Know Error Blog: DNA Confirmation of Positive Biopsy

Unnecessary Lumpectomy Attributed to Specimen Provenance Error (SPE)

2010-07-23T19:11:51Z

On July 20, 2010, a story in The Vancouver Sun revealed a case where an accidental biopsy mix up resulted in an unnecessary lumpectomy for one woman and a 10 week delay in treatment for another.

As with similar cases documented in this blog, the mix up was discovered by a pathologist performing routine post-surgical tests that revealed no cancer in the patient's tissue samples. The report states, "...DNA tests confirmed on July 16 that the woman's initial biopsy...was accidentally switched with a similar biopsy from another woman." This type of mix up is just one of many types of Specimen Provenance Errors (SPE) that can lead to diagnostic mistakes. Other examples of SPE are specimen transposition and foreign cell contamination.

Launched in the spring of 2009, the know error® system brings new levels of safety and accuracy to the biopsy evaluation process. Through the use of forensic DNA testing and bar code technology, this innovative system dramatically reduces the incidence of SPE -- and identifies otherwise undetected SPE -- so that diagnostic mistakes are minimized.

While the DNA tests in this case confirmed the mix up, this was unfortunately AFTER the unnecessary surgery and delay in treatment. The know error® system performs forensic DNA testing of biopsy tissue samples PRIOR to any treatment taking place and virtually eliminates diagnostic mistakes due to SPE. This allows both patient and physician to proceed confidently with treatment options based on the patient's biopsy results.

For more information about the know error® system, please visit our web site www.knowerror.com.

When Best Practices for Reducing Specimen Labeling Errors Fail

2010-04-19T17:15:18Z

On February 23, 2010, The College of American Pathologists posted an article on its web site titled, "When a Rose Is Not a Rose." The article discusses the problem of mislabeled specimens and the procedural improvements that can be made to prevent labeling errors.

The article explains that "...reporting a wrong result can have potentially devastating effects on the patient. This can be doubly true if there is a patient identification mix-up: one patient could receive the wrong medical or surgical treatment while another doesn't get the treatment he or she needs. Either situation can result in severe, irreversible consequences." As a remedy to the various types of labeling errors it covers, the article offers several procedural improvements such as reviewing definitions, guidelines and the protocol for what to do when an error is detected.

]]> As discussed in previous posts, procedural improvements can go a long way in the effort to reduce labeling errors but the question remains, "What happens when these processes fail?". The "best practices" suggested in this article spend a great deal of time discussing what to do when an error has been detected, how to remedy the error and how to learn from the error. However, the article does not discuss the prevention of adverse patient consequences that may result when a patient identification error remains undetected, even when these improved quality assurance practices are in place.

The know error® specimen security system, introduced in the spring of 2009 by Diagnostic ID, LLC, was designed to not only detect these types of medical switching errors but to prevent the potential resulting misdiagnoses of patients. The know error® system utilizes bar code technology and DNA confirmation testing to detect identification errors and dramatically reduces the likelihood of any resulting adverse patient outcomes. This patent-pending system delivers the benefits of greater patient safety and improved diagnostic accuracy while reducing risk to all involved in the biopsy process.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site www.knowerror.com.

Lab Switching Error Resulted in Woman's Healthy Stomach Removal

2010-04-06T14:48:21Z

In December 2009, a report out of Obrezje, Slovenia revealed a lab switching error that resulted in the unnecessary complete stomach removal of a healthy woman, 50-year old Anica Kavecic. Kavecic had no history of gastric problems, but when a biopsy showed a pervasive cancer in her stomach, she was urged to have an immediate and total gastrectomy.

The diagnosis stunned both Kavecic and her family physician but the biggest shock came after the surgery when routine post-surgical tests revealed her stomach was cancer-free. Her biopsy tissue samples had been switched with those of another patient, who in fact did have stomach cancer, resulting in the removal of her perfectly healthy stomach.

]]> Due to language translation issues, it is difficult to fully understand the outcome of this case but it appears that Kavecic was awarded €40,000 in compensation. From what can be discerned, it also appears there may have been insurance limitations involving coverage of a medical error. She has sought expert legal counsel to negotiate a higher compensation.

