are categorized as critical results.

Bacteriology
Blood Culture VALUE
CRITICAL Positive Gram Stain/ Culture
Acid Fast bacilli (AFB)
EXCEPTION Positive AFB Stain/ Culture
Sterile Body Fluids Positive Gram Stain/ Bacterial Antigen detection / Culture
(cerebral spinal fluid (CSF),
Pleural Fluid, Peritoneal fluid
and Pericardial fluid)
CSF bacteria antigen detection Positive
High Alert Bacteria Extended-spectrum Beta Lactamase Producer (ESBL)
Methicillin-Resistant Staphylococcus aureus (MRSA)
Multi-drug Resistant Organisms (MDRO)
Vancomycin -Resistant Enterococcus (VRE)
Vancomycin- Resistant Staphylococcus aureus (VRSA)
Salmonella typhi
Vibrio cholerae
Corynebacterium diphtheriae
Leptospira
Histoplasma
Neisseria gonorrhoeae
Neisseria meningitidis
Burkholderia pseudomallei
Blood Bank
Direct CoombsVALUE
CRITICAL Positive
Indirect Coombs
EXCEPTION Positive
Crossmatch Incompatible
(Especially after the release of un-crossmatched blood or
emergency crossmatched blood.)

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 Appendix 1

30
Appendix 2

31
 Appendix 3

32
Appendix 4

33
 Appendix 5

34
35
36
 Appendix 6

Cell-Free DNA BCT ®

INSTRUCTIONS FOR USE Note:

