Courier Packing and Shipping Guide

Preparing the Shipping Box

1. Cover the specimens in the frozen Styro(s) with dry ice (see Diagram 1c: Frozen Shipping Container)
   • Wear safety glasses and cloth gloves when handling dry ice.
   • If no frozen specimens are being shipped, carefully transfer the dry ice from the frozen Styro to the dry ice container and ship that Styro empty.
   • The courier may wish to dispose of the extra dry ice after topping off the frozen Styro(s). The last client on the run may have a place to do this.
     Never leave dry ice where people might burn themselves on it. Do not dump it in a parking lot, a drinking fountain, or a restroom sink.
2. Put the Specimen Control Document in the Refrigerate/Ambient Styro.
   • First, total the columns on each Specimen Control Document. Remove and keep the yellow copy for your records. This will be very important if there should be any questions about the shipment.
   • Put the Specimen Control Document inside of the Refrigerate Styro before closing the box.
3. Close the shipping box and seal it with packaging tape.
   • If shipping a Category A Infectious Substance, fold down the handles of the box and tape it closed before leaving the lab. Open and reseal the box at each additional stop.
   • If shipping a Biological Substance, Category B specimen, do not fold the handles down and tape the box until finished with all pickups.
   • Do not seal all the edges of the box. Dry ice emits a gas, which must be allowed to escape. Do not tape the Styro lids.
4. On the outside of the box, write the weight (in kilograms) of dry ice being shipped.
   • Usually shipments include some frozen specimens. The Mayo Medical Laboratories’ shipping box has the words "Dry Ice" next to the Class 9 hazard label and includes a place to write in the weight of the dry ice (in kilograms) on the box.
     If the shipment does not include dry ice, the dry ice label must be completely covered up either with tape, paper, or a marker.
   • If a shipment containing dry ice is being transported on a passenger airline, write "2.2 kg" on the appropriate line on the label. Make sure that there is no more than 2.2 kilograms (5 lb) in the frozen Styro inside the box.

This is a Mayo Medical Laboratories box properly labeled for a "Biological Substance, Category B" shipment.

Always ship both Styros in the Mayo Medical Laboratories box set, even if one Styro is empty. Never take one or both Styros out and put specimens directly in the box. Wear latex gloves any time you reach into a Styro that contains specimens.

Shipping by Air

Filling out the airbill

Mayo Medical Laboratories will provide couriers with preprinted "airbills" for shipments and instructions for filling them out.

Mayo Medical Laboratories’ policy is that Category A Infectious Substances must be shipped by FedEx. That procedure will be covered in the section on Category A Infectious Substances. "Biological Substance, Category B" specimens may generally be shipped by most major passenger airlines as well as by FedEx and AirNet.

Dropping off and reporting your shipment

The end of the courier’s route is the airline's drop-off location. Take the shipping boxes inside and hand them over to the airline's receiving person. Give the airline representative the airbill or FedEx Return Label.

After delivering the shipment to the airline, phone Mayo Medical Laboratories to report the shipment. If no phone is handy at the airline's office, couriers can do this later from another phone. Mayo Medical Laboratories’ "AUDIX call-in system" makes it very easy to report the shipment. These instructions have been printed on a handy wallet card as well.

1. Call 877-508-9797.
2. After the recording, clearly and slowly state your name, company, city, state, flight number, airbill number, name of the airline, and the number of boxes sent on each airbill.
3. Hang up.

It is important to make this call within a few hours. Mayo Medical Laboratories will need this information urgently if the shipment doesn't arrive on time.

Packaging Category A Infectious Substances

The following information describes Mayo Medical Laboratories' methods of packaging and shipping Category A Infectious Substances. For detailed Dangerous Goods Training, please refer to our website or contact MML’s Transportation Department personnel for assistance.

The packaging certified to legally and safely transport infectious specimens is a combination package consisting of inner and outer containers that have passed all of the tests required by IATA/DOT. Mayo Medical Laboratories certifies the double 10-pound berry box (MC1977-2 1b) with the inner container (T146) inside. See the Certified Packaging diagram.

This package is certified to legally transport Category A Infectious Substances only if it is used properly. The box and the inner container by themselves are  not considered certified. They are tested as a combination package and must be shipped as a combination package.

