Escolar Documentos
Profissional Documentos
Cultura Documentos
Service Manual
Artisan Pharma, Inc.
Protocol: 2-001
Covance Project Number : 510013
Manual Created : 5 June, 2007
Indianapolis
8211 SciCor Drive
Indianapolis
IN 46214-2985 USA
Tel. (317) 271-1200 (local calls)
Fax: (317) 273-4030
Singapore
1 International Business Park, #05-12A/B
The Synergy, Singapore 609917
Tel. 65-6560-8793 Fax. 65-6565-5901
Sydney
95-99 Epping Road, Macquarie Park
NSW 2113 Australia
Tel. (02) 9855-5410 Fax. (02) 9855-5419
www.covance.com
Laboratory regulatory certifications available
on Covance website
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510013_TMEA_Printed: 20070606
Geneva
Rue Mose-Marcinhes 7
1217 Meyrin/Geneva-CH
Tel. +41 22-989-7000 Fax. +41 22-989-1999
Cape Town
DSP Global Clinical Trials
PathCare Business Centre, PathCare Park
Neels Bothma Street, N1 City, Goodwood 7460
Tel: +27 21 596 3730
Fax: +27 21 596 3713
TABLE OF CONTENTS
Schedule Visit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 1
Kit Information
Stabilities
Holiday Considerations/Customs Closures
Collect Samples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 2
Visit Test Schedule
Analytes by Groups
Specimen Collection Procedures
Coagulation Testing
Blood Smear Preparation
Draw Tube Adapter Procedures
Instructions for Completing Requisition Forms
Project Specific Requisition Forms
Pack and Ship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 3
General Information
Courier Contact Numbers
Dangerous Goods Training Information
Packaging and Shipping of Samples
Resupply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 4
General Information - Supply/Resupply
Additional Kits/Material Reorder Form
Get Result . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 5
Reference Ranges/Alerts and Flags
Project Specific Reference Ranges and/or Alerts and Flags
Get Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 6
Covance CLS Customer Service Contact Numbers
Laboratory Certifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 7
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 8
Archived Pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 9
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 10
Disclaimer:
The Created Version Date and the Revised Version Date on the cover of the manual refer to either the original publication of the manual
or the customer requested changes to the protocol specific pages. The dates on the Covance standard pages are not necessarily
representative of the Revised Version Date, as the updates of these pages are due to Covance internal changes or regulatory changes,
which can occur at anytime.
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510013_TMEA_Printed: 20070606
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510013_TMEA_Printed: 20070606
KIT INFORMATION
Kits are protocol, investigator and visit specific.
Select the correct kit accordingly.
0001
and/or
A-B
Y005
Bulk Supplies
A standard bag, containing the items most frequently used in clinical trials is provided in the initial supplies.
Depending on your protocol, additional items may be provided. For some studies, no bulk supply is provided.
2003 Covance CLS
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Analyte
Chemistry Group
Total Bilirubin
Alkaline Phosphatase
LDH
GGT
ALT (SGPT)
AST (SGOT)
Urea Nitrogen
Creatinine
Uric Acid
Phosphorus
Calcium
Glucose
Total Protein
Albumin
CK
Hours
72
120
120
120
72
72
120
120
120
120
120
72
120
72
72
Days
3
5
5
5
3
3
5
5
5
5
5
3
5
3
3
Electrolytes
Sodium
Potassium
Bicarbonate
Chloride
Magnesium
120
120
72
120
120
5
5
3
5
5
Lipids
Triglycerides
Cholesterol
HDL Cholesterol
LDL Cholesterol
120
120
120
120
5
5
5
5
Hours
Days
Urinalysis
Color
Clarity
Specific Gravity
pH
Protein
Glucose
Ketones
Bilirubin
Urobilinogen
Blood
Nitrite
Leukocyte Esterase
Microscopic
96
96
96
96
96
96
96
96
96
96
96
96
96
4
4
4
4
4
4
4
4
4
4
4
4
4
Hematology
Hemoglobin
Hematocrit
RBC
MCV
MCH
MCHC
WBC
Neutrophils
Bands
Lymphocytes
Monocytes
Eosinophils
Basophils
Platelets
Morphology
72
60
72
60
72
60
72
72
72
72
72
72
72
72
72
3
2.5
3
2.5
3
2.5
3
3
3
3
3
3
3
3
3
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510013_TMEA_Printed: 20070606
Analyte
!
Important considerations
Local courier service (pickup and delivery) may be limited prior to, during and following observed
holidays in the country you are shipping specimens to. It is imperative that you check local service
schedules in advance of the holiday. Listed below are important considerations when planning your
patient visits during the holidays.
- Your courier service reserves the right to observe earlier than usual pick-up times during the
holidays. Call your courier service for local pick-up schedules.
- During the December holidays, schedule your pickups in advance of the holiday where possible.
- Call early in the day to schedule your pickup.
- When a holiday is observed on Monday, avoid laboratory collections on the preceding Saturday (e.g.
Labor Day).
- Frozen specimens should NOT be shipped on the day before the observed holiday. Send frozen
specimens on the next available business day.
- If shipping specimens on Friday, mark airbill for Saturday delivery.
- Specimens with short stabilities (eg. lymphocyte subsets, reticulocyte counts, etc.) should not be
collected on the day prior to the holiday.
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US, Canada, Puerto Rico and Latin America (specimens sent to Indianapolis)
2006
2007
2008
1 January
29 May
4 July
4 September
23 November
24 November *
25 December
1 January
28 May
4 July
3 September
22 November
23 November *
25 December
1 January
26 May
4 July
1 September
27 November
28 November *
25 December
2007
2008
1 January
14 April
17 April
25 May
5 June
1 August
7 September
24 December
25 December
31 December
1 January
6 April
9 April
17 May
28 May
1 August
6 September
24 December
25 December
31 December
1 January
21 March
24 March
1 May
12 May
1 August
11 September
24 December
25 December
31 December
Please check also your local holidays, they could cause delays.
For sites with 24 hours delivery time to Geneva, do not schedule any shipment 24 hours before one of
these dates.
For sites with 48 hours delivery time to Geneva, do not schedule any shipment 48 hours before one of
these dates.
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2007
1 January
2 January
10 January
29 January
30 January
31 January
14 April
1 May
12 May
9 August
21 October
24 October
25 December
31 December
1 January
2 January
18 February
19 February
20 February
6 April
1 May
31 May
9 August
13 October
8 November
20 December
25 December
-
2007
2008
1 January
2 January
26 January
14 April
15 April
17 April
25 April
12 June
2 October
25 December
26 December
1 January
26 January
6 April
7 April
9 April
25 April
11 June
1 October
25 December
26 December
1 January
26 January
21 March
22 March
24 March
25 April
9 June
6 October
25 December
26 December
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VISIT Baseline
OCCURRENCE Day 0
TEST GROUPS
Hematology & Differential Panel
Hematology II
Chemistry Panel
INR
D-Dimer
Fibrinogen
Specimen Management
SMI/ART-123 Ab
SMII/ART-123 Concentration
DMI/Exploratory (Citrate)
DMII/Exploratory (EDTA)
DMIII/Thrombomodulin Level
Day 1
Day 3
Day 3
Day
Early
Day 7 Day 14
Retest
Post Dose Pre Dose Post Dose
28/EOS Termination
Day 1
Day 3
Day 3 Day 7 Day 14 Day 28
N/A
N/A
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
O
O
O
X
X
X
X
X
X
X
X
X
X
X
X
X
O
O
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
O
O
O
O
O
O
O
O
O
O
O
X Mandatory testing
O Optional testing
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CHEMISTRY PANEL
Total Bilirubin
Alkaline Phosphatase
ALT (SGPT)
AST (SGOT)
LDH
Urea Nitrogen
Creatinine
Glucose
Calcium
Sodium
Potassium
Bicarbonate
Chloride
INR
Prothrombin Time
International Normalized Ratio
(Non-Anticoag Calculation)
D-DIMER
D-Dimer (enzyme immunoassay)
FIBRINOGEN
SMI/ART-123 AB
HEMATOLOGY II
Platelets
SMII/ART-123 CONCENTRATION
DMII/EXPLORATORY (EDTA)
PCI
C5a (anaphylatoxin)
DMIII/THROMBOMODULIN LEVEL
Thrombomodulin Level
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510013_TMEA_Printed: 20070606
Covance
containers
code
Vacutainer
collection
containers
Equivalent
Monovette
if applicable
Shipping
temperature
Shipping
frequency
SERUM
Chemistry Panel
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with
the clotting activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes
(tube standing upright). Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated
by a well-formed polymer barrier. Use pipette provided to transfer all the serum into the 5 ml plastic vial labelled
CHEMISTRY.
Day of
collection
Ambient
1500
0.00001118(10)
F
0.00001118(R)
N= 3663 rpm
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510013_TMEA_Printed: 20070606
N=
N=
Covance
containers
code
Vacutainer
collection
containers
Equivalent
Monovette
if applicable
Shipping
temperature
Shipping
frequency
SERUM
SMI/ART-123 Ab
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood
with the clotting activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes
(tube standing upright). Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated
by a well-formed polymer barrier. Use pipette provided to transfer all the serum into the plastic vial labelled
SMI/ART-123 AB FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of
collection.
Frozen
Day of
collection
PLASMA
INR - D-Dimer - Fibrinogen
One 4.5 ml blue top sodium citrate tube. Fill tube completely. Mix immediately by gently inverting the tube at
least 8 to 10 times. Centrifuge at a minimum of 1500 x g for 15 minutes until cells and plasma are well
separated. Use pipette provided to transfer the plasma equally into the 3 ml plastic vial labelled
INR/FIBRINOGEN FROZEN and the 5 ml plastic vial labelled D-DIMER FROZEN. Freeze immediately at
20C or -70C until shipment.
Frozen
Day of
collection
SMII/ART-123 Concentration
One 6 ml green top sodium heparin tube. Mix immediately by inverting tube 10 to 15 times. Centrifuge
immediately at 1500 x g for 10 to 15 minutes. Use the enclosed pipette to transfer the plasma into the plastic
vial labelled SMII/ART-123 CONC FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance
on day of collection.
Frozen
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510013_TMEA_Printed: 20070606
Day of
collection
Covance
containers
code
Vacutainer
collection
containers
Equivalent
Monovette
if applicable
Shipping
temperature
Shipping
frequency
PLASMA
DMI/Exploratory (Citrate) - DMIII/Thrombomodulin Level (if applicable)
Two (2) 4.5 ml blue top sodium citrate tubes. Fill tubes completely. Mix immediately by gently inverting the
tubes at least 8 to 10 times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well
separated. Use pipette provided to transfer all the plasma from both tubes equally into the 8 plastic vials
labelled EXPLOR (CITRATE) FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day
of collection.
Frozen
Day of
collection
DMII/Exploratory (EDTA)
One (1) 4.0 ml lavendar top EDTA tube. Fill tube completely. Mix immediately by gently inverting the tube at
least 8 to 10 times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well
separated. Use pipette provided to transfer all the plasma into the 4 plastic vials labelled EXPLOR (EDTA)
FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
Frozen
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510013_TMEA_Printed: 20070606
Day of
collection
Covance
containers
code
Vacutainer
collection
containers
Equivalent
Monovette
if applicable
Shipping
temperature
Shipping
frequency
WHOLE BLOOD
Hematology & Differential Panel
or
Hematology II
Draw whole blood samples last except when collecting coagulation group at the same visit.
One 3 ml lavender top tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10
times.
Make blood smears with blood from the lavender top tube using the Diff-Safe dispenser. Make two slides.
Allow to air dry and place in blue slide mailer.
Do not forget to ship the tube after using it for the hematology slides.
Ambient
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510013_TMEA_Printed: 20070606
Day of
collection
Plasma
Special care is needed for collecting and handling blood samples intended for
coagulation testing. If sample clotting or hemolysis occurs during specimen
collection or the aliquot is contaminated with platelets from the plasma cell interface
that is created by centrifugation, the test result will be invalid.
Check the expiration date on all collection tubes. If the tube has expired, obtain a fresh tube
from your site's supplies. Place an extra Covance label from the kit on the tube and write the
test name on the label.
Blood Collection Precautions
Optimal blood specimens for coagulation testing are obtained by venipuncture using a blood
collection system that collects the specimen directly into a tube containing the
anticoagulant.
Blood samples that are collected using a winged blood collection set (butterfly needle) have
a longer path between the vein and the anticoagulant and are at higher risk of clot formation
and invalid results.
Blood samples should not be collected using a syringe due to the increased risk of that the
sample may clot or hemolyze.
Use of a vascular device (VAD) is not recommended for coagulation blood sample
collections. Blood samples collected from a vascular device (VAD) are at risk of sample
dilution with flush (saline/heparin) or infusion fluids, hemolysis and a significant increased
risk of a clotted sample.
Page: 16
510013_TMEA_Printed: 20070606
Please make sure that all screw caps are tightly secured!
Plasma
Methods for Obtaining Blood Specimens for Coagulation Testing
Venipuncture: If multiple collection tubes are being filled, draw the citrate tube last. If the citrate is the first tube
drawn, a discard tube should be drawn first. Mix the blood with the additive thoroughly by gentle inversion 8
to10 times.
Blood Collection from a vascular access device (VAD) such as a central Line or an indwelling catheter:
withdraw and discard at least 2 mL of blood. Draw the citrate tube first, immediately mixing well the additive
and the blood by gentle inversion 8 to 10 times.
Note: tube should be completely filled by the vacuum in order to obtain the correct ratio of
blood to anticoagulant. Inadequate filling of the collection tube will decrease this ratio, and
will lead to inaccurate results.
1. Centrifuge the citrate tube within 30 minutes after draw. A centrifuge with a swing-out bucket rotor is
recommended. Do not refrigerate the blood prior to centrifugation.
2. Centrifuge the citrate tube at a minimum of 1500 g for at least 15 minutes. Centrifugation at lower speeds
for longer times is not acceptable.
3. Allow the centrifuge to stop without using the braking mechanism.
4. Immediately and carefully remove the citrate tube from the centrifuge, taking care not to knock or invert the
tube. You must not disturb the plasma/cell interface. Place the tube into a rack to allow it to stand upright.
5. Carefully remove the tube stopper and, using a fresh pipette, remove the plasma and place the plasma into
the labeled Covance transport tube.
Note: use the Covance-supplied pipette. Do not use the same pipette as used for separation
of serum. Hold the tube up to a strong light so that you can see the plasma/cell interface
clearly. You may see a hazy layer above the blood cells. This hazy layer contains platelets. Do
NOT place the pipette into this layer or touch the layer with the pipette. Do NOT aspirate any
of this layer.
6. After placing the separated plasma into the Covance transport tube, check to be sure that the transport tube
is labeled with the patient identification (initials or patient ID number).
7. Secure the screw cap lid(s).
8. Discard draw tube. Do NOT send back to Covance.
9. Immediately place the plasma into a -20C or -70C freezer. Ship the frozen plasma to Covance on dry ice
as directed in your protocol.
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510013_TMEA_Printed: 20070606
3. Turn the tube upside down and press the DiffSafe dispenser against the slide, 0.5 cm from
the frosted end. Discontinue pressure the
instant the drop appears.
5.
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BD, BD Logo and Eclipse are trademarks of Becton, Dickinson and Company. 2002 BD.
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510013_TMEA_Printed: 20070606
BD Vacutainer Systems
Preanalytical Solutions
1 Becton Drive
Franklin Lakes, NJ 07417
@
!
Please complete all the required information with a black ball point pen. This information is required
for patient identification and result reporting.
Any errors or missing details with regard to patient demographics will cause a delay in the
reporting of the results until information is verified!
Send the white copy of the completed requisition form together with the relevant samples to Covance Central
Laboratory Services
1. Patient number
1. Patient initials (if applicable)
2. Birthdate
2. Check the appropriate box
3. Specimen collection date
3. Specimen collection time
Check the appropriate box
(if applicable to your site)
GENERIC
REQUISITION
FORM
Page: 21
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
VISIT: BASELINE
Randomization #
Page 1 of 2
2-part
Covance
internal
use
ONLY
Employee Visa
Site #
Pt #
Subject Initials
Kit #
First
Middle
Family/Last
Birthdate
Day
Month
Sex
Male
Female
Collection Date
Day
Month
Year
Year
Collection Time
24 Hour Clock
Requisition Completed by
Full name in capital letters
Tube Count
Samples Collected by
Full name in capital letters
Ambient=
Phone number
Of the person completing the
requisition
Frozen=
All DIC and coagulation tests taken for the purposes of this study must be taken from an
original stick or venipuncture. All other blood tests may be taken from an existing port or line.
To avoid clotting cancellations, a small amount of blood must be collected from the
venipuncture site before the blood is drawn into the sodium citrate blue top tube.
Refrig=
Slides=
Validation
YES
NO
First Entry
Second Entry
Comments:
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
510013
Af 070605
Page: 22
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Page 2 of 2
2-part
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED AMBIENT DAY OF COLLECTION:
Chemistry Panel
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the 5 ml plastic vial labelled CHEMISTRY.
Hematology & Differential Panel
Draw whole blood samples last except when collecting coagulation group at the same visit.
One 3 ml lavender top tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Make blood smears with blood from the lavender top tube using the Diff-Safe dispenser. Make two slides. Allow to air dry and
place in blue slide mailer.
Do not forget to ship the tube after using it for the hematology slides.
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF COLLECTION:
INR - D-Dimer - Fibrinogen
One 4.5 ml blue top sodium citrate tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 1500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer the
plasma equally into the 3 ml plastic vial labelled INR/FIBRINOGEN FROZEN and the 5 ml plastic vial labelled D-DIMER
FROZEN. Freeze immediately at 20C or -70C until shipment.