As with many cases documented in this blog, such as the case of Janelle Trenchfield who underwent an unneccesary lumpectomy, Kavecic's case involved an unnecessary surgery due to a lab error. However, this is the first case we have covered involving removal of a healthy stomach which brings with it a completely different set of issues and post surgical concerns. Information from the American Cancer Society provides further details of a total gastrectomy, which also includes the removal of lymph nodes, as well as potential side effects of the surgery.

According to the article referenced above, the hospital had no procedure in place to prevent this type of switching error. The know error® specimen security system, introduced in 2009 by Diagnostic, ID LLC, was designed specifically to detect this type of error and to prevent resulting unnecessary treatments and surgeries. The know error® system utilizes DNA matching technology to confirm that a positive biopsy result belongs to the right patient before proceeding with treatment plans.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site www.knowerror.com.

Delayed Cancer Treatment Likely Worse than Unneccessary Treatment

2010-03-22T14:30:00Z

Recent posts discussing the cases of Darrie Eason, Scott Aprile and "Kim," a woman from Korea, revealed three similar yet different situations. Each involved some form of patient misidentification error that resulted in a cancer-free patient undergoing unnecessary breast removal surgery. Media coverage of these types of cases tends to focus on the patient who received some form of unnecessary treatment. While tragic for these patients, the reports seem to overlook a second and possibly more tragic victim - the patient WITH cancer who received delayed treatment or worse, no treatment at all.

]]> While the cancer-free patient was unnecessarily receiving treatment and/or undergoing surgery, the patient who needed treatment likely resumed life as normal believing she was cancer-free. Neither patient would know there had been a switching error until after the surgery when routine tests would reveal no cancer.

This delay in treatment could have numerous adverse effects on a patient. It could mean a more rigorous and potentially life threatening treatment plan since the cancer would have several months to advance. It could mean the cancer would have a chance to spread to other parts of the body. Or, it could have resulted in patient death that otherwise may have been avoided.

If a specimen security system, such as the know error® system, had been in place to confirm the positive biopsy result (or, in these cases, detect the switching errors), the tragic outcomes for both victims in these cases could have been averted. The know error® system utilizes DNA matching technology to confirm that a positive biopsy result belongs to the right patient before proceeding with treatment plans.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site www.knowerror.com.

"Lean" Protocol Reduces Lab Errors but Leaves Room for Improvement

2010-02-25T14:00:57Z

The January 2009 feature story of CAP TODAY, "Using Lean to End Labeling Errors," discussed the implementation of a bar-coding initiative at the surgical pathology lab at Henry Ford Health System. The program was considered a success reducing labeling problems by 85%, according to Dr. Mark Tuthill, director of pathology informatics.

The new "Lean" protocol involved bar-coding all patient-related materials - requisition form, tissue cassettes, specimen containers, and slides - all at the same time. Upon entering a patient into the system, the accessioner would print all of the bar codes for a particular patient. There were technological challenges with the bar-coding since linear bar codes couldn't be used. Tuthill partnered with General Data out of Cincinnati which had created a new cassette labeling system which could work in conjunction with the existing lab information system.

]]> Further improvements were made once the bar-coding system was up and running to provide an additional set of checks and balances. The additional steps required the accessioner to: 1) Scan the requisition form using an optical scanner, 2) Re-key patient name, medical case number, and surgical path case number, and 3) Confirm a match between the requisition label generated by the computer (with bar code label) and the one provided by the clinician (without bar code label).

The story discloses: "If the clinician has put the wrong patient identifiers on the requisition form, there's no way to catch it." As discussed in an earlier blog post, "18 Steps Between Your Biopsy and Your Biopsy Result," evaluation of a biopsy tissue specimen is an extremely complex process. There are numerous steps and individuals involved. Even with safeguards such as these implemented at the Henry Ford Health System, there is still room for human error. While these improvements have reduced labeling problems by 85%, that itself is proof that errors still find their way through even the smallest cracks in the system.

