This is a sample letter that an attorney representing you for essure injuries might send to pathology prior to your surgery.
We have found that when some patients provided this letter themselves, without representation, surgeries were delayed, or cancelled.
So as of right now, we suggest you speak to your attorney about a preservation letter to pathology and let them handle it.
Sample pathology letter for Essure preservation
Department of Pathology
Attn: Department Manager
Pathology Dept Mailing Address
City, State Zip
Re: Preservation Request
Patient Name: First Last
Date of Birth: 00/00/0000
Date of Surgery: 00/00/0000
Dear Physicians, Pathology Department & Risk Manager:
I, patient name, am scheduled for/recently had pelvic surgery to remove the Essure System on Date, at hospital/facility, and is to be/was performed by Name of HCP. My medical records, organs, tissue, fluid, paraffin blocks, slides and/or Essure implant, are all important pieces of evidence and the law requires that the necessary steps be taken to ensure that this evidence is properly preserved.
Accordingly, this letter is a formal request to retain any and all of the above-referenced items that may result/may have resulted from my Month Day, pelvic surgery. Please do not destroy any medical records, organs, tissue, fluid, paraffin blocks, slides and/or any portion(s) of the Essure System (referred to collectively as “Pathology/Histology Specimens”) pertaining to, or resulting from, my surgery.
Further, I request that the Pathology/Histology Specimens pertaining to, or resulting from, my surgery, be processed in the following manner:
1. Please take photographs and/or video throughout your gross examination of the organs, tissue and Implant.
2. The Essure System contains metal parts and is screw-like by design. If it is removed during the pathological exam, we ask that it not be pulled, but unscrewed from the tissue. Once removed, we request that the entire fallopian tube, starting with the myometrial part, be sectioned. Please orient the sections perpendicular to the tube, every 4mm. The rest of the uterus and the adnexa can be sectioned as you normally and routinely do.
3. Please preserve and retain, indefinitely, any and all organ, tissue or Implant that is removed during the surgery in an appropriate preservative fluid, e.g. 10% formalin, without cleaning, sterilization or destructive testing. Please preserve and retain the uterus in a way to preserve the endometrium (uterus to be fixed open). We would also ask that you only make one cut into the endometrial cavity. Additionally, when storing the uterus, we ask that you place some paper towels soaked in formalin into the cut and place the uterus in a container with formalin at a 10:1 ratio of formalin: specimen. Routine pathological and histological examination or surgical tissue specimens relevant to the patient’s diagnosis and care are not included in our request for preservation.
4. Please preserve and retain, indefinitely, any and all tissue or Implant (paraffin block, slides, etc.) that are submitted for pathologic or histologic examination.
5. Please transfer custody of all components, tissue samples, paraffin blocks, and/or slides to the hospital’s risk manager or pathology department chair as facility policy permits, to prevent destruction or promote retention.
6. Please do not transfer any explanted components, tissue samples, paraffin blocks and/or slides to any manufacturer’s representative, or any other party without my written permission.
I thank you in advance for your cooperation and ask that you please contact me if you are unwilling or unable to comply with these requests, or should you have any questions.