The federal government’s Department of Homeland Security recognized the public safety threat caused by the Southern Nevada Health District’s lack of a nearby facility capable of identifying biological agents. Through the Defense Appropriations Bill of 2002, funds were directed to set up the Southern Nevada Public Health Lab, which would serve as the area’s LRN lab and provide a branch laboratory of the State Laboratory in Reno, in operation since 1962.
SNPHL was to be designated a Reference Lab (like most public health laboratories in the network), tasked with analyzing samples identified as suspicious by hospital laboratories (Sentinel Labs). To become part of the network, SNPHL had to demonstrate testing accuracy, trained personnel, properly designed facilities, and appropriate equipment. In other words, the laboratory needed to prove its ability to generate quality test results.
The monies set forth by the Department of Homeland Security allowed SNPHL to purchase state-of-the-art laboratory equipment to effectively meet CDC requirements and generate accurate test results. Because testing these samples often requires rapid pipetting of very small volumes, the ability to verify liquid handling instrumentation performance at minute volumes was critical. To calibrate its pipette population consisting of six multichannel and 54 single channel instruments, some contained to cleanroom environments, SNPHL managers sought a pipette calibration solution that was fast, easy to use onsite, and capable of microliter measurement. This led SNPHL to Ratiometric Photometry technology, which measures the absorbance of light by two proprietary colorimetric reagents to combat problems associated with low-volume measurement.
SNPHL must also comply with the Clinical Laboratory Improvement Amendments (CLIA) used to accredit clinical laboratories, which mandates the maintenance of a regular pipette calibration program and documentation of results. Compliance is facilitated by the automated documentation provided by SNPHL’s liquid delivery quality assurance program.
Certification, however, is not a one-shot deal. To maintain its status as a LRN and CLIA-certified lab, SNPHL undergoes continual proficiency testing. During these evaluations, samples assessed by the laboratory are sent out for analysis. The laboratory’s test results are compared against known correct results to verify if its testing mechanisms are accurate and precise. Regular assurance of pipetting technique and objective performance of the pipettes are necessary to meet these standards.
A technician at the Southern Nevada Public Health Laboratory uses ARTEL's PCS to verify the
performance of pipettes.
NO ROOM FOR ERROR
Given the small window of time allotted for analysis of potentially harmful samples and the irreplaceability of many samples, SNPHL cannot risk incorrect test results.
To illustrate this point, consider the United States Postal Service, a victim of past anthrax attacks. Due to these attacks, the USPS continually monitors its air quality to detect the presence of biological agents. Samples identified as potentially dangerous are sent to LRN labs for analysis and results are expected in four hours. After this time period, the lack of definitive results will cause a media frenzy and spark public anxiety about the potential health crisis.
Having accurate pipettes that you can count on is important for the SNPHL, since the four-hour expected turnaround provides just enough time to complete sample testing. If liquid delivery device performance is questionable, repeat tests would be required, and this would cause delays, panic, and, in the event of a real emergency, loss of precious time. And with real bioterrorism attacks, every minute counts. The longer it takes to identify the presence and cause of an outbreak, the more people fall ill without doctors knowing why. For tourism-dependent Las Vegas, this would be devastating.