The know error® specimen security system is one way to ensure that errors, such as the switching of patient biopsies, undetected by quality assurance systems already in place do not remain undetected. Like the system at Henry Ford, the know error® system also employs a bar-coding system for the purpose of reducing errors; however, it is the DNA confirmation that prevents errors from resulting in an adverse patient outcome. The know error® system confirms a positive biopsy result by sending tissue from the biopsy and a separate tissue sample taken from the patient via a cheek swab to an independent forensics lab. The lab then matches the biopsy tissue sample with the reference sample from the patient. A match confirms the cancerous tissue sample belongs to the patient. If there is not a match, the process is halted prior to any surgery or cancer treatment taking place.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site at www.knowerror.com.

Korean Hospitals Held Liable in Case of Switched Patient Charts

2010-02-18T12:00:00Z

On August 12, 2009, an article published in The Korea Times revealed that two of Korea's top hospitals had been held liable in the case of a cancer-free woman, referred to as "Kim," who mistakenly had part of her right breast removed. In 2005, a tumor was found in Kim's right breast during a routine check-up. She had an ultrasound and biopsy to further examine the tumor; however, as the tests were being evaluated, the hospital mistakenly switched her chart with that of another patient. Based on the wrong patient's chart, she was diagnosed with cancer and it was recommended that she have part of her right breast removed. Upon seeking a second opinion, some simple tests were performed, but there was no second biopsy and the cancer diagnosis was confirmed based on the switched biopsy results.

]]> After the removal, routine post surgical tests revealed no cancer cells in the removed tissue. It was only AFTER the surgery that it was discovered that the patient charts had been switched. Initially, the court ruled that the hospital responsible for the switching error and the resulting cancer misdiagnosis was liable but the second hospital, where she received the second opinion and where the surgery was performed, was not. The court claimed that it was common not to conduct a second biopsy when giving a second opinion. However, this was overruled by Korea's high court and the second hospital was also found liable. The ruling found that since the patient had gone there for confirmation of her original diagnosis, the second hospital had an obligation to conduct an additional biopsy to verify the diagnosis.

Kim was awarded 51 million won or the equivalent of about $40,000.

It is precisely this type of error that can be avoided by the implementation of the know error® specimen security system, introduced by Diagnostic ID, LLC in 2009. The know error® system utilizes DNA matching to confirm positive biopsy results. Had this system been in place, the switched charts would have been discovered when a tissue sample from the positive biopsy was compared to a sample of the patient's DNA. The samples would not have matched thus detecting the switching prior to any adverse patient outcome.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site at www.knowerror.com.

Was Unneccessary Rectal Cancer Surgery Due to Biopsy Switching Error?

2010-02-09T15:33:37Z

An October 2009 report from The Australian revealed a medical mistake involving a Japanese man who was mistakenly diagnosed with rectal cancer and was given an artificial rectum. While the information on this case is quite limited, it appears to be similar to other cases we have covered in that post surgical tests revealed no cancer in the removed tissue. The man is suing the hospital for 35 million yen or approximately $415,000 in compensation.

]]> The source of the error is not revealed in the report; however, like the case of Scott Aprile, who had an unneccessary masectomy, it could have been due to a switching error where a patient's biopsy results are switched with those of another patient. If this type of error is not detected, it is often not until after an unnecessary surgical procedure that the mix-up is revealed.

Switching errors can be alleviated by the utilization of a specimen security system such as the know error® system, introduced by Diagnostic ID, LLC, in 2009. The know error® specimen security system uncovers patient identification errors by matching tissue from a positive biopsy result to a reference sample taken from a patient via a simple cheek swab to confirm that the tissue belongs to the patient. By peforming DNA matching prior to treatment, the know error® system assures that biopsy switching errors will be detected prior to any adverse patient outcomes.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site at www.knowerror.com.

Mix-up with Woman's Biopsy Resulted in Unneccessary Mastectomy for 28 Year Old Man

2010-02-01T15:00:00Z

In May 2009, media reports surfaced about a 28 year old man who mistakenly underwent a radical mastectomy only to find out a few months later that he never had cancer. Scott Aprile, a personal trainer from New York, received the devastating news that he had breast cancer in December of 2008. Just one month later, in January 2009, surgeons removed his right breast along with three lymph nodes. About two weeks after his surgery, Aprile was told that his biopsy had been switched with a woman's biopsy that had been performed the same day.

