Specimen Rejection: “What can be done for quick specimen registration?”

Have you ever been asked to resubmit a specimen before the experiment even began? Unfortunately, it is a common occurrence for many specimens arriving at the laboratory to be deemed unsuitable for registration.

We will explain the reasons for rejection and what you can do to prevent it.

Reasons for Specimen Rejection

The main factors causing issues during specimen registration are broadly categorized into problems with the specimen itself and incomplete documentation.

Let’s look at each reason in detail.

✅ Reasons for Specimen Unsuitability (By Type)

Blood:

• Coagulation
  1. Insufficient Inverting (90%, the most common cause)
  2. Delayed Inverting
• Specimen container (tube) is damaged or leaking
• Blood collected in a tube other than an EDTA tube

DBS (Dried Blood Spot):

• Mold growth due to the blood not being completely dry
• Insufficient number of blood spots required for the experiment

Buccal (Buccal Epithelial Cells):

• Specimen contamination – “Something is floating in the tube.”
  1. Collection without rinsing the mouth with water
• Only one of the two swabs is present, or only the preservation solution is present

DNA:

• Insufficient quantity of extracted DNA

✅ Reasons for Document Unsuitability

1. Omission of Essential Documents

• Domestic: Missing Genetic Test Consent Form
• Overseas: Missing 3billion Consent Form

※ In some cases, substitution with another consent form or a request for additional documents may occur.

2. Missing Signature

• Requisition Form – Missing physician’s signature
• Consent Form – Missing either the patient’s or the physician’s signature

3. Discrepancy between Consent Form and Portal Information

• Patient information differs
• Inconsistent consent status (Limited to overseas samples)

✅ Other Reasons

1. Inconsistent or Missing Information on the Specimen

• Patient information written on the specimen does not match the information in the portal
• No information is written on the specimen at all
• 3billion ID cannot be confirmed on either the specimen or the documents

2. Use of Unsuitable Kit

2. Methods to Prevent Rejection

✅ Precautions for Document Preparation

1. Accurate Patient Information
   The correct patient information (3billion ID, date of birth) must be fully and accurately recorded on both the specimen and the documents.
2. Inclusion/Upload of Essential Documents
   Essential documents must be included with the specimen or uploaded to the portal.

• Domestic: Consent Form (Must include both physician and patient signatures)
• Overseas: Consent Form (Must include patient signature and consistent consent status)

✅ Precautions for Specimen Collection and Storage by Specimen Type

Specimen Type	Precautions for Collection and Storage
Blood	– To prevent blood coagulation, collect 3ml in an EDTA tube and immediately and gently invert the tube to ensure the blood and solution are well mixed. – Sending blood specimens with an ice pack can reduce the risk of coagulation.
DBS	– You must use the kit provided by 3billion. – Fill all 10 Spots and ensure they are thoroughly dried.
Buccal Swab	– You must use the kit provided by 3billion.- It is crucial to collect the specimen cleanly to prevent contamination or mixing with foreign materials. – Apply moderate pressure that does not cause bleeding, and scrape multiple times to collect cell aggregates. – Before final shipment, check that both swabs are inside the preservation solution tube.
DNA	– It is important to collect DNA with a volume ≥ 25ul and total amount ≥ 1ug and seal the specimen to prevent leakage.

This concludes the guide for swift specimen registration. 3billion will continue to do its best for fast and accurate diagnosis.

Explore the Full Sample Tips Series!

1️⃣ A Complete Guide to Genetic Testing Samples – Blood vs. Buccal vs. DBS

2️⃣ Bone Marrow Transplants & Blood Transfusions – Why Is Blood No Longer an Option?

3️⃣ The Buccal Swab Trap – “I Swabbed Your Cheek, So Why Is Their DNA Here?”

4️⃣ Sample Rejection – “Why Did My EDTA Blood Sample Clot?”