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Document Created 11-Sep-2012, 14:00
Document Owner LEEDS TEACHING HOSPITALS NHS TRUST
Authored by Ms Niral Singh - Midwife - Specialist Practitioner, St James Hospital on 11-Sep-2012, 14:00
Child Screening Report


Mother Details

NHS Number 9932541276
Name Mrs Shelly Smith
Address Appleton House
Lanchester Road
Grimsby
DN3 1UJ


Newborn Birth Details

Gestational age 40 Weeks
Birth order 01
Number of births in confinement 1
Birth weight 2887 grams


NewBorn Hearing Screening Test

Children's hearing test
Results 11-Sep-2012 14:30 Hearing screening programme completed, no clear response in one ear, follow-up required
Referral 15-Sep-2012 14:30 Referral for audiology


Blood Spot Screening

Phenylketonuria screening test
Results Not screened/screening incomplete
Result Interpretation Re-evaluated Result: Laboratory Confirm as Correct
Screening Sub Status Not contactable, reasonable efforts made
Reason Text Newborn blood spot sampling
Supplementary Text Performed by midwife
Sickle cell disease screening test
Results Not screened/screening incomplete
Screening Sub Status Not contactable, reasonable efforts made
Reason Text Newborn blood spot sampling
Supplementary Text Performed by midwife
Cystic fibrosis screening test
Results Repeat / Further sample required
Result Interpretation Re-evaluated Result: Laboratory Confirm as Correct
Screening Sub Status Too soon after transfusion (less than 72 hours)
Reason Text Newborn blood spot sampling
Supplementary Text Performed by midwife
Congenital hypothyroidism screening test
Results Not screened/screening incomplete
Screening Sub Status Not contactable, reasonable efforts made
Reason Text Newborn blood spot sampling
Supplementary Text Performed by midwife
Medium-chain acyl-coenzyme A dehydrogenase deficiency screening test
Results Not screened/screening incomplete
Screening Sub Status Not contactable, reasonable efforts made
Reason Text Newborn blood spot sampling
Supplementary Text Performed by midwife
Maple syrup urine disease screening test
Results Repeat / Further sample required
Result Interpretation Re-evaluated Result: Laboratory Confirm as Correct
Screening Sub Status Unsuitable sample
Reason Text Newborn blood spot sampling
Supplementary Text Performed by midwife
Homocystinuria screening test
Results Repeat / Further sample required
Result Interpretation Re-evaluated Result: Laboratory Confirm as Correct
Screening Sub Status Insufficient sample
Reason Text Newborn blood spot sampling
Supplementary Text Performed by midwife
Isovaleric acidaemia screening test
Results Repeat / Further sample required
Result Interpretation Re-evaluated Result: Laboratory Confirm as Correct
Screening Sub Status Unsuitable sample
Reason Text Newborn blood spot sampling
Supplementary Text Performed by midwife
Glutaric aciduria type 1 screening test
Results Repeat / Further sample required
Result Interpretation Re-evaluated Result: Laboratory Confirm as Correct
Screening Sub Status Insufficient sample
Reason Text Newborn blood spot sampling
Supplementary Text Performed by midwife



Newborn Physical Examination

Newborn and Infant Physical Examination Screening Programme, hip examination Incomplete
Newborn and Infant Physical Examination Screening Programme, heart examination No abnormalities with risk factors
Newborn and Infant Physical Examination Screening Programme, eye examination Unilateral abnormality suspected (Left) with risk factors
Newborn and Infant Physical Examination Screening Programme, testis examination Bi-lateral abnormality suspected


Laboratory Details

St James Pathology Laboratory

Date of Receipt at Lab

11-Sep-2012, 13:10

Lab Card Serial Number

0902652801

Previous Lab Card Serial Number

0902652800

Specimen Collection Details

Blood specimen collected at St. James Hospital

Specimen Collection Time

11-Sep-2012, 13:00

Specimen Collected by

Mr Brian Weberly