12 ms·

I was recently called in for jury duty, as a Professor in the physical sciences - I'm rarely selected (although I love being on them.) The person next to me was

I was recently called in for jury duty, as a Professor in the physical sciences - I'm rarely selected (although I love being on them.) The person next to me was an MD. Well the question was asked of both of us, (paraphrasing): "is a lab report the end of the conversion for you?" The MD basically was a 'yeah, why would a lab tech lie?' (very true - having been in industry myself). However, I know how many ways something could yield poor results and must look at the whole picture. Whilst it is true that lab techs are not paid well enough to lie. Lab techs are not paid well at all, and so this doesn't necessary attract the best of the best. I've seen folks operating instruments that they had zero training on (as it was assumed that they saw it in school - not a good assumption of late.) Eg: One team I was an auditor for, didn't realize that the instrument they were using had effectively two (2x) ON/OFF switches - and the detector was turned off. 2 years of data had to be rejected. Now imagine a completely untrained cop with a black box, that's been bouncing around in their trunk - what could go wrong?... /s I guess what I'm saying: field tests are highly suspect, and even lab tests need to be carefully considered - all of which requires a solid grasp on scientific/critical reasoning (which is in short supply.)

sndean 7y ago
> field tests are highly suspect, and even lab tests need to be carefully considered - all of which requires a solid grasp on scientific/critical reasoning (which is in short supply.) Similarly, I've heard stories from MDs about techs in pharmacies at hospitals not knowing enough to raise an eyebrow at an order for something off by 1000-fold (mg vs. µg). Patient almost gets a lethal dose of something because sleep deprived residents are running the show and incompetent / underpaid people are filling orders.
- flowersjeff 7y ago
  YES. Dimensional analysis and a basic understanding of metric prefixes. Again, this is just ass-u-me'd to be well understood by all.
  - deleted 7y ago
    [deleted]
- bumby 7y ago
  Pharmacies are increasingly reliant on software to catch interactions. I wonder if the same is true for dosage
  - scruple 7y ago
    Yes, yes it is. I've worked on such software, in fact. Dosage calculators can, obviously, only work with the inputs they're given. Even when prompted to verify and re-verify data entry for critical things, most of the actual users are blanked out on auto pilot. I've been involved in countless conversations with program/hospital system administration types (at _the_ largest hospital systems in the US) about all of the ways we might try to mitigate against these types of issues. These admin folks are clever, too, they know how to work _our_ reporting systems through sales and product people to CYA, as it were. We typically walk into these meetings under the guise of "training issues," but it's anything but... This software we're talking about is form fields, if we're being honest about this stuff, and the real issue is overworked and underpaid staff. If you say that, though, you're on the hook for potentially losing these massive contracts. It's all very corporate, on every side, is the problem, as others are alluding.
- jwalton 7y ago
  I almost died this way. When I was about 5 years old, I had pneumonia. I went to a doctor, they misplaced a decimal point in my weight, and prescribed me a 10x over dose. The nurse didn't bother to double check it, and just blindly gave me the shot. Then the second nurse, who somehow didn't know the first nurse had given me the shot, gave me a second shot, so I was 20x over dosed. They called my parents a couple of hours later when they figured it out and told them to take me to a hospital immediately. I ended up in the hospital for a week.
save_ferris 7y ago
> Eg: One team I was an auditor for, didn't realize that the instrument they were using had effectively two (2x) ON/OFF switches - and the detector was turned off. 2 years of data had to be rejected. How is this kind of negligence legal?
- wirrbel 7y ago
  One code base I inherited at a job had a unit test suit with no assert statements. No one verified that the tests would fail with a faulty implementation. It's the same kind of error. In the lab no one verified that detector would be able to detect. As to forgetting switches, on lab equipment, especially custom built equipment it's sometimes not obvious, which switch is which. Also as a student I worked in a lab where many experiments where built by one or two generations of students and then continued by others so those producing data. Working with an existing setup is like inheriting a code base. You never know what surprises await you.
  - flowersjeff 7y ago
    The reason why the code failed to realize there was even an issue?...(in the case I mentioned earlier) The software looked at the calibration data using linear best fit (standard stuff) and provided the r^2 was within the specified range - that instrument and the data was good to go. Well, if you run your Standards{1,2,3,4,5} and all output "0.0". That is a straight (perfectly so) line. They had no idea how to read the computer monitor and the real time data coming off the instrument. They had zero real training / understanding of even how the instrument worked. I see this a lot still - people using an instrument without a great understanding of how the thing even works. Why? There's just no money/resources being spent to ensure correctness - self regulation is (and has been) all the rage for decades here in the US. Honestly, I believe in open software - and this type of software NEEDS to be opened up. I can only imagine the horrors that will be found.
  - flowersjeff 7y ago
    PS - regarding the actual switch. Agreed. This instrument was of a poor UI. One switch was in the front, the other in the back. Still, this was a regulated contract laboratory with cert's. Upon discovery - they did perform corrective actions and such. As for "in school" - oh yeah. It's a wild wild west sort of situation. Custom hardware (with who knows what thought being given) and software that someone wrote years ago (and having zero documentation and zero standard coding practices observed).
sigmaprimus 7y ago
I was given a breathalyzer test at a road block after admiting I had two bottles of beer with dinner about an hour before. The test came back with a blood alcohol level of 0.02 which is well below the legal impairment level. The officer asked me to sign a statement confirming the reading and the amount I had consumed, so that in the event that the calibration was disputed by someone they could call on me to testify in court. I agreed and was the 7th or 8th person on their list that had signed with results.
- sjg007 7y ago
  That's a funny way to do a validation study...
  - flowersjeff 7y ago
    Sadly, that 'data' will be used in a manner (most likely) inconsistent with any rigorous scientific underpinnings - but passed to policy makers as such.
- souterrain 7y ago