]]> Aprile is suing the hospital and the doctors who performed the unnecessary mastectomy. The hospital issued a statement claiming, among other things, "...[it] has put procedures in place to prevent such an occurrence in the future." This claim by the hospital raises questions since it would be nearly impossible to completely prevent such errors through procedural improvements. A study published in the Journal of Urology and conducted by Drs. John Pfeifer, Stephen Raab, and Eric Suba concluded: "Patient identification errors among prostate needle biopsies may be difficult to entirely prevent through optimization of work flow processes." The study further suggested that DNA confirmation of patient identification may be the only way to entirely prevent identification errors among all needle biopsies.

The know error® specimen security system, introduced by Diagnostic ID, LLC in 2009, employs DNA matching technology that can truly prevent patient identification errors before an adverse patient outcome. The know error®system matches tissue from a positive biopsy result to a reference sample taken from the patient via a simple cheek swab. The samples are then processed by a forensics lab that is completely independent of the pathology lab that evaluated the biopsy. In cases like Scott Aprile's, the know error®system detects when biopsies have been switched with another patient's and addresses the error prior to any cancer treatment or surgery taking place.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site at www.knowerror.com.

Eric J. Suba, John D. Pfeifer and Stephen S. Raab Patient Identification Error Among Prostate Needle Core Biopsy Specimens--Are We Ready for a DNA Time-Out? Journal of Urology Vol. 178, 1245-1248, October 2007

With DNA Matching, Second Opinions Don't Have to Mean Second Biopsies

2010-01-25T06:30:00Z

A recent blog post discussing second opinions focused on a theoretical patient who was misdiagnosed with cancer and was not helped by a second opinion since it was based on the original biopsy which had been mistakenly switched with another patient's biopsy results. This happened in the case of Darrie Eason, a 35-year old single mother who mistakenly had both breasts removed after a lab mix-up led to her cancer misdiagnosis. When appearing on Good Morning America and asked what could be learned from this, Eason, who herself sought a second opinion, responded "Maybe it's that second opinions are good but second biopsies are better."

]]> In some cases, second biopsies may be necessary when an original biopsy doesn't provide enough detail to make a conclusive diagnosis. However, why should a patient like Darrie Eason be subjected to a second biopsy when seeking a second opinion for the purpose of confirming that the original biopsy belonged to her? This raises many questions about the biopsy evaluation process. It is a complex process with numerous steps and individuals involved (click here for more information), and it is inevitable that errors will occur at some point in this process. Further, research shows that these errors cannot be eliminated by procedural improvements alone (click here for more information).

The know error® specimen security system, introduced in 2009 by Diagnostic ID, LLC, provides a solution to ensure second opinions do not have to mean second biopsies. The know error® system uncovers patient identification errors by matching tissue from a positive biopsy result to a reference sample taken from a patient via a simple cheek swab to confirm that the tissue belongs to the patient. By peforming DNA matching prior to treatment, the know error® system assures that biopsy switching errors will be detected prior to any adverse patient outcomes.

With the know error® system, a patient and her physician can rest assured that her diagnosis is based on her biopsy results for first AND second opinions. For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site at www.knowerror.com.

High Tech Error Reduction Methods Employed to Reduce Labeling Errors

2010-01-10T17:46:47Z

In an effort to reduce the number of labeling errors that may lead to the switching of biopsy tissue samples, a number of error reduction systems have been suggested and/or utilized in addition to quality assurance processes already in place. Detecting these errors is exceedingly important since the switching of a biopsy result may lead to serious consequences for the patients involved, such as the unnecessary treatment of a cancer-free patient or no treatment for a patient who has cancer and needs immediate treatment.

]]> One such error reduction method is the "inking" of specimens whereby at the time of grossing, each specimen is directly inked through the bag in one of 6 colors. The colors are always applied in the same sequence. The dissector writes the color used on the original requisition slip and dictates the color for the gross description. Each block is then routinely processed and entirely sectioned to produce at least 5 slides and 2 levels per slide. When the slides from the cases are reviewed, the pathologist compares the color of the ink in the tissue with that written in the gross description.[1]

Another error reduction method is suggested by the Mayo Clinic. Mindful of the importance of reducing identity errors and the potential for adverse consequences, the Mayo Clinic recently adopted radio frequency technology in their GI lab in Rochester, MN in an effort to determine and reduce the incidents of identification errors. An article published on the web site www.endonurse.com in October of 2007 discusses a study on this topic conducted by the Mayo Clinic.