The top of the box must be taped all the way across where the flaps meet in order to comply with the testing and certification requirements. Written instructions are on the top of the box as to which flaps to fold down first and last.

The box must be taped correctly before being transported by air or ground, even if traveling a short distance. It must also have affixed to the outer side in the space provided, Mayo Medical Laboratories current Class 6 hazard label, which contains our UN certification as part of the label. These steps must be taken prior to leaving the client site with infectious substances.

It is not up to the courier driver to decide what is "Category A Infectious Substance" or "Biological Substance, Category B" – the physician or send-out staff at the hospital lab will perform that function. Couriers will know that they are handling and transporting an infectious specimen if a specimen bag has affixed to it Mayo Medical Laboratories’ small orange "sent infectious" label, and the bag contains the Mayo Medical Laboratories-certified large infectious container (T146). See the Certified Packaging diagram.

Category A Infectious Substance Container

The client places the specimen in a primary receptacle (such as a tube or a vial) and puts the primary receptacle into a certified container. After the specimen is in the certified container, the container is placed in one of Mayo Medical Laboratories’ color-coded bags. The client will write the name of the infectious substance on an orange label and put it on the bag. The label includes the information needed to fill out the paperwork and mark the box.

Certified Packaging

"Sent Infectious" Label

• The client will place this label on the outside of the color-coded bags if the specimen is infectious.
• The client will write the name of the infectious agent on the label so that you may fill out your shipper’s declaration and mark the box correctly.

Packing Category A Infectious Substances

It is not legal to transport infectious Category A Infectious Substance specimens with "Biological Substance, Category B" specimens. These Category A Infectious Substance specimens must be shipped in certified packaging. Because many passenger airlines have restrictions or exclusions on shipping Dangerous Goods, Mayo Medical Laboratories recommends that any infectious shipments sent to our laboratories be made via FedEx.

If FedEx is not the courier’s "scheduled" carrier (for example, if the courier utilizes AirNet or a passenger airliner), the infectious specimens must be packaged in separate shipping box and shipped to Mayo Medical Laboratories via FedEx.

Please follow this procedure:

• When making a pickup at a hospital, place the certified containers with infectious specimens inside a separate Styro and box.
• After completing that pickup, apply the white "Infectious Substance" Class 6 hazard label to the outside of the box. Fold down the carrying handles and tape the box with packaging tape. This must be done prior to driving to the next stop or to the airport.
• Remember that shipping the infectious box via air will involve filling out a Shipper’s Declaration as well as a paper FedEx airbill.
• The non-infectious specimens may be shipped as usual via the courier’s "scheduled" carrier in another box.

Documenting Category A Infectious Substances

Let the air carrier know the following on the Shipper’s Declaration:

1. What infectious substances are included in the shipment?
   • The name of the infectious substance (also called the Technical Name), is written by the client on the orange Sent Infectious label.
2. How much of each infectious substance is being shipped?
   • One vial typically has 3 to 6 milliliters (mL) or 10 grams
   • The large infectious mailer holds one or two vials

Labeling Category A Infectious Substance Shipments

Two labels may be put on a shipping box containing infectious substances:

1. The orange Danger label is used ONLY when there is more than 50 mL or 50 grams of an infectious substance	2. The white Infectious Substance label. Order number T148.

The courier must write the courier’s name and address on the space provided on the box.

Airbill and the Shipper’s Declaration for Dangerous Goods

• Mayo Medical Laboratories provides a Shipper’s Declaration for Dangerous Goods for shipments with Category A Infectious Substances.
• An Airbill must accompany the Shipper’s Declaration.

To properly complete the Shipper's Declaration for Dangerous Goods:

1. Enter the FedEx Airbill number.
2. Enter the Airport of Departure.
3. Enter the technical name of the specimen.
   
4. Enter the quantity of the infectious substance.
5. Fill in the courier’s name, job title, the city being shipped from, and the date. Next, sign the Shipper’s Declaration.

If the Shipper’s Declaration is not filled out completely and correctly, FedEx will not accept the package. NOTE: The shipper (in this case, the courier) must keep a copy of the Shipper's Declaration for a minimum of two years. You must be able to provide this copy if audited by the FAA or the D.O.T.

The remaining information will be pre-printed on the Shipper’s Declaration for you.