SMI/ART-123 Ab
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the plastic vial labelled SMI/ART-123 AB FROZEN. FREEZE IMMEDIATELY on
dry ice and ship frozen to Covance on day of collection.
DMI/Exploratory (Citrate) - DMIII/Thrombomodulin Level
Two (2) 4.5 ml blue top sodium citrate tubes. Fill tubes completely. Mix immediately by gently inverting the tubes at least 8 to 10
times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to
transfer all the plasma from both tubes equally into the 8 plastic vials labelled EXPLOR (CITRATE) FROZEN. FREEZE
IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
DMII/Exploratory (EDTA)
One (1) 4.0 ml lavendar top EDTA tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer all
the plasma into the 4 plastic vials labelled EXPLOR (EDTA) FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to
Covance on day of collection.
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
1 510013
Af 070605
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510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Randomization #
Page 1 of 2
2-part
Covance
internal
use
ONLY
Employee Visa
Site #
Pt #
Subject Initials
Kit #
First
Middle
Family/Last
Birthdate
Day
Month
Sex
Male
Female
Collection Date
Day
Month
Year
Year
Collection Time
24 Hour Clock
Requisition Completed by
Full name in capital letters
Tube Count
Samples Collected by
Full name in capital letters
Ambient=
Phone number
Of the person completing the
requisition
Frozen=
All DIC and coagulation tests taken for the purposes of this study must be taken from an
original stick or venipuncture. All other blood tests may be taken from an existing port or line.
To avoid clotting cancellations, a small amount of blood must be collected from the
venipuncture site before the blood is drawn into the sodium citrate blue top tube.
Refrig=
Slides=
Specimens to be collected 12 hours (plus or minus 1 hour) after the first dose of study drug.
Was the DIC/Coagulation testing collected from
an original stick/venipuncture?
Validation
YES
NO
First Entry
Second Entry
Comments:
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
510013
Af 070605
Page: 24
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Page 2 of 2
2-part
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED AMBIENT DAY OF COLLECTION:
Hematology II
Draw whole blood samples last except when collecting coagulation group at the same visit.
One 3 ml lavender top tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Make blood smears with blood from the lavender top tube using the Diff-Safe dispenser. Make two slides. Allow to air dry and
place in blue slide mailer.
Do not forget to ship the tube after using it for the hematology slides.
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF COLLECTION:
INR - D-Dimer - Fibrinogen
One 4.5 ml blue top sodium citrate tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 1500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer the
plasma equally into the 3 ml plastic vial labelled INR/FIBRINOGEN FROZEN and the 5 ml plastic vial labelled D-DIMER
FROZEN. Freeze immediately at 20C or -70C until shipment.
DMI/Exploratory (Citrate)
Two (2) 4.5 ml blue top sodium citrate tubes. Fill tubes completely. Mix immediately by gently inverting the tubes at least 8 to 10
times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to
transfer all the plasma from both tubes equally into the 8 plastic vials labelled EXPLOR (CITRATE) FROZEN. FREEZE
IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
DMII/Exploratory (EDTA)
One (1) 4.0 ml lavendar top EDTA tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer all
the plasma into the 4 plastic vials labelled EXPLOR (EDTA) FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to
Covance on day of collection.
SMII/ART-123 Concentration
One 6 ml green top sodium heparin tube. Mix immediately by inverting tube 10 to 15 times. Centrifuge immediately at 1500 x g
for 10 to 15 minutes. Use the enclosed pipette to transfer the plasma into the plastic vial labelled SMII/ART-123 CONC
FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
2 510013
Af 070605
Page: 25
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Randomization #
Page 1 of 2
2-part
Covance
internal
use
ONLY
Employee Visa
Site #
Pt #
Subject Initials
Kit #
First
Middle
Family/Last
Collection Date
Day
Month
Year
Collection Time
24 Hour Clock
Requisition Completed by
Full name in capital letters
Samples Collected by
Full name in capital letters
Phone number
Tube Count
Ambient=
All DIC and coagulation tests taken for the purposes of this study must be taken from an
original stick or venipuncture. All other blood tests may be taken from an existing port or line.
To avoid clotting cancellations, a small amount of blood must be collected from the
venipuncture site before the blood is drawn into the sodium citrate blue top tube.
Frozen=
Refrig=
Slides=
YES
NO
Validation
First Entry
Second Entry
Comments:
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
510013
Af 070605
Page: 26
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Page 2 of 2
2-part
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED AMBIENT DAY OF COLLECTION:
Chemistry Panel
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the 5 ml plastic vial labelled CHEMISTRY.
Hematology & Differential Panel
Draw whole blood samples last except when collecting coagulation group at the same visit.
One 3 ml lavender top tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Make blood smears with blood from the lavender top tube using the Diff-Safe dispenser. Make two slides. Allow to air dry and
place in blue slide mailer.
Do not forget to ship the tube after using it for the hematology slides.
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF COLLECTION:
INR - D-Dimer - Fibrinogen
One 4.5 ml blue top sodium citrate tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 1500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer the
plasma equally into the 3 ml plastic vial labelled INR/FIBRINOGEN FROZEN and the 5 ml plastic vial labelled D-DIMER
FROZEN. Freeze immediately at 20C or -70C until shipment.
DMI/Exploratory (Citrate)
Two (2) 4.5 ml blue top sodium citrate tubes. Fill tubes completely. Mix immediately by gently inverting the tubes at least 8 to 10
times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to
transfer all the plasma from both tubes equally into the 8 plastic vials labelled EXPLOR (CITRATE) FROZEN. FREEZE
IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
DMII/Exploratory (EDTA)
One (1) 4.0 ml lavendar top EDTA tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer all
the plasma into the 4 plastic vials labelled EXPLOR (EDTA) FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to
Covance on day of collection.
SMII/ART-123 Concentration
One 6 ml green top sodium heparin tube. Mix immediately by inverting tube 10 to 15 times. Centrifuge immediately at 1500 x g
for 10 to 15 minutes. Use the enclosed pipette to transfer the plasma into the plastic vial labelled SMII/ART-123 CONC
FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
3 510013
Af 070605
Page: 27
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Randomization #
Page 1 of 2
2-part
Covance
internal
use
ONLY
Employee Visa
Site #
Pt #
Subject Initials
Kit #
First
Middle
Family/Last
Collection Date
Day
Month
Year
Collection Time
24 Hour Clock
Requisition Completed by
Full name in capital letters
Samples Collected by
Full name in capital letters
Phone number
Tube Count
Ambient=
All DIC and coagulation tests taken for the purposes of this study must be taken from an
original stick or venipuncture. All other blood tests may be taken from an existing port or line.
To avoid clotting cancellations, a small amount of blood must be collected from the
venipuncture site before the blood is drawn into the sodium citrate blue top tube.
Frozen=
Refrig=
Specimens to be collected 12 hours (plus or minus 1 hour) after the third dose of study drug.
Slides=
YES
NO
Validation
First Entry
Second Entry
Comments:
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
510013
Af 070605
Page: 28
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Page 2 of 2
2-part
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED AMBIENT DAY OF COLLECTION:
Hematology II
Draw whole blood samples last except when collecting coagulation group at the same visit.
One 3 ml lavender top tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Make blood smears with blood from the lavender top tube using the Diff-Safe dispenser. Make two slides. Allow to air dry and
place in blue slide mailer.
Do not forget to ship the tube after using it for the hematology slides.
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF COLLECTION:
INR - D-Dimer - Fibrinogen
One 4.5 ml blue top sodium citrate tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 1500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer the
plasma equally into the 3 ml plastic vial labelled INR/FIBRINOGEN FROZEN and the 5 ml plastic vial labelled D-DIMER
FROZEN. Freeze immediately at 20C or -70C until shipment.
DMI/Exploratory (Citrate)
Two (2) 4.5 ml blue top sodium citrate tubes. Fill tubes completely. Mix immediately by gently inverting the tubes at least 8 to 10
times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to
transfer all the plasma from both tubes equally into the 8 plastic vials labelled EXPLOR (CITRATE) FROZEN. FREEZE
IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
DMII/Exploratory (EDTA)
One (1) 4.0 ml lavendar top EDTA tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer all
the plasma into the 4 plastic vials labelled EXPLOR (EDTA) FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to
Covance on day of collection.
SMII/ART-123 Concentration
One 6 ml green top sodium heparin tube. Mix immediately by inverting tube 10 to 15 times. Centrifuge immediately at 1500 x g
for 10 to 15 minutes. Use the enclosed pipette to transfer the plasma into the plastic vial labelled SMII/ART-123 CONC
FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
4 510013
Af 070605
Page: 29
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
VISIT: DAY 7
Randomization #
Page 1 of 2
2-part
Covance
internal
use
ONLY
Employee Visa
Site #
Pt #
Subject Initials
Kit #
First
Middle
Family/Last
Collection Date
Day
Month
Year
Collection Time
24 Hour Clock
Requisition Completed by
Full name in capital letters
Samples Collected by
Full name in capital letters
Phone number
Tube Count
Ambient=
All DIC and coagulation tests taken for the purposes of this study must be taken from an
original stick or venipuncture. All other blood tests may be taken from an existing port or line.
To avoid clotting cancellations, a small amount of blood must be collected from the
venipuncture site before the blood is drawn into the sodium citrate blue top tube.
Frozen=
Refrig=
Specimens to be collected 144 hours (plus or minus 2 hrs) after the first dose of study drug.
Was the DIC/Coagulation testing collected from
an original stick/venipuncture?
Slides=
YES
NO
Validation
First Entry
Second Entry
Comments:
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
510013
Af 070605
Page: 30
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Page 2 of 2
2-part
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED AMBIENT DAY OF COLLECTION:
Chemistry Panel
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the 5 ml plastic vial labelled CHEMISTRY.
Hematology & Differential Panel
Draw whole blood samples last except when collecting coagulation group at the same visit.
One 3 ml lavender top tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Make blood smears with blood from the lavender top tube using the Diff-Safe dispenser. Make two slides. Allow to air dry and
place in blue slide mailer.
Do not forget to ship the tube after using it for the hematology slides.
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF COLLECTION:
INR - D-Dimer - Fibrinogen
One 4.5 ml blue top sodium citrate tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 1500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer the
plasma equally into the 3 ml plastic vial labelled INR/FIBRINOGEN FROZEN and the 5 ml plastic vial labelled D-DIMER
FROZEN. Freeze immediately at 20C or -70C until shipment.
DMI/Exploratory (Citrate)
Two (2) 4.5 ml blue top sodium citrate tubes. Fill tubes completely. Mix immediately by gently inverting the tubes at least 8 to 10
times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to
transfer all the plasma from both tubes equally into the 8 plastic vials labelled EXPLOR (CITRATE) FROZEN. FREEZE
IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
DMII/Exploratory (EDTA)
One (1) 4.0 ml lavendar top EDTA tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer all
the plasma into the 4 plastic vials labelled EXPLOR (EDTA) FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to
Covance on day of collection.
SMI/ART-123 Ab
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the plastic vial labelled SMI/ART-123 AB FROZEN. FREEZE IMMEDIATELY on
dry ice and ship frozen to Covance on day of collection.
SMII/ART-123 Concentration
One 6 ml green top sodium heparin tube. Mix immediately by inverting tube 10 to 15 times. Centrifuge immediately at 1500 x g
for 10 to 15 minutes. Use the enclosed pipette to transfer the plasma into the plastic vial labelled SMII/ART-123 CONC
FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
5 510013
Af 070605
Page: 31
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
VISIT: DAY 14
Randomization #
Page 1 of 2
2-part
Covance
internal
use
ONLY
Employee Visa
Site #
Pt #
Subject Initials
Kit #
First
Middle
Family/Last
Collection Date
Day
Month
Year
Collection Time
24 Hour Clock
Requisition Completed by
Full name in capital letters
Samples Collected by
Full name in capital letters
Phone number
Tube Count
Ambient=
All DIC and coagulation tests taken for the purposes of this study must be taken from an
original stick or venipuncture. All other blood tests may be taken from an existing port or line.
To avoid clotting cancellations, a small amount of blood must be collected from the
venipuncture site before the blood is drawn into the sodium citrate blue top tube.
Frozen=
Refrig=
YES
NO
Slides=
First Entry
Second Entry
Comments:
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
510013
Af 070605
Page: 32
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Page 2 of 2
2-part
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED AMBIENT DAY OF COLLECTION:
Chemistry Panel
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the 5 ml plastic vial labelled CHEMISTRY.
Hematology & Differential Panel
Draw whole blood samples last except when collecting coagulation group at the same visit.
One 3 ml lavender top tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Make blood smears with blood from the lavender top tube using the Diff-Safe dispenser. Make two slides. Allow to air dry and
place in blue slide mailer.
Do not forget to ship the tube after using it for the hematology slides.
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF COLLECTION:
INR - D-Dimer - Fibrinogen
One 4.5 ml blue top sodium citrate tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 1500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer the
plasma equally into the 3 ml plastic vial labelled INR/FIBRINOGEN FROZEN and the 5 ml plastic vial labelled D-DIMER
FROZEN. Freeze immediately at 20C or -70C until shipment.
DMI/Exploratory (Citrate)
Two (2) 4.5 ml blue top sodium citrate tubes. Fill tubes completely. Mix immediately by gently inverting the tubes at least 8 to 10
times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to
transfer all the plasma from both tubes equally into the 8 plastic vials labelled EXPLOR (CITRATE) FROZEN. FREEZE
IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
DMII/Exploratory (EDTA)
One (1) 4.0 ml lavendar top EDTA tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer all
the plasma into the 4 plastic vials labelled EXPLOR (EDTA) FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to
Covance on day of collection.
SMI/ART-123 Ab
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the plastic vial labelled SMI/ART-123 AB FROZEN. FREEZE IMMEDIATELY on
dry ice and ship frozen to Covance on day of collection.
SMII/ART-123 Concentration
One 6 ml green top sodium heparin tube. Mix immediately by inverting tube 10 to 15 times. Centrifuge immediately at 1500 x g
for 10 to 15 minutes. Use the enclosed pipette to transfer the plasma into the plastic vial labelled SMII/ART-123 CONC
FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
6 510013
Af 070605
Page: 33
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Randomization #
Page 1 of 1
2-part
Covance
internal
use
ONLY
Employee Visa
Site #
Pt #
Subject Initials
Kit #
First
Middle
Family/Last
Collection Date
Day
Month
Year
Collection Time
(Record Midnight as 23:59)
24 Hour Clock
Requisition Completed by
Full name in capital letters
Samples Collected by
Full name in capital letters
Phone number
Tube Count
Ambient=
Refrig=
Slides=
Validation
First Entry
Second Entry
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF
COLLECTION:
SMI/ART-123 Ab
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with
the clotting activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube
standing upright). Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a
well-formed polymer barrier. Use pipette provided to transfer all the serum into the plastic vial labelled SMI/ART123 AB FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
Comments:
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
510013
Af 070605
Page: 34
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Randomization #
Page 1 of 2
2-part
Covance
internal
use
ONLY
Employee Visa
Site #
Pt #
Kit #
PVC =
Day #
Investigator : Inv_n
Address_1
Address_2
Address_3
Address_4
Address_5
Address_6
Address_7
Subject Initials
First
Middle
Family/Last
Collection Date
Day
Month
Year
Collection Time
24 Hour Clock
Requisition Completed by
Full name in capital letters
Tube Count
Samples Collected by
Full name in capital letters
Ambient=
Phone number
Of the person completing the
requisition
Frozen=
All DIC and coagulation tests taken for the purposes of this study must be taken from an original stick or
venipuncture. All other blood tests may be taken from an existing port or line. To avoid clotting
cancellations, a small amount of blood must be collected from the venipuncture site before the blood is
drawn into the sodium citrate blue top tube.
Refrig=
Slides=
If early termination occurs before Day 14, check boxes and collect specimens for INR, D-Dimer,
Fibrinogen, DMI/Exploratory (Citrate), and DMII/Exploratory (EDTA).
Was the DIC/Coagulation testing collected from
an original stick/venipuncture?
Validation
YES
NO
Please check the box(es) to ensure proper ordering of optional test(s)! If you fail to mark the checkbox,
but return the container, all optional tests associated with the container will be ordered per Covance
policy.
INR
DMI/Exploratory (Citrate)
D-Dimer
DMII/Exploratory (EDTA)
Fibrinogen
Comments:
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
510013
Af 070605
Page: 35
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Page 2 of 2
2-part
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED AMBIENT DAY OF COLLECTION:
Chemistry Panel
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the 5 ml plastic vial labelled CHEMISTRY.
Hematology & Differential Panel
Draw whole blood samples last except when collecting coagulation group at the same visit.
One 3 ml lavender top tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Make blood smears with blood from the lavender top tube using the Diff-Safe dispenser. Make two slides. Allow to air dry and
place in blue slide mailer.
Do not forget to ship the tube after using it for the hematology slides.
THE FOLLOWING REQUIRED SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF COLLECTION:
SMI/ART-123 Ab
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the plastic vial labelled SMI/ART-123 AB FROZEN. FREEZE IMMEDIATELY on
dry ice and ship frozen to Covance on day of collection.
SMII/ART-123 Concentration
One 6 ml green top sodium heparin tube. Mix immediately by inverting tube 10 to 15 times. Centrifuge immediately at 1500 x g
for 10 to 15 minutes. Use the enclosed pipette to transfer the plasma into the plastic vial labelled SMII/ART-123 CONC
FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
THE FOLLOWING OPTIONAL SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF COLLECTION:
INR - D-Dimer - Fibrinogen
One 4.5 ml blue top sodium citrate tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 1500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer the
plasma equally into the 3 ml plastic vial labelled INR/FIBRINOGEN FROZEN and the 5 ml plastic vial labelled D-DIMER
FROZEN. Freeze immediately at 20C or -70C until shipment.