Per the Mayo Clinic study, in Q1 of 2008 AFTER implementing an error reduction program (i.e. state of the art RFID), 47 errors were still made! Since errors can still occur even after implementation of an "error reduction system," patients remain exposed to the risk of a biopsy switching error resulting in over-treatment/under-treatment, and the hospital/physician reputation is also put at risk.

A "safer" system might be to implement an "error reduction program" (e.g. bar coding, RFID, inking) AND take steps to prevent adverse patient outcomes. There have been many published reports which have advocated the use of DNA "fingerprinting" to catch those errors which are undetected by existing quality systems. One such system is the know error® specimen security system available from Diagnostic ID, LLC.

The know error® system employs both bar-coding AND forensic DNA confirmation in a process which, when adopted by pathology labs and their referring physicians, can reduce switching errors and assure that no adverse patient outcomes will occur from otherwise undetected misidentifications.

To learn more about the know error® specimen security system, visit www.knowerror.com.

[1] Andrew A. Renshaw, MD, Richard Kish, MHS, and Edwin W. Gould, MD The Value of Inking Breast Cores to Reduce Specimen Mix-up

Second Opinions Don't Protect Patients From Switched Biopsy Results

2009-11-23T16:06:21Z

After receiving the life changing diagnosis of cancer, some physicians may encourage a patient to seek a second opinion. Friends and family would most certainly insist on this; perhaps even go to the lengths of seeking out an expert in the field or a world-class hospital that specializes in a particular type of cancer.

In most cases, the purpose of the second "opinion" is to verify the cancer diagnosis and more importantly, to validate the treatment plan suggested by the first physician. For instance, if a patient seeks the second opinion of a physician taking part in a clinical study, the approach to treatment may be drastically different. After gaining both opinions, it is then up to the patient to compare both opinions and determine which approach is right for him.

However, what if the problem to be found had nothing to do with the diagnosis but rather the fact that the diagnosis was based on the wrong patient's biopsy results? In other words, a cancer free patient's results were switched with the results of a patient who had cancer (click here to read about such a switching error). In this case, a second opinion (or third or fourth) would do nothing to protect the patient. Unless a second biopsy was ordered by the physician offering the second opinion, this switching error would very likely remain undetected. At that point, a cancer free patient may have undergone an unneccessary surgery such as a double masectomy or prostatecomy.

The know error® specimen security system, introduced in 2009 by Diagnostic ID, LLC, employs a DNA matching technology that provides DNA confirmation of a positive biopsy result. With the know error® system in place, patients and physicians alike are ensured that the first opinion and any given thereafter are based on the right biopsy results.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site at www.knowerror.com.

Lab Mix-Up Results in Another Unneccessary Surgery

2009-11-16T18:32:12Z

A Newsday article published on November 11, 2009, revealed another biopsy switching error that resulted in an unnecessary lumpectomy and removal of lymph nodes. In this case, the patient was 35 year-old Janelle Trenchfield who has filed a negligence lawsuit against the medical facility where her surgery was performed.

As with cases previously covered by this blog, Trenchfield didn't find out she was cancer-free until AFTER the surgery when routine post surgical tests showed the tissue samples from the surgery were negative for cancer. Her biopsy lab results had been switched after a label with her name was attached to another patient's tissue samples. Additionally, in this case, the error was also attributed to "human error and procedural issues." A hospital spokesman claimed, "All procedures for the handling and labeling of tissue samples were immediately revised."

In each of the cases we have covered, revising or improving procedures appears to be the common solution proposed to solve these patient misidentification errors. While procedural improvements can serve to reduce the number of errors that occur, a study* published in the Journal of Urology suggested that these types of errors likely cannot be eliminated through procedural improvements alone. Additionally, the study proposed these types of errors may be entirely eliminated with the use of DNA matching prior to any treatment taking place.