  Did the officer ask you, or instruct you to sign the document? Such a situation lends itself to feel coercive, as the officer has already detained you for a search.
  - gowld 7y ago
    Legally, it's consensual. Morally, it's an order. If anyone except a police officer made a similar request, they'd be guilty of brandishing a firearm and any contract (or agreement to have sex) would be invalid. But if you accede to a police officer's "request", when they have a legal right to kill you for any reason during the encounter, it's considered consent.
    - giggles_giggles 7y ago
      You can be critical of the abuses of power that exist in the police force without resorting to hyperbole like "they have the legal right to kill you for any reason during the encounter." They most certainly do not legally have that right, and that's one reason it's reported on so heavily when people are shot by cops.
gowld 7y ago
> why would a lab tech lie?' "'Stunning' Drug Lab Scandal Could Overturn 23,000 Convictions" "She worked at the William A. Hinton State Laboratory Institute in Boston for nearly a decade before her misconduct was exposed in 2012. She admitted to tampering with evidence, forging test results and lying about it. " https://www.nbcnews.com/news/us-news/stunning-drug-lab-scandal-could-upend-23-000-convictions-n739626 https://www.nbcnews.com/news/us-news/stunning-drug-lab-scand...
- flowersjeff 7y ago
  Very true. I was thinking more of third party labs. A lot of these services are outsourced due to costs / need. For labs that are a part of the system - yeah, I definitely can see how a person working would feel the need to be a 'team' member and support their team. Sad but happens all the time.
  - Gene_Parmesan 7y ago
    In my city, where I was a criminal trial prosecutor for a few years, all lab work in criminal cases is done by the medical examiner's office, run by the county. The conflict of interest should be obvious but I don't even know whether the general scheme has ever been challenged.
- HarryHirsch 7y ago
  If you think that the Dookhan case is unique, here is another one: https://www.dothaneagle.com/news/crime_court/lab-owner-accused-of-falsifying-results-faces-additional-charges/article_79ee7b5f-abd1-5056-9124-55609bac5950.html https://www.dothaneagle.com/news/crime_court/lab-owner-accus... This time it's made-up paternity tests and made-up drug tests in custody cases. The lack of cross-checks in the judicial system is concerning, it absolutely invites corruption.
  - throwawaycanada 7y ago
    The worst part about this case was in the custody situations. Even if as a parent you prove the test was false, if they take your kid early enough and for long enough they still won't let you have your kid back. Even if you are totally innocent. And that time span is relatively short.
klenwell 7y ago
You reminded me of an interaction I had recently while getting my blood taken at a Quest office. To make small talk while I was sitting there in a chair waiting for the needle, I asked the tech if he had heard about Theranos or Elizabeth Holmes. He had not. I explained that she ran a Silicon Valley startup that was trying shrink this little cubicle area we're in here down to the size of an ipad. I thought he might identify with the difficulty if not absurdity of that mission. His response surprised me: "Good idea." "Well, actually, it turned out to be a giant fraud. She's been indicted and is awaiting trial." "Not surprised. You know how much money this industry is worth? Big Blood isn't going to let that happen." I let him focus on his work after that.
- fma 7y ago
  There was one time I went I for a physical from a "doc in a box". I was new in town and needed a physical to get some money for my HSA before a deadline. I drank water before going in for my urine test. I never did a urine test... And remember vividly peeing in the waiting room as I left, thinking it's weird I didn't do a urine test. But I didn't care as it was through away results, I just needed a formed sign for my money. Well, somehow I got results back for a urine test. When I questioned it... They said, nah no way its wrong... I did a test.
  - appleflaxen 7y ago
    that could easily be fraud. you should report things like this to your insurance company.
- paggle 7y ago
  Were you surprised? The job is not that different in what is asked of you and what is given to you than any other unskilled work. We just have a tendency to think of doctors as smarter than auto mechanics when they both are pattern-matching repair jobs, and lab techs as more capable than CVS cashiers when they are both just routine operator jobs.
- zaphod12 7y ago
  Ya know - I agree with the Tech's first statement - it's a FANTASTIC idea. Too bad it's technically infeasible. really too bad that she lied about it over and over. I'm not really surprised that he'd never heard, though. The story was much more popular in the startup/tech space than the medical space. I know a bunch of people working in molecular diagnostics who hadn't heard about it while it was happening - though they've all been incredibly fascinated and engaged by the recent book.
Paperweight 7y ago
So I take it the defense lawyer dismissed the MD offhand, but on your turn, the DA broke out into a sweat and dismissed you?
- flowersjeff 7y ago
  I really really really really wanted to be on that last one too. Especially when they asked, "does anyone have a problem with the police." I think I began to salivate. ;-)
code_duck 7y ago
Well, there's this. https://www.nbcnews.com/news/us-news/epic-drug-lab-scandal-results-more-20-000-convictions-dropped-n747891 https://www.nbcnews.com/news/us-news/epic-drug-lab-scandal-r... "A mass dismissal of wrongful convictions ─ perhaps the biggest ever ─ unfolded in a Boston courthouse on Tuesday, as prosecutors in seven Massachusetts counties dropped more than 21,000 low-level drug cases tainted by the work of a rogue lab chemist."
hyperbovine 7y ago
It sounds like you continued to be rarely selected :-)
duxup 7y ago
> so this doesn't necessary attract the best of the best Reminds me of fingerprint analysis where the standards and interpretation is all over the map and it could be just done by an officer who says "yeah that matches".
tyingq 7y ago
You're kind of leading up to the topic, so thought I would comment. The US concept of jury nullification is fascinating to me. That such a powerful tool exists, and that the prosecutor has so many aveneues to forbid it being discussed or used. One particular example that bothers me a lot: "One of the other jurors wrote a note to the judge informing on Kriho, and the latter was subsequently charged with and convicted of contempt of court for her actions, for intentionally serving on a jury with the intent to obstruct justice. " https://verdict.justia.com/2017/05/18/fresh-look-jury-nullification https://verdict.justia.com/2017/05/18/fresh-look-jury-nullif...
bonniemuffin 7y ago
Many years ago I was briefly kicked out of school over a false positive on a small-town police department's lab test. I was able to prove that it was a false positive and get myself back into school through a complicated and ridiculous sequence of events, but I'll always wonder how many other people probably suffered much worse negative consequences due to the lab's negligence.

