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Forensic Science: Chain of Custody

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What information must be documented on the chain-of-custody form for a specimen?

Name and identifying information of the patient, body, subject, or object the specimen came from

Why is it essential to maintain the integrity of the chain-of-custody process?

To prevent tampering with the specimen during transportation

Which of the following scenarios may require initiating and following a chain-of-custody process?

Urine drug testing for employment purposes

What is the purpose of using a biohazard bag with a permanent seal?

To provide a tamper-evident seal for the specimen

Which type of testing may involve toxicology testing of substances?

Forensic analysis of crime scene evidence

Why is special handling of forensic specimens crucial?

Because the specimens might be decomposing, available in only trace amounts, or require analysis in extreme environments

Who must sign the chain-of-custody form during transportation of the specimen?

Every person who had possession of the specimen for any amount of time

Which of the following is an example of a forensic specimen?

Vaginal swab from a rape kit

Why is it essential to transport microbiology specimens quickly?

To allow for timely identification of micro-organisms

What is a potential consequence of delaying delivery of specimens from clinics to reference laboratories?

Breakdown of glucose in blood cells, affecting test results

What type of transport system is usually used in an inpatient setting?

Pneumatic tube systems

What is a precaution to consider when using pneumatic tube systems for transport?

Avoiding tests for potassium, plasma hemoglobin, lactate dehydrogenase, and acid phosphatase

What is the purpose of inner padding in pneumatic tube systems?

To separate blood tubes

What is essential for the delivery process to include?

Adequate specimen handling, packaging, and communication with the courier

Why is prompt delivery of specimens from clinics or blood-collection stations to reference laboratories necessary?

To prevent interference with results of various tests

What types of specimens require prompt delivery to the laboratory?

Blood, urine, sputum, wound exudate, stool, and other body substances

What is an important aspect of handling specimens in a laboratory setting?

Labeling the container with the patient's name, date and time of collection, and specimen type

Why is it essential to coordinate with clinical staff when collecting blood samples for timed tests?

To ensure accurate test results

What is the purpose of verifying the patient's wristband or verbally verifying with the patient?

To ensure the correct labeling of the specimen

Why is it necessary to wear gloves when handling patient-collected, nonblood specimens?

To prevent infection of the phlebotomist

What should a phlebotomist do between collecting each specimen?

Change gloves

What is the importance of correct handling of specimens?

To ensure accurate test results

What type of test requires a specific timing, such as a 2-hour postprandial blood glucose level?

Timed test

Why is it important to position the label correctly on the container?

To ensure the correct labeling of the specimen

What is a unique challenge presented by forensic specimens?

They require special training or experience to collect

What is the purpose of the Federal Drug Testing Custody and Control Form (CCF)?

To record the handling and storage of drug testing specimens

What can urine drug tests usually detect?

Marijuana use within the past week and other illegal drugs within the past 2 days

Why are specific guidelines essential for collecting drug testing specimens?

To prevent employees from tampering with the specimen

What is a requirement for phlebotomists involved in drug testing?

Undergoing training and evaluation in the correct use of the CCF

What industry standard is often followed for workplace drug testing?

The U.S. Department of Transportation's mandated testing regulations

What is the primary purpose of workplace drug testing?

To detect drug use among employees

What is a benefit of using the Federal Drug Testing Custody and Control Form (CCF)?

It ensures accurate handling and storage of specimens

Which type of specimen requires special handling and protection from shock and vibration?

Coagulation specimens

What is the primary function of an automated carrier system in a laboratory?

To transport laboratory specimens

What is the purpose of a pneumatic tube system in a hospital?

To transport laboratory specimens and medications

What is the chain of custody in the context of laboratory specimens?

The process of maintaining control and accountability for laboratory specimens

What is the consequence of sending a specimen to the incorrect department?

The specimen will be delayed in processing

What is the purpose of using a secure container in a pneumatic tube system?

To maintain security and confidentiality

What is the final step in preparing a specimen for transportation in a pneumatic tube system?

Closing the door and sending the specimen

What is the purpose of the alarm or light in a pneumatic tube system?

To indicate the arrival of a specimen

A chain-of-custody form only requires the signature of the person who obtained the specimen.

False

Forensic specimen analysis only involves DNA analysis and rape test kits.

False

Workplace drug testing does not require following chain-of-custody guidelines.

False

Toxicology testing only involves analysis of blood samples.

False

Specimens for forensic analysis do not require special handling.

False

A biohazard bag with a permanent seal is not necessary for transporting specimens.

False

The delivery of specimens from clinics or blood-collection stations to reference laboratories should be delayed to allow for processing and preparation.