DMI/Exploratory (Citrate)
Two (2) 4.5 ml blue top sodium citrate tubes. Fill tubes completely. Mix immediately by gently inverting the tubes at least 8 to 10
times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to
transfer all the plasma from both tubes equally into the 8 plastic vials labelled EXPLOR (CITRATE) FROZEN. FREEZE
IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
DMII/Exploratory (EDTA)
One (1) 4.0 ml lavendar top EDTA tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer all
the plasma into the 4 plastic vials labelled EXPLOR (EDTA) FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to
Covance on day of collection.
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
T 510013
Af 070605
Page: 36
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
VISIT: RETEST
Randomization #
Page 1 of 2
2-part
Covance
internal
use
ONLY
Employee Visa
Site #
Pt #
Subject Initials
Kit #
First
Middle
Family/Last
Collection Date
Day
Month
Year
Collection Time
24 Hour Clock
Requisition Completed by
Full name in capital letters
Samples Collected by
Full name in capital letters
Phone number
Tube Count
Ambient=
All DIC and coagulation tests taken for the purposes of this study must be taken from an original stick or
venipuncture. All other blood tests may be taken from an existing port or line. To avoid clotting
cancellations, a small amount of blood must be collected from the venipuncture site before the blood is
drawn into the sodium citrate blue top tube.
Frozen=
Refrig=
YES
NO
Validation
First Entry
Chemistry Panel
DMI/Exploratory (Citrate)
DMII/Exploratory (EDTA)
Hematology II
DMIII/Thrombomodulin Level
INR
SMI/ART-123 Ab
D-Dimer
SMII/ART-123 Concentration
Second Entry
Fibrinogen
Comments:
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
510013
Af 070605
Page: 37
510013_TMEA_Printed: 20070606
Bar_req
Accession No.
Requisition_n
Bar_req
Page 2 of 2
2-part
THE FOLLOWING OPTIONAL SPECIMENS MUST BE SHIPPED AMBIENT DAY OF COLLECTION:
Chemistry Panel
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the 5 ml plastic vial labelled CHEMISTRY.
Hematology & Differential Panel - Hematology II
Draw whole blood samples last except when collecting coagulation group at the same visit.
One 3 ml lavender top tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Make blood smears with blood from the lavender top tube using the Diff-Safe dispenser. Make two slides. Allow to air dry and
place in blue slide mailer.
Do not forget to ship the tube after using it for the hematology slides.
THE FOLLOWING OPTIONAL SPECIMENS MUST BE SHIPPED FROZEN ON DRY ICE DAY OF COLLECTION:
SMI/ART-123 Ab
One 3.5 ml gold top serum separation tube. Fill tube completely. It is important to thoroughly mix the blood with the clotting
activation agent by inverting the tube not less than five times. Allow blood to clot for 30 minutes (tube standing upright).
Centrifuge at a minimum of 1500 x g for 15 minutes until clot and serum are separated by a well-formed polymer barrier. Use
pipette provided to transfer all the serum into the plastic vial labelled SMI/ART-123 AB FROZEN. FREEZE IMMEDIATELY on
dry ice and ship frozen to Covance on day of collection.
SMII/ART-123 Concentration
One 6 ml green top sodium heparin tube. Mix immediately by inverting tube 10 to 15 times. Centrifuge immediately at 1500 x g
for 10 to 15 minutes. Use the enclosed pipette to transfer the plasma into the plastic vial labelled SMII/ART-123 CONC
FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
INR - D-Dimer - Fibrinogen
One 4.5 ml blue top sodium citrate tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 1500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer the
plasma equally into the 3 ml plastic vial labelled INR/FIBRINOGEN FROZEN and the 5 ml plastic vial labelled D-DIMER
FROZEN. Freeze immediately at 20C or -70C until shipment.
DMI/Exploratory (Citrate) - DMIII/Thrombomodulin Level
Two (2) 4.5 ml blue top sodium citrate tubes. Fill tubes completely. Mix immediately by gently inverting the tubes at least 8 to 10
times. Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to
transfer all the plasma from both tubes equally into the 8 plastic vials labelled EXPLOR (CITRATE) FROZEN. FREEZE
IMMEDIATELY on dry ice and ship frozen to Covance on day of collection.
DMII/Exploratory (EDTA)
One (1) 4.0 ml lavendar top EDTA tube. Fill tube completely. Mix immediately by gently inverting the tube at least 8 to 10 times.
Centrifuge at a minimum of 2500 x g for 15 minutes until cells and plasma are well separated. Use pipette provided to transfer all
the plasma into the 4 plastic vials labelled EXPLOR (EDTA) FROZEN. FREEZE IMMEDIATELY on dry ice and ship frozen to
Covance on day of collection.
WHITE COPY-COVANCE
PINK COPY-INVESTIGATOR
PLEASE DO NOT RETURN EMPTY CONTAINERS TO COVANCE.
Bar_req
Label_6
U 510013
Af 070605
Page: 38
510013_TMEA_Printed: 20070606
Page: 39
510013_TMEA_Printed: 20070606
!
Consolidated Shipments
For your convenience, shipping materials provided by Covance are not protocol specific. Please consolidate
sample shipments of like condition (ambient or frozen) to Covance whenever possible.
Courier Pick-up Information
Prior to shipping your first specimens, we recommend that you call the courier to define your site as a new
pickup location for shipments to Covance. This will facilitate the process when you are ready for your first
shipment. Covance will be billed directly for all transportation costs.
Please be sure to inquire about your local service schedules and the latest time of day that you can call to
arrange for a pick-up. Timely pick-ups will ensure samples are shipped within stability for testing. (Refer to
Stabilities for Analytes in Section 1 of this manual.)
While most samples are specified to be shipped day of collection, we realize there are times when circumstances do not permit this to occur.
Late afternoon sample collection after last call-in or pick-up availability for courier service
Dry ice may not be available the same day as frozen sample collection
Pick-up is missed by courier service
In the event that samples cannot be shipped the day of collection, they should be stored under the condition
they are to be shipped. These samples should then be shipped to Covance CLS the very next day of
availability.
AMBIENT samples should remain at ambient temperature Do not refrigerate
REFRIGERATED samples should remain between 2C and 8C
FROZEN samples should remain frozen at the appropriate temperature
Refer to Stabilities for Analytes in Section 1 of this manual.
For Latin America, Australia, New Zealand and Asia:
When contacting courier, also inquire about local export requirements.
Shipping boxes
Containers must be securely packed in their shipping box. Please check by gently shaking the box after
packaging. If the containers are loose, repack the box by filling the empty spaces with paper.
Materials Safety Data Sheets
MSDS sheets for chemical products used in Covance studies may be accessed at the following website:
http://imv.complyplus.com/covance. The website allows you to search for the MSDS sheets by common name,
manufacturer and even print reports of all current items shown in our database.
Page: 40
510013_TMEA_Printed: 20070606
United States
DHL Express*
(888) 708-8825
Federal Express**
(800) 463-3339
World Courier**
(800) 221-6600
Canada
Federal Express
(800) 463-3339
World Courier
(800) 387-3381
Puerto Rico
Federal Express
(787) 793-9300
Japan__________________________________________
World Courier
81 3 3537-1080
* It is important to utilize the special 888 number when contacting DHL to schedule pick-ups. This is a
special number for Covance sites only. Scheduling pickups via their automated system or on the Internet
will circumvent all of the special procedures Covance has in place with DHL and increase the chances of
a missed pickup.
** Hawaii Sites Note: Covance Central Laboratory Services Logistics Department will track all shipments from
Hawaii. Please fax airbill number of shipment to 1-800-335-1462 so that tracking may occur. Shipments
should only be made Monday through Wednesday. Thursday shipments must be marked for Saturday
delivery.
Page: 41
510013_TMEA_Printed: 20070606
Airconsult
e-mail: Airconsult@wanadoo.fr
www.airconsult-bf.com
The training records must be made available upon request by the appropriate national authority.
US sites: Additional information from the Department of Transportation (DOT) can be found on their website,
http://hazmat.dot.gov
2005 Covance CLS
Page: 42
510013_TMEA_Printed: 20070606
!
8. Place the zip bag into the shipping carton. Fill empty spaces
with cushioning material (i.e.
paper).
Page: 43
510013_TMEA_Printed: 20070606
Note:
If the kit box is too large to place
in the ambient shipping carton,
wrap a rubberband around the
Gel Pak. Place the Gel Pak containing the specimen collection
bag inside the large ziplock bag.
Place the zip bag into the shipping carton. Fill empty spaces
with cushioning material (i.e.
paper).
10. US domestic shipments: Complete and affix the airbill to the designated spot on the box.
Rest of world: Insert the shipping documentation into the transparent pouch ensuring that the airbill remains visible. Affix the
pouch to the cardboard box on the Place airbill here section.
Page: 44
510013_TMEA_Printed: 20070606
2. Fill half of the styrofoam container with dry ice and insert
the
Specimen
Collection
Bag(s). Then fill up the container using at least 2.2 kg dry
ice in total.
Page: 45
510013_TMEA_Printed: 20070606
11.Place the zip bag into the cardboard box. Fill empty spaces
with cushioning material (i.e.
paper).
Note:
If the kit box is too large to place
in the ambient shipping carton,
wrap a rubberband around the
Gel Pak. Place the Gel Pak containing the specimen collection
bag inside the large ziplock bag.
Place the zip bag into the shipping carton. Fill empty spaces
with cushioning material (i.e.
paper).
Page: 46
510013_TMEA_Printed: 20070606
SHIPPING DOCUMENTS
The protocol specific shipping documents are provided in the appropriate envelope with the start-up
material. They are not automatically resupplied.
Order additional envelopes by using the resupply form provided in this manual or by contacting
Covance CLS.
Page: 47
510013_TMEA_Printed: 20070606
ress
ic add
inted
Prepr
with
ecif
site sp
Page: 48
510013_TMEA_Printed: 20070606
A
specific
h site
it
w
d
e
t
re-prin
addres
Page: 49
510013_TMEA_Printed: 20070606
inted
Prepr
ddres
cific a
spe
ith site
Signature of shipper
Name Printed
Date
Page: 50
510013_TMEA_Printed: 20070606
ecific
inted
Prepr
ite sp
with s
ss
addre
A
E
Page: 51
510013_TMEA_Printed: 20070606
A
specific
h site
it
w
d
e
t
re-prin
addres
B
C
English_US Shipping Documents Diagnostic Specimens Frozen Combined FedEx Canada_Update: 20061208
Page: 52
510013_TMEA_Printed: 20070606
inted
Prepr
ddres
cific a
spe
ith site
Signature of shipper
Name Printed
Date
Page: 53
510013_TMEA_Printed: 20070606
Page: 54
510013_TMEA_Printed: 20070606
SUPPLY/RESUPPLY
In your initial shipment, you will receive a start-up supply which is specific for your trial and your site.
For studies with automatic resupply
Scheduled visits required
When the patients first lab visit is received at Covance Central Laboratory Services, KMS sets up a delivery
schedule on all kits required for upcoming scheduled visits. This program ensures the kit supply based on the
evaluation of each patient and re-evaluates the delivery schedule based on the investigators activity or the
inventory adjustment.
Other visits
The first visit, skippable visits, retest/unscheduled, and early termination are kept at a pre-defined quantity. For
this reason, a minimum and a maximum limit is pre-defined for these types of visits. Once the inventory drops
below this quantity, KMS will trigger a resupply of kits. The pre-defined limit can be customized by request of
the investigator site by contacting the Kit Inventory Center at Covance.
There is no automatic resupply for Russia, India and Thailand, investigators in these countries are kindly
requested to contact Covance for resupply form. There is no supply of shipping boxes for Israel and Africa.
Investigators in these countries are kindly requested to order boxes to the courier each time they request a
pick-up.
Investigator sites need to actively monitor inventory of kits and shipping materials. It is crucial
that the inventories at the site are consistent with Covance automatic resupply. If you destroy or
have on your site expired kits, please contact the Kit Inventory Center in order to up-date our
schedule in accordance with your new inventory!
Page: 55
510013_TMEA_Printed: 20070606
Please make a photocopy of this page before filling it in. Type or write legibly with a black ball pen
____________________________________
Site Number:
____________________________________
Protocol Number:
Name: _______________________________________________
______________________________
KIT
Visit number/Name
Shipping Boxes
Quantity
Quantity
Reason
Expired
Lost
Not
Received
Stock
Insufficient
Shipping Documents
Quantity
On Hand
Quantity
Other _____________________________
Other ______________________________
Other _____________________________
Comments: _________________________________________
______________________________________________________
___________________________________________________________
______________________________________________________
___________________________________________________________
______________________________________________________
___________________________________________________________
______________________________________________________
___________________________________________________________
______________________________________________________
___________________________________________________________
______________________________________________________
2003 Covance CLS
Page: 56
510013_TMEA_Printed: 20070606
Page: 57
510013_TMEA_Printed: 20070606
Represents
Meaning
Notification
H
L
High Flag
Low Flag
No Notification
HT
LT
High Telephone
Low Telephone
Investigator Site
HP
LP
High Panic
Low Panic
Investigator Site
(and Sponsor
if requested)
+d
-d
Delta
Delta
No Notification
EX
Exclusions
Investigator Site
(and Sponsor
if requested)
Reporting holds
Your laboratory reports will be held for data clarification when:
- Patient data on the requisition form is missing, incomplete, or inconsistent with previous records.
- Additional data requested on the requisition form is missing.
- A kit refers to a visit that has been received earlier or to a visit out of sequence.
When the issue has been clarified the laboratory report will be released. In case of a clinically
important alert, the investigator in question will be contacted immediately.
2003 Covance CLS
Page: 58
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
01-Mar-2007
Fibrinogen (CGT285)
Both
0Y-150Y
200-400 mg/dL
<200
>400
Key:
Alert flags:
H
L
High
Low
Covance CLS
Run: 6-Jun-07
2:47 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
HT
28-Dec-2006
PT (CGT283)
Both
0Y-150Y
9.7-12.3 sec
<9.7
>12.3
>40.0
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
28-Dec-2006
INR (CGT286)
Key:
Alert flags:
Both
H
HP
HT
L
0Y-150Y
0.8-1.2
<0.8
>1.2
>3.0
>4.0
High
High Panic
High - Telephone
Low
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 59
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
23-Oct-2000
HGB (HMT40)
Female
0Y-1D
13.5-22.0 g/dL
<8.0
<10.0
<13.5
>22.0
1D-8D
13.5-22.0 g/dL
<8.0
<10.0
<13.5
>22.0
8D-15D
12.5-21.0 g/dL
<8.0
<10.0
<12.5
>21.0
15D-31D
10.0-20.0 g/dL
<8.0
<10.0
>20.0
31D-4M
10.0-14.0 g/dL
<8.0
<10.0
>14.0
4M-7M
10.0-14.0 g/dL
<8.0
<10.0
>14.0
7M-2Y
10.5-13.5 g/dL
<8.0
<10.5
>13.5
2Y-3Y
11.0-14.0 g/dL
<8.0
<11.0
>14.0
3Y-6Y
11.8-14.7 g/dL
<8.0
<11.8
>14.7
6Y-12Y
11.2-15.5 g/dL
<6.0
<9.0
<11.2
>15.5
>19.0
>21.0
12Y-59Y
11.6-16.4 g/dL
<6.0
<10.0
<11.6
>16.4
>19.0
>23.0
59Y-150Y 11.5-15.8 g/dL
<6.0
<10.0
<11.5
>15.8
>19.0
>23.0
Male
0Y-1D
13.5-22.0 g/dL
<8.0
<10.0
<13.5
>22.0
1D-8D
13.5-22.0 g/dL
<8.0
<10.0
<13.5
>22.0
8D-15D
12.5-21.0 g/dL
<8.0
<10.0
<12.5
>21.0
15D-31D
10.0-20.0 g/dL
<8.0
<10.0
>20.0
31D-4M
10.0-14.0 g/dL
<8.0
<10.0
>14.0
4M-7M
10.0-14.0 g/dL
<8.0
<10.0
>14.0
7M-2Y
10.5-13.5 g/dL
<8.0
<10.5
>13.5
2Y-3Y
11.0-14.0 g/dL
<8.0
<11.0
>14.0
3Y-6Y
11.0-14.5 g/dL
<8.0
<11.0
>14.5
6Y-12Y
11.2-15.5 g/dL
<6.0
<8.0
<11.2
>15.5
>19.0
>21.0
12Y-59Y
12.7-18.1 g/dL
<6.0
<10.0
<12.7
>18.1
>19.0
>23.0
59Y-150Y 12.5-17.0 g/dL
<6.0
<10.0
<12.5
>17.0
>19.0
>23.0
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
16-Oct-2000
HCT (HMT2)
Run: 6-Jun-07
2:47 PM
Female
0Y-1D
42-60 %
1D-8D
42-60 %
8D-15D
39-60 %
15D-31D
31-55 %
31D-4M
28-42 %
4M-7M
28-42 %
7M-2Y
33-40 %
2Y-3Y
33-42 %
3Y-6Y
35-44 %
6Y-12Y
34-44 %
12Y-59Y
34-48 %
59Y-150Y 34-48 %
Male
0Y-1D
42-60 %
1D-8D
42-60 %
8D-15D
39-60 %
15D-31D
31-55 %
31D-4M
28-42 %
4M-7M
28-42 %
7M-2Y
33-40 %
2Y-3Y
33-42 %
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA
<24
<30
<42
<24
<30
<42
<24
<30
<39
<20
<24
<31
<20
<24
<28
<20
<24
<28
<20
<24
<33
<24
<28
<33
<28
<35
<28
<34
<28
<34
<28
<34
<24
<30
<42
<24
<30
<42
<24
<30
<39
<20
<24
<31
<20
<24
<28
<20
<24
<28
<20
<24
<33
<24
<28
<33
46214-2985 (317) 271-1200 FAX
>60
>65
>60
>65
>60
>65
>55
>60
>42
>55
>42
>55
>40
>50
>42
>50
>44
>50
>44
>50
>48
>50
>48
>50
>60
>65
>60
>65
>60
>65
>55
>60
>42
>55
>42
>55
>40
>50
>42
>50
(317) 616-2351
Page:
2
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
16-Oct-2000
Continued...