sndean 7y ago

> field tests are highly suspect, and even lab tests need to be carefully considered - all of which requires a solid grasp on scientific/critical reasoning (which is in short supply.) Similarly, I've heard stories from MDs about techs in pharmacies at hospitals not knowing enough to raise an eyebrow at an order for something off by 1000-fold (mg vs. µg). Patient almost gets a lethal dose of something because sleep deprived residents are running the show and incompetent / underpaid people are filling orders.

flowersjeff 7y ago
YES. Dimensional analysis and a basic understanding of metric prefixes. Again, this is just ass-u-me'd to be well understood by all.
- deleted 7y ago
  [deleted]
bumby 7y ago
Pharmacies are increasingly reliant on software to catch interactions. I wonder if the same is true for dosage
- scruple 7y ago
  Yes, yes it is. I've worked on such software, in fact. Dosage calculators can, obviously, only work with the inputs they're given. Even when prompted to verify and re-verify data entry for critical things, most of the actual users are blanked out on auto pilot. I've been involved in countless conversations with program/hospital system administration types (at _the_ largest hospital systems in the US) about all of the ways we might try to mitigate against these types of issues. These admin folks are clever, too, they know how to work _our_ reporting systems through sales and product people to CYA, as it were. We typically walk into these meetings under the guise of "training issues," but it's anything but... This software we're talking about is form fields, if we're being honest about this stuff, and the real issue is overworked and underpaid staff. If you say that, though, you're on the hook for potentially losing these massive contracts. It's all very corporate, on every side, is the problem, as others are alluding.
jwalton 7y ago
I almost died this way. When I was about 5 years old, I had pneumonia. I went to a doctor, they misplaced a decimal point in my weight, and prescribed me a 10x over dose. The nurse didn't bother to double check it, and just blindly gave me the shot. Then the second nurse, who somehow didn't know the first nurse had given me the shot, gave me a second shot, so I was 20x over dosed. They called my parents a couple of hours later when they figured it out and told them to take me to a hospital immediately. I ended up in the hospital for a week.