False

Pneumatic tube systems are not suitable for transporting microbiology specimens.

False

Hand delivery is a suitable method for transporting specimens to a reference laboratory.

True

Forensic specimens do not require special handling and protection from shock and vibration.

False

Toxicology testing does not involve the analysis of biological specimens.

False

Workplace drug testing does not require specific guidelines for collecting and handling specimens.

False

Timed tests require a specific timing, such as a 2-hour postprandial blood glucose level, and phlebotomists are responsible for ensuring patients have satisfied the testing requirements.

True

Phlebotomists are not responsible for coordinating with clinical staff when collecting blood samples for timed tests.

False

The label on a specimen container should be positioned on the lid, not on the container.

False

Wearing gloves is not necessary when handling patient-collected, nonblood specimens.

False

Phlebotomists do not need to change gloves between each specimen.

False

Incorrect handling of specimens does not affect the quality of the specimen.

False

The phlebotomy team is not responsible for accessing and processing all specimens that come into the laboratory for testing.

False

Verifying the patient's wristband or verbally verifying with the patient is not necessary.

False

Study Notes

Chain of Custody

  • A chain of custody form must be completed each time a specimen is transferred, documenting the identity of everyone who has handled the specimen.
  • The form requires the patient's name and identifying information, the person who obtained and processed the specimen, and the date, location, and signature of the person attesting to the specimen's correctness.
  • The signature and date of every person who had possession of the specimen are also required.

Specimen Handling

  • Specimens must be labeled correctly and placed in a biohazard bag with a permanent seal to ensure no tampering.
  • Forensic specimens require special handling due to their potential decomposition, limited quantity, or need for analysis in extreme environments.
  • Toxicology testing of substances after poisoning or substance abuse is also involved in forensic specimens.

Delivery of Specimens

  • Prompt delivery of specimens from clinics or blood-collection stations to reference laboratories is crucial.
  • Delays in delivery can affect test results, especially for glucose, phosphorus, and enzymes.
  • Microbiology specimens must be transported quickly to ensure timely identification of microorganisms.

Specimen Delivery Methods

  • Hand delivery directly to a reference laboratory, following timeliness of delivery guidelines.
  • Pneumatic tube systems, usually in an inpatient setting, with enhanced mechanical reliability and increased transport distance and speed.
  • Automated carrier using a transport vehicle, such as a motorized container car that travels on a network of tracks.

Pneumatic Tube Systems

  • Used in hospitals to send and receive laboratory specimens, patients' records, medications, and bills.
  • Each sending station has a large metal box with lockable doors or pass-code entries for security and confidentiality.
  • The tube network runs throughout the hospital and connects to receiving stations.

Chain of Custody Process

  • Maintains control of and accountability for each specimen from collection to disposal.
  • Collecting forensic specimens can require special training or experience and supervision.
  • Unlike clinical specimens, forensic specimens can be in any condition, clotted, or in unacceptable containers.

Drug Testing

  • The Department of Health and Human Services initiated federal drug testing, mandatory for some government employees and private-sector employees.
  • Workplace drug testing often follows the U.S. Department of Transportation's mandated testing regulations.
  • The Federal Drug Testing Custody and Control Form (CCF) documents the handling and storage information for specimens from collection to disposal.
  • Urine drug tests can detect marijuana use within the past week and the use of cocaine, heroin, and other illegal drugs within the past 2 days.

Chain of Custody

  • Documenting identity on the chain-of-custody form is required for every person handling a specimen, including those who obtained and processed it, transported it, and had possession of it for any amount of time.
  • The form includes patient information, specimen details, date, location, and signature of the person attesting to the specimen's identity and documentation.

Labeling and Packaging

  • Correct labeling of specimens is crucial, including patient name, date and time of collection, and specimen type, with immediate labeling after collection.
  • Specimens must be placed in a biohazard bag with a permanent seal to prevent tampering.

Transporting Specimens

  • Hand delivery or pneumatic tube systems can be used to transport specimens, ensuring timely delivery and proper handling.
  • Special considerations are needed for microbiology specimens, which require quick transportation to the laboratory for analysis.

Forensic Specimens

  • Forensic laboratory analysis involves various specimen types, including those from crime scenes, autopsies, and toxicology testing.
  • Special handling of forensic specimens is crucial to ensure the integrity of the evidence.

Specimen Handling

  • Phlebotomy teams accept and accession specimens, ensuring correct handling and processing.
  • Handling requirements include pre-collection specifics, such as time, temperature, and light protection, to ensure high-quality test results.

This quiz covers the importance of documenting the chain of custody in forensic science, including the required information and signatures on the form. It explains the process of handling and transferring specimens in forensic investigations.

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