Recent Artery Conversations
Had an unusual occurrence recently where a patient coming in through the ED had a reported plasma glucose of <40, but did not have any such symptoms and remaining CMP was unremarkable (Beckman AU). Point of care level was normal (105). They sent an additional sample, also <40. We re-ran the same tube sample on blood gas machines (ABL) and got a similar result to the point of care. Best I could come up with was some odd interferent, maybe a drug or other interferent that was selectively interfering with the chemistry in the AU. Patient did not require any more draws and was sent home so we didn't really get much follow up. I have not heard of this before - and am wondering if my suspicion is correct or there are other potential issues?
If any deviation in sample preparation, tested population, specimen collection, testing conditions etc cause a test to become a lab-developed test it would seem in many cases complicated or subjective to decide what is an LDT or perhaps just about every test we perform is an LDT?
We are in the process of transitioning chemistry analyzers. Tumor marker rebaselining study showed that Beckman DXI HCG results are higher up to 100% than Ortho ECI results. Onc-Med physicians have concern since they use HCG levels as decision points for therapy. I wanted to reach out to the community to get some feedback from you all.