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Toxicology

Referral/Sendouts, Toxicology

Toxicology Testing Updates – May 2018

As of May 8, 2018, the following tests are no longer performed by Spectrum Health Laboratory. These tests are now available through Mayo Medical Laboratories as a send out. Please note that the specimen collection for these tests may have changed. Please check the Laboratory Catalog for collection information.

Discontinued Test Code Discontinue Test Name Replacement Code Replacement Name
LAB752 Clomipramine Level LAB1230481 Clomipramine, Serum
LAB683 Ethosuximide Level LAB1230480 Ethosuximide, Serum

Questions may be directed to the Toxicology Department using the “Contact Us” link above.

Compliance & Safety, Toxicology

Urgent Notice: Lead Testing

On May 17, 2017, the US Food and Drug Administration (FDA) issued a safety communication warning against using venous samples on Point of Care Magellan Diagnostics LeadCare Testing System devices (LeadCare, LeadCare II, LeadCare Plus, and LeadCare Ultra). Venous specimens appear to be at risk for having falsely low results.  Only Capillary (“finger stick” or “heel stick”) specimen types should be used.

IF YOUR OFFICE IS USING ANY OF THE MAGELLAN LEADCARE TESTING SYSTEM DEVICES: please DISCONTINUE the use of VENOUS specimens for testing. Continue Reading

Toxicology

Citrate & Oxalate 24 hour urines no longer performed at Spectrum Health Laboratory, November 1, 2016

Due to low test volumes, effective November 1st, the Toxicology Department at Spectrum Health Regional Laboratory will no longer be offering Citrate (#8768) or Oxalate (#8837) testing on 24 hour urines.  These specimens will now be routed to Mayo Medical Laboratories for testing.  These tests should be ordered as Reference Miscellaneous (#8998). Please indicate complete test name when ordering.

Please refer to the lab catalog for more detailed patient preparation and specimen requirements:

Note: Spectrum Health does not stock toluene as a preservative. Please maintain collection without preservative and store refrigerated.

Test Utilization, Toxicology

Vitamin D 1,25 Testing

Numerous 1,25-Dihydroxyvitamin D (1,25(OH)2D) requests are received daily (1200 in 2015). This is not the standard test for Vitamin D status.  1,25-Dihydroxyvitamin D testing should be reserved for patients with renal disease, sarcoid, tuberculosis, lymphoma and rickets, as well as, long term use of protease inhibitors, glucocorticoids, or anticonvulsants. Vitamin D 25 (25 OH D) level is sufficient in most cases. The number of requests and review of the ordering providers raises a concern that a number of these requests were ordered inappropriately.

In an effort to decrease the number of potential improperly ordered tests and consequently decrease unnecessary costs to patients, insurance companies, and the laboratory, please review your individual ordering practices.

In the near future, this test name will be changed to “Renal 1,25 Dihydroxyvitamin D” to better reflect its appropriate utilization.

Any questions concerning Vitamin D testing may be directed to Dr. David Alter in the Pathology Department.