HCT (HMT2)
Male
3Y-6Y
33-43 %
<24
<28
<33
>43
>50
6Y-12Y
34-44 %
<24
<34
>44
>50
12Y-59Y
39-54 %
<24
<39
>54
>55
59Y-150Y 37-51 %
<24
<37
>51
>55
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
16-Jan-2004
WBC (HMT7)
Female
0D-15D
8.30-17.60 x10E3/uL
<1.00
<4.00
<8.30
>17.60
>30.00
>50.00
15D-31D
6.90-15.00 x10E3/uL
<1.00
<3.00
<6.90
>15.00
>30.00
>50.00
31D-61D
6.10-13.80 x10E3/uL
<1.00
<3.00
<6.10
>13.80
>25.00
>30.00
61D-7M
6.80-16.20 x10E3/uL
<1.00
<3.00
<6.80
>16.20
>20.00
>30.00
7M-2Y
6.40-15.50 x10E3/uL
<1.00
<3.00
<6.40
>15.50
>20.00
>30.00
2Y-6Y
5.50-12.50 x10E3/uL
<1.00
<3.00
<5.50
>12.50
>15.00
>30.00
6Y-12Y
4.35-13.65x10E3/uL
<1.00
<2.00
<4.35
>13.65
>15.00
>30.00
12Y-18Y
4.35-13.15x10E3/uL
<1.00
<2.00
<4.35
>13.15
>15.00
>30.00
18Y-59Y
3.80-10.70 x10E3/uL
<1.00
<2.50
<3.80
>10.70
>15.00
>30.00
59Y-150Y 3.80-10.70 x10E3/uL
<1.00
<2.50
<3.80
>10.70
>15.00
>30.00
Male
0D-15D
8.60-14.90 x10E3/uL
<1.00
<4.00
<8.60
>14.90
>30.00
>50.00
15D-31D
7.40-13.30 x10E3/uL
<1.00
<3.00
<7.40
>13.30
>30.00
>50.00
31D-61D
6.00-13.70 x10E3/uL
<1.00
<3.00
<6.00
>13.70
>25.00
>30.00
61D-7M
6.60-15.60 x10E3/uL
<1.00
<3.00
<6.60
>15.60
>20.00
>30.00
7M-2Y
6.30-15.40 x10E3/uL
<1.00
<3.00
<6.30
>15.40
>20.00
>30.00
2Y-6Y
5.50-12.30 x10E3/uL
<1.00
<3.00
<5.50
>12.30
>15.00
>30.00
6Y-12Y
4.35-13.65x10E3/uL
<1.00
<2.00
<4.35
>13.65
>15.00
>30.00
12Y-18Y
4.35-13.15x10E3/uL
<1.00
<2.00
<4.35
>13.15
>15.00
>30.00
18Y-59Y
3.80-10.70 x10E3/uL
<1.00
<2.50
<3.80
>10.70
>15.00
>30.00
59Y-150Y 3.80-10.70 x10E3/uL
<1.00
<2.50
<3.80
>10.70
>15.00
>30.00
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Dec-2000
Neutrophil (HMT8)
Female
0D-1D
6.00-26.00 x10E3/uL
<1.00
<6.00
>26.00
>40.00
1D-8D
2.00-21.00 x10E3/uL
<1.00
<2.00
>21.00
>40.00
8D-15D
1.00-10.00 x10E3/uL
<0.50
<1.00
>10.00
>40.00
15D-31D
1.00-9.50 x10E3/uL
<0.50
<1.00
>9.50
>11.00
31D-4M
1.00-9.00 x10E3/uL
<0.50
<1.00
>9.00
>11.00
4M-7M
1.00-9.00 x10E3/uL
<0.50
<1.00
>9.00
>11.00
7M-2Y
1.50-9.60 x10E3/uL
<0.50
<1.00
<1.50
>9.60
>12.00
2Y-3Y
1.00-9.00 x10E3/uL
<0.50
<1.00
>9.00
>11.00
3Y-6Y
1.00-9.00 x10E3/uL
<0.50
<1.00
>9.00
>11.00
6Y-12Y
1.35-8.15 x10E3/uL
<0.50
<1.00
<1.35
>8.15
>11.00
12Y-18Y
1.65-8.15 x10E3/uL
<0.50
<1.00
<1.65
>8.15
>11.00
18Y-59Y
1.96-7.23 x10E3/uL
<0.50
<1.00
<1.96
>7.23
>11.00
59Y-150Y 1.96-7.23 x10E3/uL
<0.50
<1.00
<1.96
>7.23
>11.00
Male
0D-1D
6.00-26.00 x10E3/uL
<1.00
<6.00
>26.00
>40.00
1D-8D
2.00-21.00 x10E3/uL
<1.00
<2.00
>21.00
>40.00
8D-15D
1.00-10.00 x10E3/uL
<0.50
<1.00
>10.00
>40.00
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 60
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
3
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Dec-2000
Continued...
Neutrophil (HMT8)
Male
15D-31D
1.00-9.50 x10E3/uL
<0.50
<1.00
>9.50
>11.00
31D-4M
1.00-9.00 x10E3/uL
<0.50
<1.00
>9.00
>11.00
4M-7M
1.00-9.00 x10E3/uL
<0.50
<1.00
>9.00
>11.00
7M-2Y
1.50-9.40 x10E3/uL
<0.50
<1.00
<1.50
>9.40
>12.00
2Y-3Y
1.35-8.65 x10E3/uL
<0.50
<1.00
<1.35
>8.65
>11.00
3Y-6Y
1.35-8.65 x10E3/uL
<0.50
<1.00
<1.35
>8.65
>11.00
6Y-12Y
1.35-8.15 x10E3/uL
<0.50
<1.00
<1.35
>8.15
>11.00
12Y-18Y
1.65-8.15 x10E3/uL
<0.50
<1.00
<1.65
>8.15
>11.00
18Y-59Y
1.96-7.23 x10E3/uL
<0.50
<1.00
<1.96
>7.23
>11.00
59Y-150Y 1.96-7.23 x10E3/uL
<0.50
<1.00
<1.96
>7.23
>11.00
__________________________________________________________________________________________________________________________________________________________
H
29-Sep-1993
Bands (HMT20)
Both
0Y-150Y
0.00-0.27 x10E3/uL
>0.27
__________________________________________________________________________________________________________________________________________________________
LT
L
H
HT
26-Dec-2000
Lymphocyte (HMT9)
Female
Male
Covance CLS
Run: 6-Jun-07
2:47 PM
0D-1D
1D-8D
8D-15D
15D-31D
31D-4M
4M-7M
7M-2Y
2Y-3Y
3Y-6Y
6Y-12Y
12Y-18Y
18Y-59Y
59Y-150Y
0D-1D
1D-8D
8D-15D
15D-31D
31D-4M
4M-7M
7M-2Y
2Y-3Y
3Y-6Y
6Y-12Y
12Y-18Y
18Y-59Y
59Y-150Y
2.00-11.00 x10E3/uL
2.00-17.00 x10E3/uL
2.00-17.00 x10E3/uL
2.50-17.00 x10E3/uL
2.50-16.00 x10E3/uL
3.00-15.00 x10E3/uL
1.70-6.70 x10E3/uL
1.50-10.00 x10E3/uL
1.50-8.00 x10E3/uL
1.15-6.65 x10E3/uL
0.95-5.25 x10E3/uL
0.91-4.28 x10E3/uL
0.80-3.00 x10E3/uL
2.00-11.00 x10E3/uL
2.00-17.00 x10E3/uL
2.00-17.00 x10E3/uL
2.50-17.00 x10E3/uL
2.50-16.00 x10E3/uL
3.00-15.00 x10E3/uL
1.70-6.50 x10E3/uL
1.50-10.00 x10E3/uL
1.50-8.00 x10E3/uL
1.15-6.65 x10E3/uL
0.95-5.25 x10E3/uL
0.91-4.28 x10E3/uL
0.80-3.00 x10E3/uL
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<1.30
<1.00
<1.00
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<1.30
<1.00
<1.00
<2.00
<2.00
<2.00
<2.50
<2.50
<3.00
<1.70
<1.50
<1.50
<1.15
<0.95
<0.91
<0.80
<2.00
<2.00
<2.00
<2.50
<2.50
<3.00
<1.70
<1.50
<1.50
<1.15
<0.95
<0.91
<0.80
>11.00
>17.00
>17.00
>17.00
>16.00
>15.00
>6.70
>10.00
>8.00
>6.65
>5.25
>4.28
>3.00
>11.00
>17.00
>17.00
>17.00
>16.00
>15.00
>6.50
>10.00
>8.00
>6.65
>5.25
>4.28
>3.00
>25.00
>25.00
>25.00
>25.00
>25.00
>25.00
>10.00
>25.00
>25.00
>25.00
>25.00
>25.00
>25.00
>25.00
>25.00
>10.00
>25.00
>25.00
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
4
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
13-Jul-2006
Monocytes (HMT10)
Female
0D-4D
0.20-2.20 x10E3/uL
<0.20
>2.20
4D-8D
0.20-2.20 x10E3/uL
<0.20
>2.20
8D-15D
0.10-2.90 x10E3/uL
<0.10
>2.90
15D-31D
0.20-5.00 x10E3/uL
<0.20
>5.00
31D-61D
0.20-2.10 x10E3/uL
<0.20
>2.10
61D-180D 0.60-1.90 x10E3/uL
<0.60
>1.90
180D-2Y
0.30-1.50 x10E3/uL
<0.30
>1.50
2Y-6Y
0.50-1.10 x10E3/uL
<0.50
>1.10
6Y-12Y
0.40-0.90 x10E3/uL
<0.40
>0.90
12Y-18Y
0.40-0.90 x10E3/uL
<0.40
>0.90
18Y-150Y 0.12-0.92 x10E3/uL
<0.12
>0.92
Male
0D-4D
0.20-1.80 x10E3/uL
<0.20
>1.80
4D-8D
0.20-2.20 x10E3/uL
<0.20
>2.20
8D-15D
0.30-3.00 x10E3/uL
<0.30
>3.00
15D-31D
0.20-3.50 x10E3/uL
<0.20
>3.50
31D-61D
0.30-2.70 x10E3/uL
<0.30
>2.70
61D-180D 0.50-1.90 x10E3/uL
<0.50
>1.90
180D-2Y
0.40-2.00 x10E3/uL
<0.40
>2.00
2Y-6Y
0.30-1.20 x10E3/uL
<0.30
>1.20
6Y-12Y
0.30-0.90 x10E3/uL
<0.30
>0.90
12Y-18Y
0.40-1.30 x10E3/uL
<0.40
>1.30
18Y-150Y 0.12-0.92 x10E3/uL
<0.12
>0.92
__________________________________________________________________________________________________________________________________________________________
H
13-Jul-2006
Eosinophil (HMT11)
Female
0D-4D
0.00-0.20 x10E3/uL
>0.20
4D-8D
0.00-0.50 x10E3/uL
>0.50
8D-15D
0.00-0.60 x10E3/uL
>0.60
15D-31D
0.00-0.50 x10E3/uL
>0.50
31D-61D
0.00-0.20 x10E3/uL
>0.20
61D-180D 0.00-0.10 x10E3/uL
>0.10
180D-2Y
0.00-0.20 x10E3/uL
>0.20
2Y-6Y
0.00-0.20 x10E3/uL
>0.20
6Y-12Y
0.00-0.20 x10E3/uL
>0.20
12Y-18Y
0.00-0.20 x10E3/uL
>0.20
18Y-150Y 0.00-0.57 x10E3/uL
>0.57
Male
0D-4D
0.00-0.30 x10E3/uL
>0.30
4D-8D
0.00-0.80 x10E3/uL
>0.80
8D-15D
0.00-0.60 x10E3/uL
>0.60
15D-31D
0.00-0.90 x10E3/uL
>0.90
31D-61D
0.00-0.50 x10E3/uL
>0.50
61D-180D 0.00-0.40 x10E3/uL
>0.40
180D-2Y
0.00-0.30 x10E3/uL
>0.30
2Y-6Y
0.00-0.20 x10E3/uL
>0.20
6Y-12Y
0.00-0.30 x10E3/uL
>0.30
12Y-18Y
0.00-0.30 x10E3/uL
>0.30
18Y-150Y 0.00-0.57 x10E3/uL
>0.57
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 61
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
5
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
29-Sep-1993
Basophils (HMT12)
Both
0Y-150Y
0.00-0.20 x10E3/uL
>0.20
__________________________________________________________________________________________________________________________________________________________
L
H
09-Sep-1993
Neutrophil (HMT15)
Both
0Y-150Y
40.5-75.0 %
<40.5
>75.0
__________________________________________________________________________________________________________________________________________________________
H
18-Aug-1993
Bands (HMT21)
Both
0Y-150Y
0.0-3.0 %
>3.0
__________________________________________________________________________________________________________________________________________________________
L
H
02-Jun-1993
Lymphocyte (HMT16)
Both
0Y-150Y
15.4-48.5%
<15.4
>48.5
__________________________________________________________________________________________________________________________________________________________
L
H
13-Jul-2006
Monocytes (HMT17)
Female
0D-4D
5.0-11.0 %
<5.0
>11.0
4D-8D
6.0-14.0 %
<6.0
>14.0
8D-15D
6.0-19.0 %
<6.0
>19.0
15D-31D
5.0-14.0 %
<5.0
>14.0
31D-61D
5.0-14.0 %
<5.0
>14.0
61D-180D 4.0-12.0 %
<4.0
>12.0
180D-2Y
4.0-9.0 %
<4.0
>9.0
2Y-6Y
4.0-8.0 %
<4.0
>8.0
6Y-12Y
4.0-7.0 %
<4.0
>7.0
12Y-18Y
4.0-7.0 %
<4.0
>7.0
18Y-150Y 2.6-10.1 %
<2.6
>10.1
Male
0D-4D
4.0-13.0 %
<4.0
>13.0
4D-8D
7.0-17.0 %
<7.0
>17.0
8D-15D
7.0-18.0 %
<7.0
>18.0
15D-31D
6.0-18.0 %
<6.0
>18.0
31D-61D
6.0-17.0 %
<6.0
>17.0
61D-180D 4.0-11.0 %
<4.0
>11.0
180D-2Y
1.0-10.0 %
<1.0
>10.0
2Y-6Y
4.0-9.0 %
<4.0
>9.0
6Y-12Y
4.0-8.0 %
<4.0
>8.0
12Y-18Y
4.0-8.0 %
<4.0
>8.0
18Y-150Y 2.6-10.1 %
<2.6
>10.1
__________________________________________________________________________________________________________________________________________________________
H
13-Jul-2006
Eosinophil (HMT18)
Female
Covance CLS
Run: 6-Jun-07
2:47 PM
0D-4D
0.0-3.9 %
>3.9
4D-8D
0.0-7.5 %
>7.5
8D-15D
0.0-4.1 %
>4.1
15D-31D
0.0-5.4 %
>5.4
31D-61D
0.0-3.1 %
>3.1
61D-180D 0.0-2.8 %
>2.8
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
6
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
13-Jul-2006
Continued...
Eosinophil (HMT18)
Female
180D-2Y
0.0-3.1 %
>3.1
2Y-6Y
0.0-3.3 %
>3.3
6Y-12Y
0.0-4.0 %
>4.0
12Y-18Y
0.0-4.1 %
>4.1
18Y-150Y 0.0-6.8 %
>6.8
Male
0D-4D
0.0-2.9 %
>2.9
4D-8D
0.0-5.4 %
>5.4
8D-15D
0.0-5.0 %
>5.0
15D-31D
0.0-7.0 %
>7.0
31D-61D
0.0-5.4 %
>5.4
61D-180D 0.0-3.5 %
>3.5
180D-2Y
0.0-2.0 %
>2.0
2Y-6Y
0.0-2.4 %
>2.4
6Y-12Y
0.0-4.8 %
>4.8
12Y-18Y
0.0-2.8 %
>2.8
18Y-150Y 0.0-6.8 %
>6.8
__________________________________________________________________________________________________________________________________________________________
H
13-Jul-2006
Basophils (HMT19)
0D-4D
0.0-1.0 %
>1.0
4D-8D
0.0-1.0 %
>1.0
8D-15D
0.0-1.0 %
>1.0
15D-31D
0.0-1.0 %
>1.0
31D-61D
0.0-1.0 %
>1.0
61D-180D 0.0-1.0 %
>1.0
180D-2Y
0.0-1.0 %
>1.0
2Y-6Y
0.0-1.0 %
>1.0
6Y-12Y
0.0-1.0 %
>1.0
12Y-18Y
0.0-1.0 %
>1.0
18Y-150Y 0.0-2.0 %
>2.0
Male
0D-4D
0.0-1.0 %
>1.0
4D-8D
0.0-1.0 %
>1.0
8D-15D
0.0-1.0 %
>1.0
15D-31D
0.0-1.0 %
>1.0
31D-61D
0.0-1.0 %
>1.0
61D-180D 0.0-1.0 %
>1.0
180D-2Y
0.0-1.0 %
>1.0
2Y-6Y
0.0-1.0 %
>1.0
6Y-12Y
0.0-1.0 %
>1.0
12Y-18Y
0.0-1.0 %
>1.0
18Y-150Y 0.0-2.0 %
>2.0
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Apr-1995
Platelets (HMT13)
Female
Female
Covance CLS
0D-1D
200-400 x10E3/uL
<100
<110
<200
>400
>600
1D-8D
200-400 x10E3/uL
<100
<110
<200
>400
>600
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 62
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
7
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Apr-1995
Continued...
