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Dear colleagues, I and a number of others are in the process of carryin out a major revision of CPA's laboratory accreditation standards in order to ensure that they do not fall short of the ISO document 15189 and the relevant parts of ISO 9002. One of the topics that has cropped up is that of "chain of custody" documentation. We use this system in our own hospital where it is thought that a sample may be needed subsequently for medico-legal reasons, e.g. when a young child has been brought in semi-comatose and there is a possibility that he or she may have had a toxic drug administered by a member of the family or when a driver involved in a traffic accident is brought in with injuries and thought to be under the influence of alcohol to such an extent that it would have impaired their ability to drive a vehicle safely. (There is of course the added problem of the procedure through which the police might obtain either the sample or a result from it when that sample has been collected purely for medical purposes. But I am not concerned with that at present.) Should it be incumbent on hospitals under such circumstances to identify cases with possible medico-legal consequences and, in the interests of judicial truth, to institute a "chain of custody" policy that would stsnd up agaist cross exemination in the court room? I should be grateful for any views you might have. David Williams. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%