Cell-Free DNA BCT® is a direct draw whole blood collection tube intended for collection, transport and storage of 1. For best results, a 21G or 22G needle is advised. Slower fill times may be observed when using a smaller
blood samples. This product has not been cleared by the U.S. Food and Drug Administration for In Vitro gauge needle.
Diagnostic use. The product is For Research Use Only. Not for use in diagnostic procedures. 2. When using a winged (butterfly) collection set for venipuncture and the Streck Cell-Free DNA BCT is the first
tube drawn, a non-additive or EDTA discard tube should be partially drawn first in order to eliminate air or
SUMMARY AND PRINCIPLES “dead space” from the tubing.
Cell-Free DNA BCT stabilizes cell-free plasma DNA as well as preserves cellular genomic DNA present in 3. For the 2.0ml Cell-Free DNA BCT, care must be taken to center the tube so the middle of the stopper is
nucleated blood cells and circulating epithelial cells (tumor cells) found in whole blood. punctured per the figure below. To aid with proper insertion of the tube in standard holders and stabilize the
Accurate analysis of cf-DNA can be compromised by sample handling, shipping and processing, causing lysis of tube during the draw, a pediatric tube adapter is strongly recommended to modify the standard holder to fit
nucleated blood cells and subsequent release of cellular genomic DNA. Additionally, degradation of cf-DNA due the 10.25mm diameter 2.0ml Cell-Free DNA BCT (Streck part number: 230242, 230243).
to nuclease activity can be problematic.
The preservative reagent contained in Cell-Free DNA BCT stabilizes nucleated blood cells, preventing the release
of cellular genomic DNA, and inhibits nuclease mediated degradation of cf-DNA, contributing to the overall
stabilization of cf-DNA. Samples collected in Cell-Free DNA BCT are stable for up to 14 days at temperatures
Correctly punctured stopper
between 6 °C to 37 °C, allowing convenient sample collection, transport and storage.
4. Cell-Free DNA BCT does not dilute blood samples; therefore, no dilution factor correction is necessary.
The preservative reagent contained in Cell-Free DNA BCT stabilizes circulating epithelial cells (tumor cells) in
5. As in the case with most clinical laboratory specimens, hemolysis, icterus and lipemia may affect the results
whole blood for up to 7 days at temperatures between 15 °C to 30 °C.
obtained on blood samples preserved with Cell-Free DNA BCT.
REAGENTS
Cell-Free DNA BCT contains the anticoagulant K3EDTA and a cell preservative in a liquid medium. DNA EXTRACTION
Extraction of cell-free plasma DNA and cellular genomic DNA can be accomplished using most commercially
PRECAUTIONS available kits that include a Proteinase K treatment step.
1. For Research Use Only. Not for use in diagnostic procedures.
2. Do not freeze specimens collected in glass Cell-Free DNA BCT. (Streck part numbers: 218961, 218962, Cell-Free Plasma DNA
218992, 230242, 230243) Streck has qualified two separate plasma separation spin protocols for your convenience.
3. Do not use tubes after expiration date.
4. Do not use tubes for collection of materials to be injected into patients. Double Spin Protocol 1
5. Product is intended for use as supplied. Do not dilute or add other components to Cell-Free DNA BCT. Step 1. To separate plasma, centrifuge whole blood at 300 x g for 20 minutes at room temperature.
6. Overfilling or underfilling of tubes will result in an incorrect blood-to-additive ratio and may lead to incorrect Step 2. Remove the upper plasma layer and transfer to a new conical tube (not provided).
analytic results or poor product performance. Step 3. Centrifuge the plasma at 5000 x g for 10 minutes.
CAUTION Step 4. Isolate cell-free DNA per kit manufacturer instructions.
a. Glass has the potential for breakage; precautionary measures should be taken during handling of glass
tubes (Streck part numbers: 218961, 218962, 218992, 230242, 230243). Double Spin Protocol 2 (for maximum plasma recovery)
b. All biological specimens and materials coming in contact with them are considered biohazards and should Step 1. To separate plasma, centrifuge whole blood at 1600 x g for 10 minutes at room temperature.
be treated as if capable of transmitting infection. Dispose of in accordance with federal, state and local Step 2. Remove the upper plasma layer and transfer to a new conical tube (not provided).
regulations. Avoid contact with skin and mucous membranes. Step 3. Centrifuge the plasma at 16000 x g for 10 minutes.
c. Product should be disposed with infectious medical waste. Step 4. Isolate cell-free DNA per kit manufacturer instructions.
d. Remove and reinsert stopper by either gently rocking the stopper from side to side or by grasping
with a simultaneous twisting and pulling action. A “thumb roll” procedure for stopper removal is NOT For optimal results, include a Proteinase K treatment step (≥ 30 mAU/mL digest) at 60 °C in the presence of
recommended as tube breakage and injury may result. chaotropic salts for 1 hour when extracting cell-free DNA.
e. A pediatric tube adapter is strongly recommended to better fit the 10.25mm diameter 2.0ml Cell-Free DNA
BCT. Cellular Genomic DNA
7. SDS can be obtained at www.streck.com or by calling 800-843-0912. Step 1. To separate the white blood cells, either lyse the red blood cells and wash, or centrifuge whole blood
and collect the buffy coat layer.
STORAGE AND STABILITY Step 2. Isolate genomic DNA per kit manufacturer instructions.
1. When stored at 2 °C to 30 °C, empty Cell-Free DNA BCT is stable through expiration date.
2. Short-term storage at 2 °C to 40 °C is acceptable for empty Cell-Free DNA BCT for up to 14 days. For optimal results, include a Proteinase K treatment step (≥ 30 mAU/ml digest) at 60 °C in the presence of
3. Do not freeze empty Cell-Free DNA BCT. Proper insulation may be required for shipment during extreme chaotropic salts for 2 hours when extracting cellular genomic DNA.
temperature conditions.
4. Sample storage/stability: FREEZING AND THAWING
PLASMA
Sample Type
1. To Freeze: For long-term storage, after spinning, collect and transfer the upper plasma layer to a cryogenic
Cell-Free DNA Cellular Genomic DNA Epithelial Cells tube (not provided) and freeze at -20 ºC or -80 ºC.
(Tumor Cells) 2. To Thaw: Thaw cryogenic tubes at appropriate temperature as specified in your protocol.
Note: If cryoprecipitates form in the plasma, vortex the tube for 30 seconds after thawing. Do not centrifuge
Sample Stability 14 days 14 days 7 days the plasma.
Sample Storage Temperature 6 ºC to 37 ºC 6 ºC to 37 ºC 15 ºC to 30 ºC CONCENTRATED CELLULAR COMPLEMENT
After spinning and the upper plasma layer is collected and transferred to a cryogenic tube, the remaining cellular
INDICATIONS OF PRODUCT DETERIORATION material in the plastic Cell-Free DNA BCT (Streck part numbers: 230252, 230253, 230254) may be frozen for
1. Cloudiness or precipitate visible in reagent of empty tube. future use.
2. If indications of product deterioration occur, contact Streck Technical Services at 800-843-0912 or 1. To Freeze: For long-term storage, freeze the remaining cellular material vertically directly in the plastic Cell-
technicalservices@streck.com. Free DNA BCT at -20 ºC or -80 ºC.
2. To Thaw: Thaw tubes at appropriate temperature as specified in your protocol.
INSTRUCTIONS FOR USE Note: A plastic Cell-Free DNA BCT, which has been completely filled with whole blood, should not be frozen;
For a video demonstration, visit www.streck.com/mixing. breakage may occur.
1. Collect specimen by venipuncture according to CLSI GP41-A61.
Prevention of Backflow - Since Cell-Free DNA BCT contains chemical additives, it is important to avoid LIMITATIONS
possible backflow from the tube. 1. For single use only.
To guard against backflow, observe the following precautions: 2. Samples drawn in other anticoagulants or preservatives may cause coagulation in Cell-Free DNA BCT.
a. Keep patient’s arm in the downward position during the collection procedure. 3. Specimen transport via pneumatic tube system is not advised.
b. Hold the tube with the stopper in the uppermost position so that the tube contents do not touch the stopper
or the end of the needle during sample collection. REFERENCES
c. Release tourniquet once blood starts to flow in the tube, or within 2 minutes of application. 1. Clinical and Laboratory Standards Institute. GP41-A6, Procedures for the collection of diagnostic blood
2. Follow recommendations for order of draw outlined in CLSI GP41-A61. Cell-Free DNA BCT should be drawn specimens by venipuncture. Approved Standard - Sixth Edition.
after the EDTA tube and before the fluoride oxalate (glycolytic inhibitor) tube. If a Cell-Free DNA BCT tube
immediately follows a heparin tube in the draw order, Streck recommends collecting a non-additive or EDTA ORDERING INFORMATION
tube as a waste tube prior to collection in the Cell-Free DNA BCT. Please call our Customer Service Department toll free 800-228-6090 for assistance. Additional information can
3. Fill tube completely. be found online at www.streck.com.
4. Remove tube from adapter and immediately mix by gentle inversion 8 to 10 times. Inadequate or delayed GLOSSARY OF SYMBOLS
mixing may result in incorrect analytical results or poor product performance. One inversion is a complete See the Instructions (IFU) tab under Resources on the product page at www.streck.com.
turn of the wrist, 180 degrees, and back per the figure below:

Canada Patent 2,690,651; Europe Patent EP2228453; Other Patents Pending.

See www.streck.com/patents for patents that may be applicable to this product.

Streck 350547-12
5. After collection, transport and store tubes within the recommended temperature range. 7002 S. 109 Street, La Vista, NE 68128 USA 2017-06

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