Requirements for Specimen Submission

Currently, whole blood and epithelial cells are accepted for testing at HRG. Please ensure a completed requisition form is submitted with the specimen.

We accept whole blood in either yellow-top or lavender-top Vacutainer tubes (For further information, please download the Vacutainer Guide):

Yellow-top, containing additive ACD (Acid Citrate Dextrose), invert gently 8 times at blood collection. Do not shake;

Lavender-top, containing additive EDTA, invert gently 8 times at blood collection. Do not shake;


We accept epithelial cells obtained from buccal (inside mouth) area. DNA isolation and genetic tests maybe performed on buccal epithelial cells. Those who refuse venipuncture and blood collection are requested to donate a specimen of buccal cells. Also, patients who have been recipients of bone marrow or blood products should donate epithelial cells for DNA based IBM2 testing. Subjects may collect the sample themselves and mail it back to the laboratory, or may come in the laboratory and perform the collection with the help of a technician. The cells may be collected by either a buccal swab (by cotton swab or cytobrush), or with a simple "swish-and-spit" technique using a commercial mouthwash.
  • Buccal swab
    1. Brush your teeth as you usually do, and wait about 20 - 30 minutes. Do not eat or drink anything other than water during this time.
    2. Prepare an empty sample envelope, and either 4 cytology brushes or 4 cotton swabs (cotton should be only on one side of the swab stick).
    3. Write the patient's name, patient's birthdate, and the date & time of sample collection on the specimen envelope.
    4. Firmly scrape inside of cheeks (buccal area) several times with provided cotton swab or cytology brush. Use one swab or brush at a time.
    5. Allow brush or swab to dry before placing in designated container.
    6. Place the container in an envelope and deliver to lab in person or by mail/courier. Specimens may be transported at room temperature.

  • Mouth wash: Mouth wash kit is available upon request. Please contact us to obtain a kit, it will make the process easier.

Labeling

The last part of this section covers labeling, which is critically important because inaccurate labeling is a very common cause of testing errors. The critical information on the label are:
  1. Patient's Name
  2. Patient's Date of Birth
  3. Date & time sample was collected

Criteria for Rejection of Specimen

Below is a non-comprehensive list of reasons for rejecting a specimen.
  1. Requisition or consent form is missing information. Requisition must contain following information:
    • Requesting party and referring authority, usually a healthcare professional.
    • Patient identifying information - Name or alias if anonymous;
    • Test requested, Clinical indication for testing;
    • Date and time specimen collection;
    • Type of sample (e.g. whole blood or epithelial cells obtained by buccal swab);
    • All other identifying information (e.g. social security number, telephone number, hospital ID, sex ... etc.) is optional, but useful for accurate differentiating between patients with similar names.
  2. Label is unclear;
  3. Blood specimen is from a recipient of bone marrow transplant;
  4. Specimen is inappropriate for test requested;
  5. Blood sample is clotted or hemolyzed;
  6. Incorrect container or Vacutainer used;
  7. Buccal swab seems to contain food or other particles;
  8. Buccal swabs are exposed to outside of container/envelope.
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