Diagnosed with diabetes even after repeated blood glucose counts at the para lab gave a clean chit. Type of jaundice masked since only total bilirubin count was done, and not the crucial differential one. Labelled a leukaemia patient when perfectly healthy, because samples got switched…
A rubber-stamped and signed report from your local path lab could well be the first step to complication, not cure. Absence of documentation, a dearth of qualified pathologists and lab technicians, improper calibration of equipment, use of cheap reagents, unscientific and crude sample transport chain — all add up to often render that all-important lab report meaningless and misleading.
Of the 500-plus pathological labs in the city and its fringes doing brisk business, “less than 10 per cent” would pass a reliability check for international quality-assurance standards by the National Accreditation Board for Testing and Calibration Laboratories (NABL), feel senior pathologists.
NABL, an autonomous body under the aegis of the department of science & technology, government of India, provides third-party assessment and a formal recognition, authorisation and registration of the capability, competence and credibility of a laboratory to carry out testing and calibration activities with quality assurance.
“Only a correct report would provide the doctor an unambiguous and meaningful picture relevant to the clinical problem, and in order to ensure correct reports, the laboratory should follow good practices,” said A.S. Kanagasabapathy, technical adviser, NABL.
He was, on Sunday, addressing a workshop to generate awareness on quality control in laboratories. Organised by Bio-Rad Laboratories, in tandem with the Association of Practising Pathologists, Calcutta, it brought together 50 pathologists.
NABL, which has implemented ISO/IEC 17025, the new global standard for laboratory accreditation, is keen to raise awareness among city labs on the importance to “produce reliable and reproducible results”.
Maintaining linkages with leading international bodies, it has an exhaustive ‘code of right conduct’ to ensure quality.
“The state government has a clinical establishment section. But it is hardly equipped to visit all the labs and lacks the intricate knowledge in the science of pathology to do an acceptable assessment,” observed veteran pathologist Subir Kumar Dutta.
Dutta’s Scientific Clinical Research Laboratory on Ram Chandra Das Row, Taltala, is one of the three labs in town accredited by NABL. Drs Tribedi & Roy Diagnostic Laboratories Pvt Ltd on Park Street and Ruby General Hospital’s lab on the Bypass are the other two.
Ashok Laboratory in Jodhpur Park, Doyen Diagnostics on Bhupen Bose Avenue, SRL Pathology Clinic on Prince Anwar Shah Road and NG Medicare, near Triangular Park, have applied for accreditation and are being evaluated by the national board.
In the absence of any quality-control mandate by the government, city labs should come forward to get assessed by NABL, felt Dutta. “Since diagnosis is frequently based on results and interpretations of lab tests, irreversible harm may be caused by erroneous tests. Laboratory personnel should know that quality control is an obligation to the patient.”
Pathologist Rajat Mukherjee, too, ranked most city labs “very low” on the reliability scale. “There is a whole chain of unscrupulous elements contributing to the mess most labs are in. The biggest menace is the ‘lineman’ who collects samples from patients’ residences and ferries those to the clinics. I have even seen blood samples carried in filthy bhanrs (earthen cups).”
These couriers often pocket up to 60 per cent of the test charges. “Such ridiculously low margins prompt mushroom labs to cut corners and conduct just part of the prescribed test,” said Mukherjee.