save_ferris 7y ago

> Eg: One team I was an auditor for, didn't realize that the instrument they were using had effectively two (2x) ON/OFF switches - and the detector was turned off. 2 years of data had to be rejected. How is this kind of negligence legal?

wirrbel 7y ago
One code base I inherited at a job had a unit test suit with no assert statements. No one verified that the tests would fail with a faulty implementation. It's the same kind of error. In the lab no one verified that detector would be able to detect. As to forgetting switches, on lab equipment, especially custom built equipment it's sometimes not obvious, which switch is which. Also as a student I worked in a lab where many experiments where built by one or two generations of students and then continued by others so those producing data. Working with an existing setup is like inheriting a code base. You never know what surprises await you.
- flowersjeff 7y ago
  The reason why the code failed to realize there was even an issue?...(in the case I mentioned earlier) The software looked at the calibration data using linear best fit (standard stuff) and provided the r^2 was within the specified range - that instrument and the data was good to go. Well, if you run your Standards{1,2,3,4,5} and all output "0.0". That is a straight (perfectly so) line. They had no idea how to read the computer monitor and the real time data coming off the instrument. They had zero real training / understanding of even how the instrument worked. I see this a lot still - people using an instrument without a great understanding of how the thing even works. Why? There's just no money/resources being spent to ensure correctness - self regulation is (and has been) all the rage for decades here in the US. Honestly, I believe in open software - and this type of software NEEDS to be opened up. I can only imagine the horrors that will be found.
- flowersjeff 7y ago
  PS - regarding the actual switch. Agreed. This instrument was of a poor UI. One switch was in the front, the other in the back. Still, this was a regulated contract laboratory with cert's. Upon discovery - they did perform corrective actions and such. As for "in school" - oh yeah. It's a wild wild west sort of situation. Custom hardware (with who knows what thought being given) and software that someone wrote years ago (and having zero documentation and zero standard coding practices observed).

sigmaprimus 7y ago

I was given a breathalyzer test at a road block after admiting I had two bottles of beer with dinner about an hour before. The test came back with a blood alcohol level of 0.02 which is well below the legal impairment level. The officer asked me to sign a statement confirming the reading and the amount I had consumed, so that in the event that the calibration was disputed by someone they could call on me to testify in court. I agreed and was the 7th or 8th person on their list that had signed with results.

sjg007 7y ago
That's a funny way to do a validation study...
- flowersjeff 7y ago
  Sadly, that 'data' will be used in a manner (most likely) inconsistent with any rigorous scientific underpinnings - but passed to policy makers as such.
souterrain 7y ago
Did the officer ask you, or instruct you to sign the document? Such a situation lends itself to feel coercive, as the officer has already detained you for a search.
- gowld 7y ago
  Legally, it's consensual. Morally, it's an order. If anyone except a police officer made a similar request, they'd be guilty of brandishing a firearm and any contract (or agreement to have sex) would be invalid. But if you accede to a police officer's "request", when they have a legal right to kill you for any reason during the encounter, it's considered consent.
  - giggles_giggles 7y ago
    You can be critical of the abuses of power that exist in the police force without resorting to hyperbole like "they have the legal right to kill you for any reason during the encounter." They most certainly do not legally have that right, and that's one reason it's reported on so heavily when people are shot by cops.

gowld 7y ago

> why would a lab tech lie?' "'Stunning' Drug Lab Scandal Could Overturn 23,000 Convictions" "She worked at the William A. Hinton State Laboratory Institute in Boston for nearly a decade before her misconduct was exposed in 2012. She admitted to tampering with evidence, forging test results and lying about it. " https://www.nbcnews.com/news/us-news/stunning-drug-lab-scandal-could-upend-23-000-convictions-n739626 https://www.nbcnews.com/news/us-news/stunning-drug-lab-scand...