Platelets (HMT13)
Female
8D-15D
200-400 x10E3/uL
<100
<110
<200
>400
>600
15D-31D
200-400 x10E3/uL
<100
<110
<200
>400
>600
31D-4M
200-400 x10E3/uL
<100
<110
<200
>400
>600
4M-7M
200-400 x10E3/uL
<100
<110
<200
>400
>600
7M-2Y
200-400 x10E3/uL
<100
<110
<200
>400
>600
2Y-3Y
252-582 x10E3/uL
<100
<110
<252
>582
>600
3Y-6Y
240-570 x10E3/uL
<100
<110
<240
>570
>600
6Y-12Y
130-394 x10E3/uL
<100
<110
<130
>394
>600
12Y-60Y
140-400 x10E3/uL
<100
<110
<140
>400
>600
60Y-150Y 130-394 x10E3/uL
<100
<110
<130
>394
>600
Male
0D-1D
200-400 x10E3/uL
<100
<110
<200
>400
>600
1D-8D
200-400 x10E3/uL
<100
<110
<200
>400
>600
8D-15D
200-400 x10E3/uL
<100
<110
<200
>400
>600
15D-31D
200-400 x10E3/uL
<100
<110
<200
>400
>600
31D-4M
200-400 x10E3/uL
<100
<110
<200
>400
>600
4M-7M
200-400 x10E3/uL
<100
<110
<200
>400
>600
7M-2Y
200-400 x10E3/uL
<100
<110
<200
>400
>600
2Y-3Y
252-582 x10E3/uL
<100
<110
<252
>582
>600
3Y-6Y
240-570 x10E3/uL
<100
<110
<240
>570
>600
6Y-12Y
130-394 x10E3/uL
<100
<110
<130
>394
>600
12Y-60Y
140-400 x10E3/uL
<100
<110
<140
>400
>600
60Y-150Y 130-394 x10E3/uL
<100
<110
<130
>394
>600
Key:
Alert flags:
H
HP
HT
L
LP
LT
High
High Panic
High - Telephone
Low
Low Panic
Low - Telephone
Covance CLS
Run: 6-Jun-07
2:47 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Blasts (HMT97)
Both
0Y-150Y
0%
>0
Key:
Alert flags:
HT
High - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 63
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Metamyelo (HMT69)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Myelocyte (HMT68)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Promyelocy (HMT67)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Myeloblast (HMT66)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0%
>0
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:47 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Prolymph (HMT56)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Ly,Immunob (HMT59)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Ly,Plasmcy (HMT60)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Lymph,Reac (HMT61)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Lymphoblas (HMT62)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Atyp Lymph (HMT96)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Lymphoma C (HMT55)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Sezary, % (HMT57)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0%
>0
High
High - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 64
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Promonocyt (HMT63)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Mono,Immat (HMT65)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Monoblast (HMT64)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0%
>0
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:47 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
14-Feb-1997
Eos,Immat (HMT49)
Both
0Y-150Y
0%
>0
Key:
Alert flags:
High
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 65
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
18-Jul-1994
Baso,Immat (HMT48)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Pre (HMT52)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
14-Feb-1997
Plasma Imm (HMT53)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Cel (HMT54)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Malign,Nos (HMT50)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Hairy Cell (HMT58)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
NRBC (HMT70)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
18-Sep-1992
CBC Commt: (HMT51)
Both
0Y-150Y
Key:
Alert flags:
H
HT
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:47 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Blasts (HMT94)
Both
0Y-150Y
0 x10E3/uL
>0.00
Key:
Alert flags:
HT
High - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 66
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Metamyelo (HMT93)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Myelocyte (HMT92)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Promyelocy (HMT91)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Myeloblast (HMT90)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0 x10E3/uL
>0.00
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:47 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Prolymph (HMT81)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Ly,Immunob (HMT83)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Ly,Plasmcy (HMT84)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Lymph,Reac (HMT85)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Lymphoblas (HMT86)
Both
0Y-150Y
0 x10E3/uL
>0.00
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Atyp Lymph (HMT95)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Lymphoma C (HMT80)
Both
0Y-150Y
0 x10E3/uL
>0.00
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Sezary,Abs (HMT72)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0 X10E3/uL
>0
High
High - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 67
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Promonocyt (HMT87)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Mono,Immat (HMT89)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Monoblast (HMT88)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0 x10E3/uL
>0.00
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:47 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Eos,Immat (HMT75)
Both
0Y-150Y
x10E3/uL
>0
0
Key:
Alert flags:
High
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 68
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Baso,Immat (HMT74)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Pre (HMT77)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Imm (HMT78)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Cel (HMT79)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Malign,NOS (HMT76)
Both
0Y-150Y
0 x10E3/uL
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Hairy Cell (HMT82)
Both
0Y-150Y
0 x10E3/uL
>0.00
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
NRBC (HMT98)
Both
0Y-150Y
0%
>0.00
__________________________________________________________________________________________________________________________________________________________
09-Dec-1992
CBC Commt: (HMT99)
Both
0Y-150Y
Key:
Alert flags:
H
HT
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:47 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Apr-1995
Platelets (HMT13)
Female
0D-1D
200-400 x10E3/uL
<100
<110
<200
>400
>600
1D-8D
200-400 x10E3/uL
<100
<110
<200
>400
>600
8D-15D
200-400 x10E3/uL
<100
<110
<200
>400
>600
15D-31D
200-400 x10E3/uL
<100
<110
<200
>400
>600
31D-4M
200-400 x10E3/uL
<100
<110
<200
>400
>600
4M-7M
200-400 x10E3/uL
<100
<110
<200
>400
>600
7M-2Y
200-400 x10E3/uL
<100
<110
<200
>400
>600
2Y-3Y
252-582 x10E3/uL
<100
<110
<252
>582
>600
3Y-6Y
240-570 x10E3/uL
<100
<110
<240
>570
>600
6Y-12Y
130-394 x10E3/uL
<100
<110
<130
>394
>600
12Y-60Y
140-400 x10E3/uL
<100
<110
<140
>400
>600
60Y-150Y 130-394 x10E3/uL
<100
<110
<130
>394
>600
Male
0D-1D
200-400 x10E3/uL
<100
<110
<200
>400
>600
1D-8D
200-400 x10E3/uL
<100
<110
<200
>400
>600
8D-15D
200-400 x10E3/uL
<100
<110
<200
>400
>600
15D-31D
200-400 x10E3/uL
<100
<110
<200
>400
>600
31D-4M
200-400 x10E3/uL
<100
<110
<200
>400
>600
4M-7M
200-400 x10E3/uL
<100
<110
<200
>400
>600
7M-2Y
200-400 x10E3/uL
<100
<110
<200
>400
>600
2Y-3Y
252-582 x10E3/uL
<100
<110
<252
>582
>600
3Y-6Y
240-570 x10E3/uL
<100
<110
<240
>570
>600
6Y-12Y
130-394 x10E3/uL
<100
<110
<130
>394
>600
12Y-60Y
140-400 x10E3/uL
<100
<110
<140
>400
>600
60Y-150Y 130-394 x10E3/uL
<100
<110
<130
>394
>600
Key:
Alert flags:
H
HT
L
LP
LT
High
High - Telephone
Low
Low Panic
Low - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 69
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
HT
20-Apr-2007
D-Dimer (IMT1209)
Both
0Y-18Y
ng/mL(FEU)
No Ref Rng
18Y-150Y <500 ng/mL(FEU)
>499.999999
Key:
Alert flags:
HT
High - Telephone
Covance CLS
Run: 6-Jun-07
2:47 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
22-Mar-2001
Total Bili (RCT1)
Both
0W-2W
0.2-11.7 mg/dL
<0.2
>11.7
>20.0
2W-18Y
0.2-1.2 mg/dL
<0.2
>1.2
>2.0
>3.0
18Y-150Y 0.2-1.2 mg/dL
<0.2
>1.2
>2.0
>3.0
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
24-Jan-2003
Alk Phos (RCT1407)
Female
0M-1M
48-406 U/L
<48
>406
>500
>750
1M-1Y
124-341 U/L
<124
>341
>500
>750
1Y-4Y
108-317 U/L
<108
>317
>500
>750
4Y-7Y
96-297 U/L
<96
>297
>500
>750
7Y-10Y
69-325 U/L
<69
>325
>500
>750
10Y-15Y
51-300 U/L
<51
>300
>400
>750
15Y-18Y
31-110 U/L
<31
>110
>200
>500
18Y-50Y
31-106 U/L
<31
>106
>200
>500
50Y-60Y
35-123 U/L
<35
>123
>300
>500
60Y-70Y
35-123 U/L
<35
>123
>300
>500
70Y-80Y
35-135 U/L
<35
>135
>300
>500
80Y-90Y
35-135 U/L
<35
>135
>300
>500
90Y-150Y 35-140 U/L
<35
>140
>300
>500
Male
0M-1M
75-316 U/L
<75
>316
>500
>750
1M-1Y
82-383 U/L
<82
>383
>500
>750
1Y-4Y
104-345 U/L
<104
>345
>500
>750
4Y-7Y
93-309 U/L
<93
>309
>500
>750
7Y-10Y
86-315 U/L
<86
>315
>500
>750
10Y-15Y
95-385 U/L
<95
>385
>500
>750
15Y-18Y
50-250 U/L
<50
>250
>300
>750
18Y-50Y
31-129 U/L
<31
>129
>250
>500
50Y-60Y
35-131 U/L
<35
>131
>300
>500
60Y-70Y
35-125 U/L
<35
>125
>300
>500
70Y-80Y
35-130 U/L
<35
>130
>300
>500
80Y-90Y
35-125 U/L
<35
>125
>300
>500
90Y-150Y 35-125 U/L
<35
>125
>300
>500
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
23-Nov-2004
ALT (SGPT) (RCT4)
Female
0Y-1Y
<=54 U/L
1Y-4Y
6-34 U/L
4Y-7Y
6-34 U/L
7Y-10Y
6-34 U/L
10Y-18Y
6-34 U/L
18Y-69Y
6-34 U/L
69Y-150Y 6-32 U/L
Male
0Y-1Y
<=54 U/L
1Y-4Y
6-34 U/L
4Y-7Y
6-34 U/L
7Y-10Y
6-34 U/L
10Y-18Y
6-43 U/L
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA
>54
>100
>200
>34
>100
>200
>34
>100
>200
>34
>100
>200
>34
>200
>300
>34
>200
>300
>32
>200
>300
>54
>100
>200
<6
>34
>100
>200
<6
>34
>100
>200
<6
>34
>100
>200
<6
>43
>200
>300
46214-2985 (317) 271-1200 FAX (317) 616-2351
<6
<6
<6
<6
<6
<6
Page: 70
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:47 PM
Page:
2
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
23-Nov-2004
Continued...
ALT (SGPT) (RCT4)
Male
18Y-69Y
6-43 U/L
<6
>43
>200
>300
69Y-150Y 6-35 U/L
<6
>35
>200
>300
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
27-Dec-2000
AST (SGOT) (RCT5)
Female
0Y-1Y
10-80 U/L
<10
>80
>200
>300
1Y-4Y
10-56 U/L
<10
>56
>100
>200
4Y-7Y
10-48 U/L
<10
>48
>100
>200
7Y-18Y
10-40 U/L
<10
>40
>100
>200
18Y-59Y
9-34 U/L
<9
>34
>200
>300
59Y-150Y 9-34 U/L
<9
>34
>200
>300
Male
0Y-1Y
10-80 U/L
<10
>80
>200
>300
1Y-4Y
10-69 U/L
<10
>69
>100
>200
4Y-7Y
10-59 U/L
<10
>59
>100
>200
7Y-18Y
10-40 U/L
<10
>40
>100
>200
18Y-59Y
11-36 U/L
<11
>36
>200
>300
59Y-150Y 11-36 U/L
<11
>36
>200
>300
__________________________________________________________________________________________________________________________________________________________
L
H
HP
24-Jan-2003
LDH (RCT1408)
Female
Both
0M-1M
145-765 U/L
<145
>765
>1000
1M-1Y
190-420 U/L
<190
>420
>1000
1Y-3Y
165-395 U/L
<165
>395
>500
3Y-6Y
135-345 U/L
<135
>345
>500
6Y-9Y
140-280 U/L
<140
>280
>500
9Y-12Y
120-260 U/L
<120
>260
>500
12Y-15Y
100-275 U/L
<100
>275
>500
15Y-18Y
105-230 U/L
<105
>230
>500
18Y-150Y 53-234 U/L
<53
>234
>350
Male
0M-1M
125-735 U/L
<125
>735
>1000
1M-1Y
170-450 U/L
<170
>450
>1000
1Y-3Y
155-345 U/L
<155
>345
>500
3Y-6Y
155-345 U/L
<155
>345
>500
6Y-9Y
145-300 U/L
<145
>300
>500
9Y-12Y
120-325 U/L
<120
>325
>500
12Y-15Y
120-290 U/L
<120
>290
>500
15Y-18Y
105-235 U/L
<105
>235
>500
18Y-150Y 53-234 U/L
<53
>234
>350
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
25-Jun-2005
Covance CLS
Run: 6-Jun-07
2:47 PM
0Y-18Y
18Y-70Y
70Y-80Y
80Y-150Y
4-24
4-24
4-29
4-34
mg/dL
mg/dL
mg/dL
mg/dL
<4
<4
<4
<4
>24
>24
>29
>34
>35
>35
>40
>40
>50
>50
>50
>50
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
3
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
24-Aug-2000
Creatinine (RCT392)
Female
0M-1M
0.2-0.6 mg/dL
<0.2
>0.6
>1.0
>1.5
1M-1Y
0.1-0.3 mg/dL
<0.1
>0.3
>1.0
>1.5
1Y-4Y
0.1-0.4 mg/dL
<0.1
>0.4
>1.0
>1.5
4Y-7Y
0.2-0.5 mg/dL
<0.2
>0.5
>1.0
>1.5
7Y-10Y
0.2-0.6 mg/dL
<0.2
>0.6
>1.0
>1.5
10Y-13Y
0.3-0.7 mg/dL
<0.3
>0.7
>1.2
>1.7
13Y-16Y
0.4-0.8 mg/dL
<0.4
>0.8
>1.5
>2.0
16Y-18Y
0.5-0.9 mg/dL
<0.5
>0.9
>2.0
>3.0
18Y-50Y
0.4-1.1 mg/dL
<0.4
>1.1
>2.0
>3.0
50Y-70Y
0.4-1.1 mg/dL
<0.4
>1.1
>2.0
>3.0
70Y-80Y
0.4-1.2 mg/dL
<0.4
>1.2
>2.0
>3.0
80Y-150Y 0.4-1.4 mg/dL
<0.4
>1.4
>2.0
>3.0
Male
0M-1M
0.2-0.9 mg/dL
<0.2
>0.9
>1.2
>1.5
1M-1Y
0.1-0.4 mg/dL
<0.1
>0.4
>1.0
>1.5
1Y-4Y
0.1-0.4 mg/dL
<0.1
>0.4
>1.0
>1.5
4Y-7Y
0.2-0.5 mg/dL
<0.2
>0.5
>1.0
>1.5
7Y-10Y
0.3-0.6 mg/dL
<0.3
>0.6
>1.0
>1.5
10Y-13Y
0.3-0.7 mg/dL
<0.3
>0.7
>1.2
>1.7
13Y-16Y
0.3-0.9 mg/dL
<0.3
>0.9
>1.5
>2.0
16Y-18Y
0.5-1.1 mg/dL
<0.5
>1.1
>2.0
>3.0
18Y-50Y
0.5-1.2 mg/dL
<0.5
>1.2
>2.0
>3.0
50Y-70Y
0.5-1.3 mg/dL
<0.5
>1.3
>2.0
>3.0
70Y-80Y
0.5-1.5 mg/dL
<0.5
>1.5
>2.0
>3.0
80Y-150Y 0.5-1.6 mg/dL
<0.5
>1.6
>2.0
>3.0
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
20-Oct-2006
Glucose (RCT11)
Both
0M-1M
55-115 mg/dL
<40
<45
<55
>115
>200
>250
1M-18Y
70-115 mg/dL
<40
<45
<70
>115
>300
>400
18Y-59Y
70-115 mg/dL
<40
<45
<70
>115
>300
>400
59Y-150Y 70-120 mg/dL
<40
<45
<70
>120
>300
>400
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
21-Mar-2002
Calcium (RCT183)
Both
Sodium (RCT15)
Both
0Y-2Y
9.0-11.0 mg/dL
<5.0
<7.0
<9.0
>11.0
>12.5
>14.0
2Y-18Y
8.4-10.3 mg/dL
<5.0
<7.0
<8.4
>10.3
>11.0
>13.0
18Y-150Y 8.3-10.6 mg/dL
<5.0
<7.0
<8.3
>10.6
>11.0
>13.0
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
29-Apr-1997
0Y-18Y
132-147 mEq/L
<115
<125
<132
>147
>155
>165
18Y-59Y
132-147 mEq/L
<115
<125
<132
>147
>155
>165
59Y-150Y 135-145 mEq/L
<115
<125
<135
>145
>155
>165
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
29-Apr-1997
Potassium (RCT16)
Both
0Y-1Y
3.7-5.6 mEq/L
<2.6
<3.0
<3.7
>5.6
>6.0
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 71
510013_TMEA_Printed: 20070606
>6.9
Run: 6-Jun-07
2:47 PM
Page:
4
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
29-Apr-1997
Continued...
