The Hidden Burden of Error in Surgical Pathology: What We Miss and Why It Matters

Technical error in surgical pathology threatens diagnostic accuracy and patient safety, yet its true prevalence remains unclear due to inconsistent definitions and variability in what constitutes a reportable event. Drawing on findings from a systematic review and meta-analysis of the surgical pathology Total Testing Process, this webinar examines the gap between reported (logged) errors and those identified through active detection methods, highlighting how surveillance approaches and quality culture shape observed error rates. Underrecognized contributors, such as specimen contamination, and the challenges of identifying human error in complex manual workflows, will be examined. Framed as a systems-level issue, this session emphasizes the need to move beyond individual blame toward improved definitions, detection strategies, and system design to strengthen diagnostic reliability and patient safety.

Speaker:

Amanda Katsma, PA(ASCP)

University of Jamestown, Clinical Research PhD program

Medical College of Wisconsin

Vector Surgical

Amanda Katsma, PA(ASCP), is a clinical research doctoral candidate at the University of Jamestown, where her work focuses on quality and patient safety in surgical pathology, with particular emphasis on technical error, human factors, and systems-based approaches to improvement. She holds a Bachelor of Science in Clinical Laboratory Science with a medical technology emphasis and a minor in chemistry, as well as a Master of Science from Rosalind Franklin University of Medicine and Science in the Pathologists’ Assistant program. Amanda has worked in surgical pathology since 2009, bringing extensive practical experience in specimen handling, laboratory workflows, and diagnostic processes. Her research integrates epidemiology, human factors engineering, and healthcare quality frameworks to better understand and address vulnerabilities across the surgical pathology total testing process.

Moderator:

Aisha Sethi, MD

Pathologist

VA Medical Center, Cincinnati