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A large laboratory runs 10,000 SSTs daily through the Chemistry
analyzer and 4500 Hepatitis B surface Antigen tests through their Immunology analyzer every day. The lab manager worries about reporting a false positive HBsAg result because the Chemistry analyzer doesn't use discrete tips when sampling. The Chemistry Supervisor doesn't want to seperately aliquot the sample becaise of the risk of potential mislabling and possilbe aeresol contamination, which also could result in a false positive. So he assures his manager that sharing the tube between instruments is not likely to ever result in reporting a false positive HBsAg. - A phlebotomist draws two SSTs and three other tubes from a patient with hepatitis (Patient A). The blood is taken to the laboratory for testing. - The primary SST is placed on a Chemistry instrument that uses washes between each test and has a 1 in 10 chance of contaminating the subsequent tube. - Any SST sample following Patient A's hepatitis positive SST has a 25% chance of having a hepatitis test ordered. - In order to be deemed positive, a patients sample must be repeated using an alternate tube if available, and if the repeat is found to be positive, it then has to be confirmed using an alternative method and an alternative sample. - 99% of the patient samples that have hepatitis ordered have at least 3 different tubes drawn that can be used for repeat and confirmation. - Of the remaining 2%, 1% go one the Chemistry analyzer and could possilbly be contaminated by Patient A's sample, the other 1% go directly to the hapatitis analyzer for testing. What is the probability of reporting a false positive result? |
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