Potassium (RCT16)
Both
1Y-18Y
3.4-5.4 mEq/L
<2.6
<3.0
<3.4
>5.4
>5.8
>6.9
18Y-59Y
3.4-5.4 mEq/L
<2.6
<3.0
<3.4
>5.4
>5.8
>6.9
59Y-150Y 3.4-5.4 mEq/L
<2.6
<3.0
<3.4
>5.4
>5.8
>6.9
__________________________________________________________________________________________________________________________________________________________
LT
L
H
HT
29-Mar-2000
Bicarb (RCT17)
Female
0Y-1Y
12.0-28.0 mEq/L
<12.0
>28.0
>32.0
1Y-4Y
12.0-28.0 mEq/L
<12.0
>28.0
>32.0
4Y-18Y
17.0-30.6 mEq/L
<15.1
<17.0
>30.6
>34.9
18Y-70Y
17.0-30.6 mEq/L
<15.1
<17.0
>30.6
>34.9
70Y-150Y 17.0-32.0 mEq/L
<15.1
<17.0
>32.0
>34.9
Male
0Y-1Y
12.0-28.0 mEq/L
<12.0
>28.0
>32.0
1Y-4Y
12.0-28.0 mEq/L
<12.0
>28.0
>32.0
4Y-18Y
17.0-30.6 mEq/L
<15.1
<17.0
>30.6
>34.9
18Y-70Y
17.0-30.6 mEq/L
<15.1
<17.0
>30.6
>34.9
70Y-150Y 17.0-32.0 mEq/L
<15.1
<17.0
>32.0
>34.9
__________________________________________________________________________________________________________________________________________________________
L
H
25-Apr-1997
Chloride (RCT18)
Both
Key:
Alert flags:
H
HP
HT
L
LP
LT
0Y-18Y
18Y-150Y
94-112 mEq/L
94-112 mEq/L
<94
<94
>112
>112
High
High Panic
High - Telephone
Low
Low Panic
Low - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 72
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:53 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
01-Mar-2007
Fibrinogen (CGT285)
Both
0Y-150Y
200-400 mg/dL
<200
>400
Key:
Alert flags:
H
L
High
Low
Covance CLS
Run: 6-Jun-07
2:53 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
HT
28-Dec-2006
PT (CGT283)
Both
0Y-150Y
9.7-12.3 sec
<9.7
>12.3
>40.0
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
28-Dec-2006
INR (CGT286)
Key:
Alert flags:
Both
H
HP
HT
L
0Y-150Y
0.8-1.2
<0.8
>1.2
>3.0
>4.0
High
High Panic
High - Telephone
Low
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 73
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:53 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
23-Oct-2000
HGB (HMT40)
Female
0Y-1D
135-220 g/L
<80
<100
<135
>220
1D-8D
135-220 g/L
<80
<100
<135
>220
8D-15D
125-210 g/L
<80
<100
<125
>210
15D-31D
100-200 g/L
<80
<100
>200
31D-4M
100-140 g/L
<80
<100
>140
4M-7M
100-140 g/L
<80
<100
>140
7M-2Y
105-135 g/L
<80
<105
>135
2Y-3Y
110-140 g/L
<80
<110
>140
3Y-6Y
118-147 g/L
<80
<118
>147
6Y-12Y
112-155 g/L
<60
<90
<112
>155
>190
>210
12Y-59Y
116-164 g/L
<60
<100
<116
>164
>190
>230
59Y-150Y 115-158 g/L
<60
<100
<115
>158
>190
>230
Male
0Y-1D
135-220 g/L
<80
<100
<135
>220
1D-8D
135-220 g/L
<80
<100
<135
>220
8D-15D
125-210 g/L
<80
<100
<125
>210
15D-31D
100-200 g/L
<80
<100
>200
31D-4M
100-140 g/L
<80
<100
>140
4M-7M
100-140 g/L
<80
<100
>140
7M-2Y
105-135 g/L
<80
<105
>135
2Y-3Y
110-140 g/L
<80
<110
>140
3Y-6Y
110-145 g/L
<80
<110
>145
6Y-12Y
112-155 g/L
<60
<80
<112
>155
>190
>210
12Y-59Y
127-181 g/L
<60
<100
<127
>181
>190
>230
59Y-150Y 125-170 g/L
<60
<100
<125
>170
>190
>230
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
16-Oct-2000
HCT (HMT2)
Run: 6-Jun-07
2:53 PM
Female
0Y-1D
0.42-0.60
<0.24
<0.30
<0.42
>0.60
>0.65
1D-8D
0.42-0.60
<0.24
<0.30
<0.42
>0.60
>0.65
8D-15D
0.39-0.60
<0.24
<0.30
<0.39
>0.60
>0.65
15D-31D
0.31-0.55
<0.20
<0.24
<0.31
>0.55
>0.60
31D-4M
0.28-0.42
<0.20
<0.24
<0.28
>0.42
>0.55
4M-7M
0.28-0.42
<0.20
<0.24
<0.28
>0.42
>0.55
7M-2Y
0.33-0.40
<0.20
<0.24
<0.33
>0.40
>0.50
2Y-3Y
0.33-0.42
<0.24
<0.28
<0.33
>0.42
>0.50
3Y-6Y
0.35-0.44
<0.28
<0.35
>0.44
>0.50
6Y-12Y
0.34-0.44
<0.28
<0.34
>0.44
>0.50
12Y-59Y
0.34-0.48
<0.28
<0.34
>0.48
>0.50
59Y-150Y 0.34-0.48
<0.28
<0.34
>0.48
>0.50
Male
0Y-1D
0.42-0.60
<0.24
<0.30
<0.42
>0.60
>0.65
1D-8D
0.42-0.60
<0.24
<0.30
<0.42
>0.60
>0.65
8D-15D
0.39-0.60
<0.24
<0.30
<0.39
>0.60
>0.65
15D-31D
0.31-0.55
<0.20
<0.24
<0.31
>0.55
>0.60
31D-4M
0.28-0.42
<0.20
<0.24
<0.28
>0.42
>0.55
4M-7M
0.28-0.42
<0.20
<0.24
<0.28
>0.42
>0.55
7M-2Y
0.33-0.40
<0.20
<0.24
<0.33
>0.40
>0.50
2Y-3Y
0.33-0.42
<0.24
<0.28
<0.33
>0.42
>0.50
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
2
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
16-Oct-2000
Continued...
HCT (HMT2)
Male
3Y-6Y
0.33-0.43
<0.24
<0.28
<0.33
>0.43
>0.50
6Y-12Y
0.34-0.44
<0.24
<0.34
>0.44
>0.50
12Y-59Y
0.39-0.54
<0.24
<0.39
>0.54
>0.55
59Y-150Y 0.37-0.51
<0.24
<0.37
>0.51
>0.55
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
16-Jan-2004
WBC (HMT7)
Female
0D-15D
8.30-17.60 GI/L
<1.00
<4.00
<8.30
>17.60
>30.00
>50.00
15D-31D
6.90-15.00 GI/L
<1.00
<3.00
<6.90
>15.00
>30.00
>50.00
31D-61D
6.10-13.80 GI/L
<1.00
<3.00
<6.10
>13.80
>25.00
>30.00
61D-7M
6.80-16.20 GI/L
<1.00
<3.00
<6.80
>16.20
>20.00
>30.00
7M-2Y
6.40-15.50 GI/L
<1.00
<3.00
<6.40
>15.50
>20.00
>30.00
2Y-6Y
5.50-12.50 GI/L
<1.00
<3.00
<5.50
>12.50
>15.00
>30.00
6Y-12Y
4.35-13.65 GI/L
<1.00
<2.00
<4.35
>13.65
>15.00
>30.00
12Y-18Y
4.35-13.15 GI/L
<1.00
<2.00
<4.35
>13.15
>15.00
>30.00
18Y-59Y
3.80-10.70 GI/L
<1.00
<2.50
<3.80
>10.70
>15.00
>30.00
59Y-150Y 3.80-10.70 GI/L
<1.00
<2.50
<3.80
>10.70
>15.00
>30.00
Male
0D-15D
8.60-14.90 GI/L
<1.00
<4.00
<8.60
>14.90
>30.00
>50.00
15D-31D
7.40-13.30 GI/L
<1.00
<3.00
<7.40
>13.30
>30.00
>50.00
31D-61D
6.00-13.70 GI/L
<1.00
<3.00
<6.00
>13.70
>25.00
>30.00
61D-7M
6.60-15.60 GI/L
<1.00
<3.00
<6.60
>15.60
>20.00
>30.00
7M-2Y
6.30-15.40 GI/L
<1.00
<3.00
<6.30
>15.40
>20.00
>30.00
2Y-6Y
5.50-12.30 GI/L
<1.00
<3.00
<5.50
>12.30
>15.00
>30.00
6Y-12Y
4.35-13.65 GI/L
<1.00
<2.00
<4.35
>13.65
>15.00
>30.00
12Y-18Y
4.35-13.15 GI/L
<1.00
<2.00
<4.35
>13.15
>15.00
>30.00
18Y-59Y
3.80-10.70 GI/L
<1.00
<2.50
<3.80
>10.70
>15.00
>30.00
59Y-150Y 3.80-10.70 GI/L
<1.00
<2.50
<3.80
>10.70
>15.00
>30.00
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Dec-2000
Neutrophil (HMT8)
Female
0D-1D
6.00-26.00 GI/L
<1.00
<6.00
>26.00
>40.00
1D-8D
2.00-21.00 GI/L
<1.00
<2.00
>21.00
>40.00
8D-15D
1.00-10.00 GI/L
<0.50
<1.00
>10.00
>40.00
15D-31D
1.00-9.50 GI/L
<0.50
<1.00
>9.50
>11.00
31D-4M
1.00-9.00 GI/L
<0.50
<1.00
>9.00
>11.00
4M-7M
1.00-9.00 GI/L
<0.50
<1.00
>9.00
>11.00
7M-2Y
1.50-9.60 GI/L
<0.50
<1.00
<1.50
>9.60
>12.00
2Y-3Y
1.00-9.00 GI/L
<0.50
<1.00
>9.00
>11.00
3Y-6Y
1.00-9.00 GI/L
<0.50
<1.00
>9.00
>11.00
6Y-12Y
1.35-8.15 GI/L
<0.50
<1.00
<1.35
>8.15
>11.00
12Y-18Y
1.65-8.15 GI/L
<0.50
<1.00
<1.65
>8.15
>11.00
18Y-59Y
1.96-7.23 GI/L
<0.50
<1.00
<1.96
>7.23
>11.00
59Y-150Y 1.96-7.23 GI/L
<0.50
<1.00
<1.96
>7.23
>11.00
Male
0D-1D
6.00-26.00 GI/L
<1.00
<6.00
>26.00
>40.00
1D-8D
2.00-21.00 GI/L
<1.00
<2.00
>21.00
>40.00
8D-15D
1.00-10.00 GI/L
<0.50
<1.00
>10.00
>40.00
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 74
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:53 PM
Page:
3
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Dec-2000
Continued...
Neutrophil (HMT8)
Male
15D-31D
1.00-9.50 GI/L
<0.50
<1.00
>9.50
>11.00
31D-4M
1.00-9.00 GI/L
<0.50
<1.00
>9.00
>11.00
4M-7M
1.00-9.00 GI/L
<0.50
<1.00
>9.00
>11.00
7M-2Y
1.50-9.40 GI/L
<0.50
<1.00
<1.50
>9.40
>12.00
2Y-3Y
1.35-8.65 GI/L
<0.50
<1.00
<1.35
>8.65
>11.00
3Y-6Y
1.35-8.65 GI/L
<0.50
<1.00
<1.35
>8.65
>11.00
6Y-12Y
1.35-8.15 GI/L
<0.50
<1.00
<1.35
>8.15
>11.00
12Y-18Y
1.65-8.15 GI/L
<0.50
<1.00
<1.65
>8.15
>11.00
18Y-59Y
1.96-7.23 GI/L
<0.50
<1.00
<1.96
>7.23
>11.00
59Y-150Y 1.96-7.23 GI/L
<0.50
<1.00
<1.96
>7.23
>11.00
__________________________________________________________________________________________________________________________________________________________
H
29-Sep-1993
Bands (HMT20)
Both
0Y-150Y
0.00-0.27 GI/L
>0.27
__________________________________________________________________________________________________________________________________________________________
LT
L
H
HT
26-Dec-2000
Lymphocyte (HMT9)
Female
Male
Covance CLS
Run: 6-Jun-07
2:53 PM
0D-1D
1D-8D
8D-15D
15D-31D
31D-4M
4M-7M
7M-2Y
2Y-3Y
3Y-6Y
6Y-12Y
12Y-18Y
18Y-59Y
59Y-150Y
0D-1D
1D-8D
8D-15D
15D-31D
31D-4M
4M-7M
7M-2Y
2Y-3Y
3Y-6Y
6Y-12Y
12Y-18Y
18Y-59Y
59Y-150Y
2.00-11.00 GI/L
2.00-17.00 GI/L
2.00-17.00 GI/L
2.50-17.00 GI/L
2.50-16.00 GI/L
3.00-15.00 GI/L
1.70-6.70 GI/L
1.50-10.00 GI/L
1.50-8.00 GI/L
1.15-6.65 GI/L
0.95-5.25 GI/L
0.91-4.28 GI/L
0.80-3.00 GI/L
2.00-11.00 GI/L
2.00-17.00 GI/L
2.00-17.00 GI/L
2.50-17.00 GI/L
2.50-16.00 GI/L
3.00-15.00 GI/L
1.70-6.50 GI/L
1.50-10.00 GI/L
1.50-8.00 GI/L
1.15-6.65 GI/L
0.95-5.25 GI/L
0.91-4.28 GI/L
0.80-3.00 GI/L
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<1.30
<1.00
<1.00
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<1.30
<1.00
<1.00
<2.00
<2.00
<2.00
<2.50
<2.50
<3.00
<1.70
<1.50
<1.50
<1.15
<0.95
<0.91
<0.80
<2.00
<2.00
<2.00
<2.50
<2.50
<3.00
<1.70
<1.50
<1.50
<1.15
<0.95
<0.91
<0.80
>11.00
>17.00
>17.00
>17.00
>16.00
>15.00
>6.70
>10.00
>8.00
>6.65
>5.25
>4.28
>3.00
>11.00
>17.00
>17.00
>17.00
>16.00
>15.00
>6.50
>10.00
>8.00
>6.65
>5.25
>4.28
>3.00
>25.00
>25.00
>25.00
>25.00
>25.00
>25.00
>10.00
>25.00
>25.00
>25.00
>25.00
>25.00
>25.00
>25.00
>25.00
>10.00
>25.00
>25.00
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
4
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
13-Jul-2006
Monocytes (HMT10)
Female
0D-4D
0.20-2.20 GI/L
<0.20
>2.20
4D-8D
0.20-2.20 GI/L
<0.20
>2.20
8D-15D
0.10-2.90 GI/L
<0.10
>2.90
15D-31D
0.20-5.00 GI/L
<0.20
>5.00
31D-61D
0.20-2.10 GI/L
<0.20
>2.10
61D-180D 0.60-1.90 GI/L
<0.60
>1.90
180D-2Y
0.30-1.50 GI/L
<0.30
>1.50
2Y-6Y
0.50-1.10 GI/L
<0.50
>1.10
6Y-12Y
0.40-0.90 GI/L
<0.40
>0.90
12Y-18Y
0.40-0.90 GI/L
<0.40
>0.90
18Y-150Y 0.12-0.92 GI/L
<0.12
>0.92
Male
0D-4D
0.20-1.80 GI/L
<0.20
>1.80
4D-8D
0.20-2.20 GI/L
<0.20
>2.20
8D-15D
0.30-3.00 GI/L
<0.30
>3.00
15D-31D
0.20-3.50 GI/L
<0.20
>3.50
31D-61D
0.30-2.70 GI/L
<0.30
>2.70
61D-180D 0.50-1.90 GI/L
<0.50
>1.90
180D-2Y
0.40-2.00 GI/L
<0.40
>2.00
2Y-6Y
0.30-1.20 GI/L
<0.30
>1.20
6Y-12Y
0.30-0.90 GI/L
<0.30
>0.90
12Y-18Y
0.40-1.30 GI/L
<0.40
>1.30
18Y-150Y 0.12-0.92 GI/L
<0.12
>0.92
__________________________________________________________________________________________________________________________________________________________
H
13-Jul-2006
Eosinophil (HMT11)
Female
0D-4D
0.00-0.20 GI/L
>0.20
4D-8D
0.00-0.50 GI/L
>0.50
8D-15D
0.00-0.60 GI/L
>0.60
15D-31D
0.00-0.50 GI/L
>0.50
31D-61D
0.00-0.20 GI/L
>0.20
61D-180D 0.00-0.10 GI/L
>0.10
180D-2Y
0.00-0.20 GI/L
>0.20
2Y-6Y
0.00-0.20 GI/L
>0.20
6Y-12Y
0.00-0.20 GI/L
>0.20
12Y-18Y
0.00-0.20 GI/L
>0.20
18Y-150Y 0.00-0.57 GI/L
>0.57
Male
0D-4D
0.00-0.30 GI/L
>0.30
4D-8D
0.00-0.80 GI/L
>0.80
8D-15D
0.00-0.60 GI/L
>0.60
15D-31D
0.00-0.90 GI/L
>0.90
31D-61D
0.00-0.50 GI/L
>0.50
61D-180D 0.00-0.40 GI/L
>0.40
180D-2Y
0.00-0.30 GI/L
>0.30
2Y-6Y
0.00-0.20 GI/L
>0.20
6Y-12Y
0.00-0.30 GI/L
>0.30
12Y-18Y
0.00-0.30 GI/L
>0.30
18Y-150Y 0.00-0.57 GI/L
>0.57
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 75
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:53 PM
Page:
5
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
29-Sep-1993
Basophils (HMT12)
Both
0Y-150Y
0.00-0.20 GI/L
>0.20
__________________________________________________________________________________________________________________________________________________________
L
H
09-Sep-1993
Neutrophil (HMT15)
Both
0Y-150Y
40.5-75.0 %
<40.5
>75.0
__________________________________________________________________________________________________________________________________________________________
H
18-Aug-1993
Bands (HMT21)
Both
0Y-150Y
0.0-3.0 %
>3.0
__________________________________________________________________________________________________________________________________________________________
L
H
02-Jun-1993
Lymphocyte (HMT16)
Both
0Y-150Y
15.4-48.5%
<15.4
>48.5
__________________________________________________________________________________________________________________________________________________________
L
H
13-Jul-2006
Monocytes (HMT17)
Female
0D-4D
5.0-11.0 %
<5.0
>11.0
4D-8D
6.0-14.0 %
<6.0
>14.0
8D-15D
6.0-19.0 %
<6.0
>19.0
15D-31D
5.0-14.0 %
<5.0
>14.0
31D-61D
5.0-14.0 %
<5.0
>14.0
61D-180D 4.0-12.0 %
<4.0
>12.0
180D-2Y
4.0-9.0 %
<4.0
>9.0
2Y-6Y
4.0-8.0 %
<4.0
>8.0
6Y-12Y
4.0-7.0 %
<4.0
>7.0
12Y-18Y
4.0-7.0 %
<4.0
>7.0
18Y-150Y 2.6-10.1 %
<2.6
>10.1
Male
0D-4D
4.0-13.0 %
<4.0
>13.0
4D-8D
7.0-17.0 %
<7.0
>17.0
8D-15D
7.0-18.0 %
<7.0
>18.0
15D-31D
6.0-18.0 %
<6.0
>18.0
31D-61D
6.0-17.0 %
<6.0
>17.0
61D-180D 4.0-11.0 %
<4.0
>11.0
180D-2Y
1.0-10.0 %
<1.0
>10.0
2Y-6Y
4.0-9.0 %
<4.0
>9.0
6Y-12Y
4.0-8.0 %
<4.0
>8.0
12Y-18Y
4.0-8.0 %
<4.0
>8.0
18Y-150Y 2.6-10.1 %
<2.6
>10.1
__________________________________________________________________________________________________________________________________________________________
H
13-Jul-2006
Eosinophil (HMT18)
Female
Covance CLS
Run: 6-Jun-07
2:53 PM
0D-4D
0.0-3.9 %
>3.9
4D-8D
0.0-7.5 %
>7.5
8D-15D
0.0-4.1 %
>4.1
15D-31D
0.0-5.4 %
>5.4
31D-61D
0.0-3.1 %
>3.1
61D-180D 0.0-2.8 %
>2.8
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
6
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
13-Jul-2006
Continued...
