Deadline to send baby blood sample now 1 business day

LITTLE ROCK -- The Arkansas Board of Health gave final approval to two rule changes to blood sampling for newborn babies Thursday, including one measure to send samples to a state laboratory more quickly for testing.

Blood samples from newborns now must be sent from the hospital where they were collected within one business day, replacing the previous rule that required hospitals to send the samples within 48 hours of their collection.

The samples, sent to the Arkansas Department of Health's Public Health Laboratory in Little Rock, are tested for disorders such as cystic fibrosis or sickle cell disease. Samples are supposed to be collected within 24 to 72 hours after a baby is born.

The Health Department's newborn screening program gets about 2,800 to 3,500 samples each month, spokesman Kerry Krell said. Those totals don't reflect the number of babies born in Arkansas.

"Sometimes there are multiple samples for a single baby," she said. "Especially for babies in the NICU."

The change was approved with no discussion just more than a year after a Milwaukee Journal-Sentinel investigation revealed that thousands of samples collected nationwide each year were delayed five or more days before arriving at a laboratory for testing.

In Paragould, one baby's blood sample was not tested until 3 1/2 weeks after the baby was born, the newspaper reported.

The test found that the child had galactosemia, a disorder that prevented his body from digesting galactose, a sugar in breast milk.

By the time the boy's mother learned about the diagnosis, he had already spent two weeks at Arkansas Children's Hospital in Little Rock after being rushed by ambulance with a rash and swollen stomach, the newspaper reported.

In November 2013, the Arkansas Democrat-Gazette reported that the newborns' blood samples were being sent to the state laboratory within the 48-hour rule only 13 percent of the time.

In 2014, hospitals sent samples on time 45.2 percent of the time, Krell said.

Now hospitals have only one business day to send samples to the state laboratory, the latest in steps the department has taken to improve delivery of blood samples, said Dr. Glen Baker, the laboratory's director.

The department started a courier service three years ago that delivers samples from county health units to the laboratory at no charge to hospitals. Additionally, the state laboratory is now open Saturdays, an expense made possible through a increase in the cost of screening from $89 to $121.

Hospitals can be penalized for not delivering samples on time, Krell said. But such penalization is uncommon because the department prefers to work with hospitals to make improvements and to keep the process "open" between the two parties.

"It's more important that the program improves," she said.

Krell said improvements have been made since 2013 because of outreach efforts that the department will continue to use with the new standards.

"There's going to be an education process with our program in the hospitals," she said.

The "one business day" rule was arrived at after the initial suggestion of within 24 hours because of concerns raised by the Arkansas Hospital Association, the department has said.

Samples still could wait 48 hours over a weekend or even longer if a state holiday coincides with the weekend, Krell said, although that's not a change from the previous rule.

The second rule change approved Thursday adds a 29th test that detects severe combined immunodeficiency disorders.

The test will be able to determine whether a newborn suffers from one of those disorders, which indicate a compromised immune system and subsequent increased vulnerability to infectious diseases.

"Obviously, if you don't have the diagnosis early on, it could be lethal," he said.

Baker said he hopes the new test will be in place May 1 if it's approved by the Food and Drug Administration.

If it's not, Baker hopes to still have the equipment by mid-March to use the test for research. The test can be used clinically only if approved by the Food and Drug Administration, he said.

NW News on 01/23/2015

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