The College of American Pathologists (CAP) -- the nation's primary laboratory accreditation agency -- gave its highest rating to Maryland General Hospital's lab in July, failing to detect widespread, serious operational deficiencies that went unaddressed until a whistleblower's complaint brought in state inspectors this year. The hospital's lab was "accredited with distinction," CAP reported July 16, based on a review conducted last April. State inspectors, however, have since found that the lab generated suspect test results for HIV and hepatitis, and botched tests for STDs and Legionella bacteria dating back to at least August of 2002.

State and federal law mandates that routine inspections and accreditation of hospitals be carried out by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a nonprofit association. If a hospital is accredited by JCAHO, said Maryland's Health Secretary Nelson J. Sabatini, it is considered in compliance with state and federal requirements. In turn, JCAHO has a federally sanctioned agreement under which CAP inspects hospital laboratories. CAP is a nonprofit association representing board-certified pathologists.

"We now understand that sometime after the college conducted its regularly scheduled inspection in April of 2003, the state of Maryland received a complaint report from a former laboratory employee," said CAP spokesperson Anthony Phipps. "The nature of the problem... is such that a routine accreditation inspection would not have readily identified the problem without a prior complaint having been filed," Phipps said, noting that the college is now conducting its own investigation of the lab.

JCAHO Vice President Margaret Van Amringe termed the Maryland General case the first of its kind. She also noted that a November visit to the lab by state inspectors sounded no alarms. That visit was apparently in response to a complaint.

In December, former lab employee Kristin S. Turner wrote to her ex-boss at Maryland General reminding him he had known about equipment defects undermining accurate testing for many months. Turner is suing the hospital, alleging a defective machine caused her to become infected with HIV and hepatitis C.

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