Eosinophil (HMT18)
Female
180D-2Y
0.0-3.1 %
>3.1
2Y-6Y
0.0-3.3 %
>3.3
6Y-12Y
0.0-4.0 %
>4.0
12Y-18Y
0.0-4.1 %
>4.1
18Y-150Y 0.0-6.8 %
>6.8
Male
0D-4D
0.0-2.9 %
>2.9
4D-8D
0.0-5.4 %
>5.4
8D-15D
0.0-5.0 %
>5.0
15D-31D
0.0-7.0 %
>7.0
31D-61D
0.0-5.4 %
>5.4
61D-180D 0.0-3.5 %
>3.5
180D-2Y
0.0-2.0 %
>2.0
2Y-6Y
0.0-2.4 %
>2.4
6Y-12Y
0.0-4.8 %
>4.8
12Y-18Y
0.0-2.8 %
>2.8
18Y-150Y 0.0-6.8 %
>6.8
__________________________________________________________________________________________________________________________________________________________
H
13-Jul-2006
Basophils (HMT19)
0D-4D
0.0-1.0 %
>1.0
4D-8D
0.0-1.0 %
>1.0
8D-15D
0.0-1.0 %
>1.0
15D-31D
0.0-1.0 %
>1.0
31D-61D
0.0-1.0 %
>1.0
61D-180D 0.0-1.0 %
>1.0
180D-2Y
0.0-1.0 %
>1.0
2Y-6Y
0.0-1.0 %
>1.0
6Y-12Y
0.0-1.0 %
>1.0
12Y-18Y
0.0-1.0 %
>1.0
18Y-150Y 0.0-2.0 %
>2.0
Male
0D-4D
0.0-1.0 %
>1.0
4D-8D
0.0-1.0 %
>1.0
8D-15D
0.0-1.0 %
>1.0
15D-31D
0.0-1.0 %
>1.0
31D-61D
0.0-1.0 %
>1.0
61D-180D 0.0-1.0 %
>1.0
180D-2Y
0.0-1.0 %
>1.0
2Y-6Y
0.0-1.0 %
>1.0
6Y-12Y
0.0-1.0 %
>1.0
12Y-18Y
0.0-1.0 %
>1.0
18Y-150Y 0.0-2.0 %
>2.0
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Apr-1995
Platelets (HMT13)
Female
Female
Covance CLS
0D-1D
200-400 GI/L
<100
<110
<200
>400
>600
1D-8D
200-400 GI/L
<100
<110
<200
>400
>600
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 76
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:53 PM
Page:
7
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Apr-1995
Continued...
Platelets (HMT13)
Female
8D-15D
200-400 GI/L
<100
<110
<200
>400
>600
15D-31D
200-400 GI/L
<100
<110
<200
>400
>600
31D-4M
200-400 GI/L
<100
<110
<200
>400
>600
4M-7M
200-400 GI/L
<100
<110
<200
>400
>600
7M-2Y
200-400 GI/L
<100
<110
<200
>400
>600
2Y-3Y
252-582 GI/L
<100
<110
<252
>582
>600
3Y-6Y
240-570 GI/L
<100
<110
<240
>570
>600
6Y-12Y
130-394 GI/L
<100
<110
<130
>394
>600
12Y-60Y
140-400 GI/L
<100
<110
<140
>400
>600
60Y-150Y 130-394 GI/L
<100
<110
<130
>394
>600
Male
0D-1D
200-400 GI/L
<100
<110
<200
>400
>600
1D-8D
200-400 GI/L
<100
<110
<200
>400
>600
8D-15D
200-400 GI/L
<100
<110
<200
>400
>600
15D-31D
200-400 GI/L
<100
<110
<200
>400
>600
31D-4M
200-400 GI/L
<100
<110
<200
>400
>600
4M-7M
200-400 GI/L
<100
<110
<200
>400
>600
7M-2Y
200-400 GI/L
<100
<110
<200
>400
>600
2Y-3Y
252-582 GI/L
<100
<110
<252
>582
>600
3Y-6Y
240-570 GI/L
<100
<110
<240
>570
>600
6Y-12Y
130-394 GI/L
<100
<110
<130
>394
>600
12Y-60Y
140-400 GI/L
<100
<110
<140
>400
>600
60Y-150Y 130-394 GI/L
<100
<110
<130
>394
>600
Key:
Alert flags:
H
HP
HT
L
LP
LT
High
High Panic
High - Telephone
Low
Low Panic
Low - Telephone
Covance CLS
Run: 6-Jun-07
2:53 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Blasts (HMT97)
Both
0Y-150Y
0%
>0
Key:
Alert flags:
HT
High - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 77
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:53 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Metamyelo (HMT69)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Myelocyte (HMT68)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Promyelocy (HMT67)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Myeloblast (HMT66)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0%
>0
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:53 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Prolymph (HMT56)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Ly,Immunob (HMT59)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Ly,Plasmcy (HMT60)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Lymph,Reac (HMT61)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Lymphoblas (HMT62)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Atyp Lymph (HMT96)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Lymphoma C (HMT55)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Sezary, % (HMT57)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0%
>0
High
High - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 78
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:53 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Promonocyt (HMT63)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Mono,Immat (HMT65)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Monoblast (HMT64)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0%
>0
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:53 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
14-Feb-1997
Eos,Immat (HMT49)
Both
0Y-150Y
0%
>0
Key:
Alert flags:
High
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 79
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:53 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
18-Jul-1994
Baso,Immat (HMT48)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Pre (HMT52)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
14-Feb-1997
Plasma Imm (HMT53)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Cel (HMT54)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Malign,Nos (HMT50)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Hairy Cell (HMT58)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
NRBC (HMT70)
Both
0Y-150Y
0%
>0
__________________________________________________________________________________________________________________________________________________________
18-Sep-1992
CBC Commt: (HMT51)
Both
0Y-150Y
Key:
Alert flags:
H
HT
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:54 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Blasts (HMT94)
Both
0Y-150Y
0 GI/L
>0.00
Key:
Alert flags:
HT
High - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 80
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:54 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Metamyelo (HMT93)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Myelocyte (HMT92)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Promyelocy (HMT91)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Myeloblast (HMT90)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0 GI/L
>0.00
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:54 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Prolymph (HMT81)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Ly,Immunob (HMT83)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Ly,Plasmcy (HMT84)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Lymph,Reac (HMT85)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Lymphoblas (HMT86)
Both
0Y-150Y
0 GI/L
>0.00
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Atyp Lymph (HMT95)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Lymphoma C (HMT80)
Both
0Y-150Y
0 GI/L
>0.00
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Sezary,Abs (HMT72)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0 GI/L
>0
High
High - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 81
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:54 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Promonocyt (HMT87)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Mono,Immat (HMT89)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Monoblast (HMT88)
Key:
Alert flags:
Both
H
HT
0Y-150Y
0 GI/L
>0.00
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:54 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Eos,Immat (HMT75)
Both
0Y-150Y
GI/L
>0
0
Key:
Alert flags:
High
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 82
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:54 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Baso,Immat (HMT74)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Pre (HMT77)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Imm (HMT78)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Plasma Cel (HMT79)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
Malign,NOS (HMT76)
Both
0Y-150Y
0 GI/L
>0
__________________________________________________________________________________________________________________________________________________________
HT
19-Jul-1994
Hairy Cell (HMT82)
Both
0Y-150Y
0 GI/L
>0.00
__________________________________________________________________________________________________________________________________________________________
H
19-Jul-1994
NRBC (HMT98)
Both
0Y-150Y
0%
>0.00
__________________________________________________________________________________________________________________________________________________________
09-Dec-1992
CBC Commt: (HMT99)
Both
0Y-150Y
Key:
Alert flags:
H
HT
High
High - Telephone
Covance CLS
Run: 6-Jun-07
2:54 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
26-Apr-1995
Platelets (HMT13)
Female
0D-1D
200-400 GI/L
<100
<110
<200
>400
>600
1D-8D
200-400 GI/L
<100
<110
<200
>400
>600
8D-15D
200-400 GI/L
<100
<110
<200
>400
>600
15D-31D
200-400 GI/L
<100
<110
<200
>400
>600
31D-4M
200-400 GI/L
<100
<110
<200
>400
>600
4M-7M
200-400 GI/L
<100
<110
<200
>400
>600
7M-2Y
200-400 GI/L
<100
<110
<200
>400
>600
2Y-3Y
252-582 GI/L
<100
<110
<252
>582
>600
3Y-6Y
240-570 GI/L
<100
<110
<240
>570
>600
6Y-12Y
130-394 GI/L
<100
<110
<130
>394
>600
12Y-60Y
140-400 GI/L
<100
<110
<140
>400
>600
60Y-150Y 130-394 GI/L
<100
<110
<130
>394
>600
Male
0D-1D
200-400 GI/L
<100
<110
<200
>400
>600
1D-8D
200-400 GI/L
<100
<110
<200
>400
>600
8D-15D
200-400 GI/L
<100
<110
<200
>400
>600
15D-31D
200-400 GI/L
<100
<110
<200
>400
>600
31D-4M
200-400 GI/L
<100
<110
<200
>400
>600
4M-7M
200-400 GI/L
<100
<110
<200
>400
>600
7M-2Y
200-400 GI/L
<100
<110
<200
>400
>600
2Y-3Y
252-582 GI/L
<100
<110
<252
>582
>600
3Y-6Y
240-570 GI/L
<100
<110
<240
>570
>600
6Y-12Y
130-394 GI/L
<100
<110
<130
>394
>600
12Y-60Y
140-400 GI/L
<100
<110
<140
>400
>600
60Y-150Y 130-394 GI/L
<100
<110
<130
>394
>600
Key:
Alert flags:
H
HT
L
LP
LT
High
High - Telephone
Low
Low Panic
Low - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 83
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:54 PM
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
HT
20-Apr-2007
D-Dimer (IMT1209)
Both
0Y-18Y
ng/mL(FEU)
No Ref Rng
18Y-150Y <500 ng/mL(FEU)
>499.999999
Key:
Alert flags:
HT
High - Telephone
Covance CLS
Run: 6-Jun-07
2:54 PM
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
1
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
22-Mar-2001
Total Bili (RCT1)
Both
0W-2W
3-200 umol/L
<3
>200
>342
2W-18Y
3-21 umol/L
<3
>21
>34
>51
18Y-150Y 3-21 umol/L
<3
>21
>34
>51
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
24-Jan-2003
Alk Phos (RCT1407)
Female
0M-1M
48-406 U/L
<48
>406
>500
>750
1M-1Y
124-341 U/L
<124
>341
>500
>750
1Y-4Y
108-317 U/L
<108
>317
>500
>750
4Y-7Y
96-297 U/L
<96
>297
>500
>750
7Y-10Y
69-325 U/L
<69
>325
>500
>750
10Y-15Y
51-300 U/L
<51
>300
>400
>750
15Y-18Y
31-110 U/L
<31
>110
>200
>500
18Y-50Y
31-106 U/L
<31
>106
>200
>500
50Y-60Y
35-123 U/L
<35
>123
>300
>500
60Y-70Y
35-123 U/L
<35
>123
>300
>500
70Y-80Y
35-135 U/L
<35
>135
>300
>500
80Y-90Y
35-135 U/L
<35
>135
>300
>500
90Y-150Y 35-140 U/L
<35
>140
>300
>500
Male
0M-1M
75-316 U/L
<75
>316
>500
>750
1M-1Y
82-383 U/L
<82
>383
>500
>750
1Y-4Y
104-345 U/L
<104
>345
>500
>750
4Y-7Y
93-309 U/L
<93
>309
>500
>750
7Y-10Y
86-315 U/L
<86
>315
>500
>750
10Y-15Y
95-385 U/L
<95
>385
>500
>750
15Y-18Y
50-250 U/L
<50
>250
>300
>750
18Y-50Y
31-129 U/L
<31
>129
>250
>500
50Y-60Y
35-131 U/L
<35
>131
>300
>500
60Y-70Y
35-125 U/L
<35
>125
>300
>500
70Y-80Y
35-130 U/L
<35
>130
>300
>500
80Y-90Y
35-125 U/L
<35
>125
>300
>500
90Y-150Y 35-125 U/L
<35
>125
>300
>500
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
23-Nov-2004
ALT (SGPT) (RCT4)
Female
0Y-1Y
<=54 U/L
1Y-4Y
6-34 U/L
4Y-7Y
6-34 U/L
7Y-10Y
6-34 U/L
10Y-18Y
6-34 U/L
18Y-69Y
6-34 U/L
69Y-150Y 6-32 U/L
Male
0Y-1Y
<=54 U/L
1Y-4Y
6-34 U/L
4Y-7Y
6-34 U/L
7Y-10Y
6-34 U/L
10Y-18Y
6-43 U/L
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA
>54
>100
>200
>34
>100
>200
>34
>100
>200
>34
>100
>200
>34
>200
>300
>34
>200
>300
>32
>200
>300
>54
>100
>200
<6
>34
>100
>200
<6
>34
>100
>200
<6
>34
>100
>200
<6
>43
>200
>300
46214-2985 (317) 271-1200 FAX (317) 616-2351
<6
<6
<6
<6
<6
<6
Page: 84
510013_TMEA_Printed: 20070606
Run: 6-Jun-07
2:54 PM
Page:
2
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
23-Nov-2004
Continued...