The know error® specimen security system, introduced in 2009 by Diagnostic ID, LLC, provides a solution to finding biopsy identity switches by incorporating both an error reduction system and DNA fingerprinting technology. The know error® system employs patient-specific bar-coding for the purpose of reducing errors and forensic DNA fingerprinting for the purpose of preventing errors that may result in an adverse patient outcome.

The know error® system uncovers patient identification errors by matching tissue from a positive biopsy result to a reference sample taken from the patient via a simple cheek swab to confirm that the tissue belongs to the patient. By performing DNA matching PRIOR to treatment, the know error® specimen security system assures that biopsy switching errors will be detected prior to any unnecessary surgery or treatment.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site at www.knowerror.com.

* Eric J. Suba, John D. Pfeifer and Stephen S. Raab Patient Identification Error Among Prostate Needle Core Biopsy Specimens--Are We Ready for a DNA Time-Out? Journal of Urology Vol. 178, 1245-1248, October 2007

Video overview of the know error® system

2009-11-05T17:25:41Z

A new video overview of the know error® specimen security system has been created and can be viewed online at www.knowerror.com/video. The video illustrates the three key elements that make up the know error® system process: swab. sample. dna match.

swab. Before a biopsy procedure, a reference sample of a patient's DNA is taken by gently swabbing the inside of his cheek. The swab is sent to an independent forensic DNA lab with the patient's unique patient ID.

sample. The unique bar code is attached to the patient's file along with all other materials in the biopsy kit.

dna match. When a patient's pathology result is positive for cancer, all positive specimens are sent to the DNA lab for DNA matching with the reference sample.

By confirming a DNA match, patients and physicians can confidently proceed with treatment options based on the patient's lab results. When adopted by pathology labs and their referring physicians, the know error® system can reduce switching errors and assure that no adverse patient outcomes will occur from otherwise undetected misidentifications.

The know error® specimen security system, introduced in 2009 by Diagnostic ID, LLC, represents an important innovation in the process of evaluating biopsies. By providing DNA identity confirmation of positive biopsies, the know error® system virtually eliminates the possibility that a misidentification error will result in an adverse patient outcome.

The know error® system to be featured at the 2009 LUGPA Forum

2009-10-28T16:15:01Z

The know error® specimen security system is being showcased at the Annual Meeting of the Large Urology Group Practice Association (LUGPA). The meeting is being held November 6-7, 2009, at the Drake Hotel in Chicago, IL. For more information on this meeting, visit www.lugpa.org.

]]> The know error® specimen security system, introduced in 2009 by Diagnostic ID, LLC, provides a solution to finding biopsy identity switches by incorporating both an error reduction system and DNA fingerprinting technology. The know error® system employs patient-specific bar-coding for the purpose of reducing errors and forensic DNA fingerprinting for the purpose of preventing errors from resulting in adverse patient outcomes.

The know error® system uncovers patient identification errors by matching tissue from a positive biopsy result to a reference sample taken from the patient via a simple cheek swab to confirm that the tissue belongs to the patient. By performing DNA matching prior to treatment, the know error® specimen security system assures that biopsy switching errors will be detected prior to any adverse patient outcomes.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site at www.knowerror.com.

The know error® system to be featured this week at the South Central Section of AUA's Annual Meeting

2009-10-13T16:14:17Z

The know error® specimen security system is being showcased this week at the Annual Meeting of the South Central Section of the American Urological Association (AUA). The meeting is being held October 14-17, 2009, at the Camelback Inn, JW Marriott Resort, in Scottsdale, Arizona. Look for us at Booth #151 in the exhibit hall.

The know error® specimen security system, introduced in 2009 by Diagnostic ID, LLC, provides a solution to finding biopsy identity switches by incorporating both an error reduction system and DNA fingerprinting technology. The know error® system employs patient-specific bar-coding for the purpose of reducing errors and forensic DNA fingerprinting for the purpose of preventing errors.

The know error® system uncovers patient identification errors by matching tissue from a positive biopsy result to a reference sample taken from the patient via a simple cheek swab to confirm that the tissue belongs to the patient. By performing DNA matching prior to treatment, the know error® specimen security system assures that biopsy switching errors will be detected prior to any adverse patient outcomes.

For more information about the know error® specimen security system with unique patient code and DNA confirmation, please visit our web site at www.knowerror.com.