Specimen Quality Examples

Some specimens are considered unsatisfactory due to the quality of specimen collection or handling. These specimens are tested for extreme values but another specimen must be obtained to complete the screening tests. The need to obtain a repeat specimen could delay diagnosis and treatment of an affected infant. The poster below shows images of unsatisfactory specimen quality examples along with common causes.

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Invalid Specimens	Possible Causes
1. Specimen quantity insufficient for testing.	Removing filter paper before blood has completely filled circle or before blood has soaked through to second side. Applying blood to filter paper with a capillary tube. Touching filter paper before or after blood specimen collection with gloved or ungloved hands, hand lotion, etc. Allowing filter paper to come in contact with gloved or ungloved hands or substances such as hand lotion or powder, either before or after blood specimen collection.
2. Specimen appears scratched or abraded.	Applying blood with a capillary tube or other device.
3. Specimen not dry before mailing	Mailing the specimen before drying for a minimum of four hours.
4. Specimen appears supersaturated.	Applying excess blood to filter paper, usually with a device. Applying blood to both sides of filter paper.
5. Specimen appears diluted, discolored or contaminated.	Squeezing or "milking" of area surrounding the puncture site. Allowing filter paper to come in contact with gloved or ungloved hands or substances such as alcohol, formula, antiseptic solutions, water, hand lotion or powder, etc., either before or after the blood specimen collection. Exposing blood spots to direct heat.
6. Specimen exhibits serum rings.	Not wiping alcohol from puncture site before making skin puncture. Allowing filter paper to come in contact with alcohol, hand lotion, etc. Squeezing area surrounding puncture site excessively. Drying specimen improperly. Applying blood to filter paper with capillary tube.
7. Specimen appears clotted or layered.	Touching the same circle on filter paper to blood drop several times. Filling circle on both sides of filter paper.
8. No blood	Failure to obtain blood specimen.

Printed with permission from Schleicher & Schuell, P.O. Box 2012, Keene, New Hampshire 03431 Phone: 800/437-7003 Fax: 603/357-3627 and The New York State Department of Health Schleicher & Schuell knows this information to be true only when using S&S 903 Specimen Collection Paper.