ALT (SGPT) (RCT4)
Male
18Y-69Y
6-43 U/L
<6
>43
>200
>300
69Y-150Y 6-35 U/L
<6
>35
>200
>300
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
27-Dec-2000
AST (SGOT) (RCT5)
Female
0Y-1Y
10-80 U/L
<10
>80
>200
>300
1Y-4Y
10-56 U/L
<10
>56
>100
>200
4Y-7Y
10-48 U/L
<10
>48
>100
>200
7Y-18Y
10-40 U/L
<10
>40
>100
>200
18Y-59Y
9-34 U/L
<9
>34
>200
>300
59Y-150Y 9-34 U/L
<9
>34
>200
>300
Male
0Y-1Y
10-80 U/L
<10
>80
>200
>300
1Y-4Y
10-69 U/L
<10
>69
>100
>200
4Y-7Y
10-59 U/L
<10
>59
>100
>200
7Y-18Y
10-40 U/L
<10
>40
>100
>200
18Y-59Y
11-36 U/L
<11
>36
>200
>300
59Y-150Y 11-36 U/L
<11
>36
>200
>300
__________________________________________________________________________________________________________________________________________________________
L
H
HP
24-Jan-2003
LDH (RCT1408)
Female
Both
0M-1M
145-765 U/L
<145
>765
>1000
1M-1Y
190-420 U/L
<190
>420
>1000
1Y-3Y
165-395 U/L
<165
>395
>500
3Y-6Y
135-345 U/L
<135
>345
>500
6Y-9Y
140-280 U/L
<140
>280
>500
9Y-12Y
120-260 U/L
<120
>260
>500
12Y-15Y
100-275 U/L
<100
>275
>500
15Y-18Y
105-230 U/L
<105
>230
>500
18Y-150Y 53-234 U/L
<53
>234
>350
Male
0M-1M
125-735 U/L
<125
>735
>1000
1M-1Y
170-450 U/L
<170
>450
>1000
1Y-3Y
155-345 U/L
<155
>345
>500
3Y-6Y
155-345 U/L
<155
>345
>500
6Y-9Y
145-300 U/L
<145
>300
>500
9Y-12Y
120-325 U/L
<120
>325
>500
12Y-15Y
120-290 U/L
<120
>290
>500
15Y-18Y
105-235 U/L
<105
>235
>500
18Y-150Y 53-234 U/L
<53
>234
>350
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
25-Jun-2005
Covance CLS
Run: 6-Jun-07
2:54 PM
0Y-18Y
18Y-70Y
70Y-80Y
80Y-150Y
1.4-8.6 mmol/L
1.4-8.6 mmol/L
1.4-10.4 mmol/L
1.4-12.1 mmol/L
<1.4
<1.4
<1.4
<1.4
>8.6
>8.6
>10.4
>12.1
>12.5
>12.5
>14.3
>14.3
>17.9
>17.9
>17.9
>17.9
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page:
3
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
L
H
HT
HP
24-Aug-2000
Creatinine (RCT392)
Female
0M-1M
14-57 umol/L
<14
>57
>92
>137
1M-1Y
5-30 umol/L
<5
>30
>92
>137
1Y-4Y
5-39 umol/L
<5
>39
>92
>137
4Y-7Y
14-48 umol/L
<14
>48
>92
>137
7Y-10Y
14-57 umol/L
<14
>57
>92
>137
10Y-13Y
23-66 umol/L
<23
>66
>110
>154
13Y-16Y
31-75 umol/L
<31
>75
>137
>181
16Y-18Y
40-83 umol/L
<40
>83
>181
>269
18Y-50Y
31-101 umol/L
<31
>101
>181
>269
50Y-70Y
31-101 umol/L
<31
>101
>181
>269
70Y-80Y
31-110 umol/L
<31
>110
>181
>269
80Y-150Y 31-128 umol/L
<31
>128
>181
>269
Male
0M-1M
14-83 umol/L
<14
>83
>110
>137
1M-1Y
5-39 umol/L
<5
>39
>92
>137
1Y-4Y
5-39 umol/L
<5
>39
>92
>137
4Y-7Y
14-48 umol/L
<14
>48
>92
>137
7Y-10Y
23-57 umol/L
<23
>57
>92
>137
10Y-13Y
23-66 umol/L
<23
>66
>110
>154
13Y-16Y
23-83 umol/L
<23
>83
>137
>181
16Y-18Y
40-101 umol/L
<40
>101
>181
>269
18Y-50Y
40-110 umol/L
<40
>110
>181
>269
50Y-70Y
40-119 umol/L
<40
>119
>181
>269
70Y-80Y
40-137 umol/L
<40
>137
>181
>269
80Y-150Y 40-145 umol/L
<40
>145
>181
>269
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
20-Oct-2006
Glucose (RCT11)
Both
0M-1M
3.1-6.4 mmol/L
<2.2
<2.5
<3.1
>6.4
>11.1
>13.9
1M-18Y
3.9-6.4 mmol/L
<2.2
<2.5
<3.9
>6.4
>16.7
>22.2
18Y-59Y
3.9-6.4 mmol/L
<2.2
<2.5
<3.9
>6.4
>16.7
>22.2
59Y-150Y 3.9-6.7 mmol/L
<2.2
<2.5
<3.9
>6.7
>16.7
>22.2
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
21-Mar-2002
Calcium (RCT183)
Both
Sodium (RCT15)
Both
0Y-2Y
2.25-2.74 mmol/L
<1.25
<1.75
<2.25
>2.74
>3.12
>3.49
2Y-18Y
2.10-2.57 mmol/L
<1.25
<1.75
<2.10
>2.57
>2.74
>3.24
18Y-150Y 2.07-2.64 mmol/L
<1.25
<1.75
<2.07
>2.64
>2.74
>3.24
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
29-Apr-1997
0Y-18Y
132-147 mmol/L
<115
<125
<132
>147
>155
>165
18Y-59Y
132-147 mmol/L
<115
<125
<132
>147
>155
>165
59Y-150Y 135-145 mmol/L
<115
<125
<135
>145
>155
>165
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
29-Apr-1997
Potassium (RCT16)
Both
0Y-1Y
3.7-5.6 mmol/L
<2.6
<3.0
<3.7
>5.6
>6.0
Covance CLS 8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 85
510013_TMEA_Printed: 20070606
>6.9
Run: 6-Jun-07
2:54 PM
Page:
4
Project: 510013
Test
Ethnic
Sex
Age
Range
A l e r t
F l a g s
Effective Date
__________________________________________________________________________________________________________________________________________________________
LP
LT
L
H
HT
HP
29-Apr-1997
Continued...
Potassium (RCT16)
Both
1Y-18Y
3.4-5.4 mmol/L
<2.6
<3.0
<3.4
>5.4
>5.8
>6.9
18Y-59Y
3.4-5.4 mmol/L
<2.6
<3.0
<3.4
>5.4
>5.8
>6.9
59Y-150Y 3.4-5.4 mmol/L
<2.6
<3.0
<3.4
>5.4
>5.8
>6.9
__________________________________________________________________________________________________________________________________________________________
LT
L
H
HT
29-Mar-2000
Bicarb (RCT17)
Female
0Y-1Y
12.0-28.0 mmol/L
<12.0
>28.0
>32.0
1Y-4Y
12.0-28.0 mmol/L
<12.0
>28.0
>32.0
4Y-18Y
17.0-30.6 mmol/L
<15.1
<17.0
>30.6
>34.9
18Y-70Y
17.0-30.6 mmol/L
<15.1
<17.0
>30.6
>34.9
70Y-150Y 17.0-32.0 mmol/L
<15.1
<17.0
>32.0
>34.9
Male
0Y-1Y
12.0-28.0 mmol/L
<12.0
>28.0
>32.0
1Y-4Y
12.0-28.0 mmol/L
<12.0
>28.0
>32.0
4Y-18Y
17.0-30.6 mmol/L
<15.1
<17.0
>30.6
>34.9
18Y-70Y
17.0-30.6 mmol/L
<15.1
<17.0
>30.6
>34.9
70Y-150Y 17.0-32.0 mmol/L
<15.1
<17.0
>32.0
>34.9
__________________________________________________________________________________________________________________________________________________________
L
H
25-Apr-1997
Chloride (RCT18)
Both
Key:
Alert flags:
H
HP
HT
L
LP
LT
0Y-18Y
18Y-150Y
94-112 mmol/L
94-112 mmol/L
<94
<94
>112
>112
High
High Panic
High - Telephone
Low
Low Panic
Low - Telephone
Covance CLS
8211 SciCor Drive, Indianapolis, IN USA 46214-2985 (317) 271-1200 FAX (317) 616-2351
Page: 86
510013_TMEA_Printed: 20070606
Page: 87
510013_TMEA_Printed: 20070606
1-317-271-1200
Latin America
Argentina (ALA)
Argentina (Telecom)
Argentina (Telefonica)
Brazil
0800-891-2507 (Direct)
or 0800-890-0288 (Toll Free)
or 0800-8888-288 (Toll Free)
plus 800-476-7136
Chile (Entel)
plus 800-476-7136
1230-020-0078 (Direct)
or 800-225-288 (Toll Free)
plus 800-476-7136
01-800-912-0075 (Direct)
or 01-800-911-0010 (Toll Free)
plus 800-476-7136
0-800-011-0870 (Direct)
or 0-800-0-114-114 (Toll Free)
plus 800-476-7136
Colombia
Costa Rica
Dominican Republic
Ecuador (Andinatel)
Ecuador (Pacifictel)
El Salvador
Guatemala
Honduras
Mexico
001-800-476-7136 (Direct)
or 01-800-288-2872 (Toll Free)
Panama
Peru (Telephonica)
Uruguay
000-411-008-5447 (Direct)
or 000-410 (Toll Free)
Venezuela
plus 800-476-7136
plus 800-476-7136
plus 800-476-7136
plus 800-476-7136
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00 800 88 77 44 11 (Tel)
00 800 88 77 44 22 (Fax)
Croatia
0800 22 30 61 (Tel)
0800 22 30 60 (Fax)
Czech Republic
Finland
Greece
Latvia
800 31 43 (Tel)
800 31 01 (Fax)
Lithuania
Monaco
Poland
Russia
Turkey
For countries without a toll free line, please call your local telephone
operator and ask for a collect call to one of the below numbers:
English
+41 22 989 7901
French
+41 22 989 7902
German
+41 22 989 7903
Italian
+41 22 989 7904
Spanish
+41 22 989 7905
Fax
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Hong Kong
India
0008006501323
Indonesia
Malaysia
Pakistan
Philippines
Singapore
6560-8793 (Tel)
6565-5901(Fax)
South Korea
Taiwan
Thailand
Vietnam
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Korea
New Zealand
Philippines
Singapore
Taiwan
Thailand
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CURRICULUM VITAE
MARIETTA M. HENRY, MD
PERSONAL DATA:
Business Address: Covance Central Laboratory
8211 SciCor Drive
Indianapolis, IN 46214
Office: 317-273-7934
Fax: 317-273-7990
Indiana Medical License: #01021501
New York State Department of Health, Certificate of Qualification: HENRM1
EDUCATION:
1967
1965
1963
PROFESSIONAL EXPERIENCE:
January 1990 - present
Vice President of Medical Affairs and Global Laboratory Medical Director, Covance Central Laboratory
Services - Indianapolis, IN.
January 1988 - December 1989
Medical Director, Clarkson School of Medical Technology - Omaha, NE.
January 1987 - December 1989
Chairman, Department of Pathology, Clarkson Hospital - Omaha, NE. Clinical Pathologist in charge of
Microbiology, Serology, Clinical Microscopy, Laboratory Services, Phlebotomy, Chemistry, Hematology
and Blood Bank.
September 1979 - December 1989
Clinical Assistant Professor, Department of Pathology and Microbiology, University of Nebraska
Medical Center - Omaha, NE.
Participated in lecturing to medical students, pharmacy students, and medical technology students. Sat
on Residency Interview Committee.
July 1979 - December 1987
Pathologist, Bishop Clarkson Memorial Hospital - Omaha, NE.
First in charge of Microbiology, Serology, Clinical Microscopy and Phlebotomy. Later added remainder
of Laboratory as well as participated in reading of Cytology samples (PAP smears and FNS's). Rotated
on autopsy service.
July 1978 - July 1979
Fellowship in Clinical Microbiology, Department of Clinical Pathology, Indiana University Medical Center
- Indianapolis, IN.
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1979 - 1989
1978 - 1979
1978 - 1979
1970 - 1971
1968 - 1969
1968
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GLOSSARY
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GLOSSARY (CONTINUED)
Frozen specimens require dry ice to maintain a frozen state during shipment. Avoid a frost-free refrigerator
during storage of specimens. Please consult your investigator manual for proper storage instructions.
Hemolysis: indicates the rupture of red cells with release of hemoglobin and other analytes into the specimen.
Hemolysis will interfere with the performance of particular tests, which will result in specific cancellations.
High and Low flags: H for high and L for low flags appear to the right of the test result on the laboratory
report if the result falls outside the reference range. High and low results are not telephoned to the investigator
or sponsor.
Improper ratio of blood to anticoagulant: this is the result of the lavender or blue top tube not being filled
completely during collection, causing inconsistent results.
Incorrect specimen type: this phrase indicates that an incorrect specimen type was submitted, based on
protocol testing requirements, (e.g. serum received when plasma is required or vice versa, urine is received
for serum, etc.)
Invalid: in terms of calculations, an invalid comment would indicate that one component of the calculation
renders the calculation of a meaningful result impossible. Can also be used when the result is not reasonable
due to specimen irregularities; used when one component of a calculation is out of stability. Example: MCV,
MCHC and HCT resulted as invalid if specimen is greater than 60 hours old.
Investigational use only (IUO): the manufacturer of the reagent has informed us the performance
characteristics of this assay have not been fully established as required by the Food and Drug Administration
(FDA) regulations as outlined in 21 CFR (Code of Federal Regulations) 809 (In Vitro Diagnostic Products For
Human Use). Accordingly, test results for this assay may not presently be used as a diagnostic tool alone,
without confirmation by another medically established procedure.
Lipemic: serum or plasma with a turbid or milky appearance. This is caused by an elevation in triglycerides
and may be seen in a nonfasting specimen or in certain disorders of lipid metabolism. Lipemia will interfere
with several laboratory tests.
Microclots: Microclots may be reported for the platelet count when a valid count cannot be obtained due to
platelet clumping. Please consult your investigator manual for proper mixing instructions.
Myeloperoxidase deficiency: a common inherited disorder of neutrophil function. It is detected when using
an automated hematology instrument which performs a white blood cell differential using a peroxidase channel.
Patients rarely know they have the disorder and usually require no treatment. Myeloperoxidase deficiency can
also be acquired and is mostly seen in acute myelogenous leukemia, myelodysplastic syndrome and Battens
disease.
Panic alerts: HP for a high panic or LP for a low panic alert. They are associated with critical laboratory
values which may indicate medical emergencies. These flags appear to the right of the test result on the
laboratory report. These values are telephoned immediately to the investigator and confirmation of receipt
for these critical results must be obtained.
Pharmacokinetics: the study of the action of drugs within the body, including the routes and mechanisms of
absorption, distribution, excretion, and metabolism; onset of action; duration of effect; biotransformation;
effects and routes of excretion of the metabolites of the drug; rate of appearance and disappearance in blood,
urine or other body tissues.
Plasma: the fluid portion of the blood in which blood cells are suspended. This yellowish fluid separates from
a blood specimen which was mixed with an anticoagulant (e.g. EDTA, heparin, citrate or other anticoagulants)
upon centrifugation.
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GLOSSARY (CONTINUED)
Prolonged cell contact: the condition which occurs when a serum is allowed to remain in contact with cells
for a prolonged period of time. This may occur at the investigator site prior to centrifugation or may be due to
red blood cells present in the serum or plasma during transport. A combination of cellular metabolism and
cellular damage produces a pronounced decrease in serum glucose and elevations in potassium and
phosphorus.
Quantity not sufficient: this phrase is used when an insufficient sample volume is received for testing.
Refrigeration during collection: This phrase means the specimen must be 2-8C during the entire collection
procedure, (e.g. 24 hour urine collection). Please consult your specific collection instructions.
Repeat reactive (positive), confirmed: screening testing indicates specimen was positive; confirmation by a
more specific test also indicates that the specimen was positive. Specimen result is positive for the analyte.
Repeat reactive (positive), unconfirmed: screening testing indicates specimen was positive; however,
specific confirmation testing was not positive. Results are indeterminate. Recollection may be requested.
Sample drawn in expired tube: specimen received in expired container - Due to regulatory requirements,
Covance cannot report results from collection containers that are past the expiration date placed on the
container from the manufacturer. Results from expired containers will be cancelled.
Serum: the clear fluid portion of the blood obtained after the cells have formed a clot and the specimen is
centrifuged. This clear, straw-colored liquid portion of the blood does not contain fibrinogen or blood cells.
Sample is collected in a tube which does not contain an anticoagulant.
Short draw collection tubes: Covance is providing short draw collection tubes for this study. The short draw
Vacutainer brand tubes with Hemogard Closure are designed for collecting a small volume of blood. The short
draw tubes are the same size as adult size vacutainer tubes but contain only enough vacuum to fill the tube to
the indicator line. Short draw tubes fill more slowly than full volume tubes due to a lower vacuum.
Specimen received ambient: this phrase is used when a specimen intended for refrigerated or frozen
shipment is received at Covance Central Laboratory Services not in required shipping condition. Reasons
include: Dry ice evaporated, too little dry ice used, incorrectly packaged for frozen shipment, shipment
delayed, etc.
Specimen received beyond stability: this indicates too much time has elapsed to perform a valid assay
when the specimen is received at Covance Central Laboratory Services. The test will be cancelled if the
specimen is received beyond the established stability period for a given analyte. It can also indicate that the
specimen should have been received frozen but was received ambient and the test will be cancelled as
received beyond stability since the ambient stability has expired.
Telephone alerts: HT for a high telephone alert or LT for a low telephone alert. They are associated with
laboratory values which may indicate clinical problems and need critical evaluation by the investigator. These
values are telephoned to the investigator site and mailed to the sponsor. Telephone alerts are phoned to the
sponsor if Covance Central Laboratory Services fails to reach the investigator after at least two attempts.
TNTC: Too Numerous To Count. Too many cells to be counted under high power field microscopy. For
example: on a laboratory report for urinalysis, the red blood cells (RBC) and/or the white blood cells (WBC)
in the urine microscopy can be "TNTC".
Unable to verify test result: this cancellation is applied to specimens that fail the required confirmatory
analysis following the initial analysis.
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