flowersjeff 7y ago
Very true. I was thinking more of third party labs. A lot of these services are outsourced due to costs / need. For labs that are a part of the system - yeah, I definitely can see how a person working would feel the need to be a 'team' member and support their team. Sad but happens all the time.
- Gene_Parmesan 7y ago
  In my city, where I was a criminal trial prosecutor for a few years, all lab work in criminal cases is done by the medical examiner's office, run by the county. The conflict of interest should be obvious but I don't even know whether the general scheme has ever been challenged.
HarryHirsch 7y ago
If you think that the Dookhan case is unique, here is another one: https://www.dothaneagle.com/news/crime_court/lab-owner-accused-of-falsifying-results-faces-additional-charges/article_79ee7b5f-abd1-5056-9124-55609bac5950.html https://www.dothaneagle.com/news/crime_court/lab-owner-accus... This time it's made-up paternity tests and made-up drug tests in custody cases. The lack of cross-checks in the judicial system is concerning, it absolutely invites corruption.
- throwawaycanada 7y ago
  The worst part about this case was in the custody situations. Even if as a parent you prove the test was false, if they take your kid early enough and for long enough they still won't let you have your kid back. Even if you are totally innocent. And that time span is relatively short.

klenwell 7y ago

You reminded me of an interaction I had recently while getting my blood taken at a Quest office. To make small talk while I was sitting there in a chair waiting for the needle, I asked the tech if he had heard about Theranos or Elizabeth Holmes. He had not. I explained that she ran a Silicon Valley startup that was trying shrink this little cubicle area we're in here down to the size of an ipad. I thought he might identify with the difficulty if not absurdity of that mission. His response surprised me: "Good idea." "Well, actually, it turned out to be a giant fraud. She's been indicted and is awaiting trial." "Not surprised. You know how much money this industry is worth? Big Blood isn't going to let that happen." I let him focus on his work after that.

fma 7y ago
There was one time I went I for a physical from a "doc in a box". I was new in town and needed a physical to get some money for my HSA before a deadline. I drank water before going in for my urine test. I never did a urine test... And remember vividly peeing in the waiting room as I left, thinking it's weird I didn't do a urine test. But I didn't care as it was through away results, I just needed a formed sign for my money. Well, somehow I got results back for a urine test. When I questioned it... They said, nah no way its wrong... I did a test.
- appleflaxen 7y ago
  that could easily be fraud. you should report things like this to your insurance company.
paggle 7y ago
Were you surprised? The job is not that different in what is asked of you and what is given to you than any other unskilled work. We just have a tendency to think of doctors as smarter than auto mechanics when they both are pattern-matching repair jobs, and lab techs as more capable than CVS cashiers when they are both just routine operator jobs.
zaphod12 7y ago
Ya know - I agree with the Tech's first statement - it's a FANTASTIC idea. Too bad it's technically infeasible. really too bad that she lied about it over and over. I'm not really surprised that he'd never heard, though. The story was much more popular in the startup/tech space than the medical space. I know a bunch of people working in molecular diagnostics who hadn't heard about it while it was happening - though they've all been incredibly fascinated and engaged by the recent book.

Paperweight 7y ago

So I take it the defense lawyer dismissed the MD offhand, but on your turn, the DA broke out into a sweat and dismissed you?

flowersjeff 7y ago
I really really really really wanted to be on that last one too. Especially when they asked, "does anyone have a problem with the police." I think I began to salivate. ;-)

code_duck 7y ago

Well, there's this. https://www.nbcnews.com/news/us-news/epic-drug-lab-scandal-results-more-20-000-convictions-dropped-n747891 https://www.nbcnews.com/news/us-news/epic-drug-lab-scandal-r... "A mass dismissal of wrongful convictions ─ perhaps the biggest ever ─ unfolded in a Boston courthouse on Tuesday, as prosecutors in seven Massachusetts counties dropped more than 21,000 low-level drug cases tainted by the work of a rogue lab chemist."

hyperbovine 7y ago

It sounds like you continued to be rarely selected :-)

duxup 7y ago

> so this doesn't necessary attract the best of the best Reminds me of fingerprint analysis where the standards and interpretation is all over the map and it could be just done by an officer who says "yeah that matches".

tyingq 7y ago

You're kind of leading up to the topic, so thought I would comment. The US concept of jury nullification is fascinating to me. That such a powerful tool exists, and that the prosecutor has so many aveneues to forbid it being discussed or used. One particular example that bothers me a lot: "One of the other jurors wrote a note to the judge informing on Kriho, and the latter was subsequently charged with and convicted of contempt of court for her actions, for intentionally serving on a jury with the intent to obstruct justice. " https://verdict.justia.com/2017/05/18/fresh-look-jury-nullification https://verdict.justia.com/2017/05/18/fresh-look-jury-nullif...

bonniemuffin 7y ago

Many years ago I was briefly kicked out of school over a false positive on a small-town police department's lab test. I was able to prove that it was a false positive and get myself back into school through a complicated and ridiculous sequence of events, but I'll always wonder how many other people probably suffered much worse negative consequences due to the lab's negligence.