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Courier Packing and Shipping Guide

Packaging Specimens

For convenience, biohazard color-coded by temperature bags are provided to client laboratories by Mayo Medical Laboratories:

Biohazard bags color-coded by temperatureMedical samples being transported to testing laboratories must be maintained at an appropriate temperature: ambient, refrigerate, or frozen.

Specimens must be separated by temperature, and each of these temperature bags must be packaged in a specific manner. Mayo Medical Laboratories provides a raspberry-colored shipping box which holds two Styrofoam (Styro) containers inside. Styro transportation coolers provided by Mayo Medical Laboratories have corresponding color-coded labels and contain appropriate labeling for dry ice and biohazards. One of the Styro containers holds the cool packs needed to keep refrigerate/ambient specimens cool up to 48 hours.

All specimens must be shipped in a leak-proof container, regardless of transport temperature. The color-coded bags also contain material that can absorb the full liquid content of the specimen(s) placed inside.

The following pages provide couriers with detailed instructions for packaging specimens for shipping. This includes preparing the Styros, packing specimens at the appropriate temperature (refrigerated, ambient, and frozen), completing shipping documents, and shipping specimens. In addition, the guide includes information about shipping infectious substances, safety in the laboratory, and cleaning up leaks and spills.

Completing the Mayo Medical Laboratories Specimen Control Document
(Courier use only)

The following information needs to be filled out completely on the Specimen Control Document we provide for you:

Number of
Frozen Bags
  1. On the top section of the control document, on the specified line, print:
    • complete name of the courier company
    • date of the run and day of the week
    • name of the person making the run
    • city and state
  2. Fill in the Client name: the name(s) of the hospitals, clinics, or laboratories from which specimens were picked up.
  3. Fill in the account number: Each client is given an account number by Mayo Medical Laboratories. If you do not know the account number, our Transportation Department can provide you with that information.
  4. Mark down the number of bags you picked up for each temperature as well as any other material you may get, such as X-rays or envelopes.
  5. Log the time you picked up the specimen(s) and have a lab employee initial the Specimen Control Document stating you have picked up everything.

"On-Call" Clients

Check with your dispatch department for any "on-call" clients who may have called in requesting a pick up. "On-Call" clients are those clients not on your regular daily route.

  1. Determine the most efficient way to include the on-call clients into your scheduled route.
  2. Add the on-call client information to the control document as you would for a regular pick up.

The Specimen Control Document is a two-part form. Please place the original in the Refrigerate/Ambient Styro and keep the copy for your records for future reference.

Preparing the Styros

Prepare to pack the refrigerated/ambient specimens in the same Styro. The lid of the Styro has a pink label to indicate Refrigerate Specimens and a white label to indicate Ambient Specimens. Specimens should be in temperature color-coded bags that should match the color of the label on the Styro lid. Put on gloves prior to placing the specimen bags into the Styros.

Packing Refrigerated Specimens

  1. Place a cold cool pack in the bottom of a Styro.
  2. Place three to four paper towels (for insulation) over the cool pack.
  3. Locate the refrigerated specimens and count the bags. Make sure all the bags are pink.
  4. Record the number of refrigerated bags on the Specimen Control Document.
  5. Open the lid of the refrigerated/ambient Styro. Remove any ambient specimens from previous pickups.
  6. Insert the pink refrigerated specimen bags in the Styro. Place two paper towels over the refrigerated specimens, separating them from the ambient specimens. Replace the ambient specimens.
  7. Immediately replace the Styro lid.

Packing Ambient Specimens

Use the same refrigerated Styro, however:

  1. Locate the ambient specimens and count the bags. Make sure all the bags have white labels.
  2. Record the number of ambient bags on the Specimen Control Document.
  3. Open the lid of the refrigerated/ambient Styro and place two paper towels over the top of the pink refrigerated bags.
  4. Insert the white ambient specimen bags. Ambient specimens go on top of the refrigerated specimens, separated by paper towels.
  5. Fill the remaining space inside the Styro with packing material such as paper towels.
  6. From November through March, also place a non-refrigerated cool pack at the top of the Styro.
  7. Immediately replace the Styro lid.

Refrigerate/Ambient Shipping Container
November through March

Diagram 1a

Diagram 1a: Packing a Refrigerate/Ambient Shipping Container in winter

Refrigerate/Ambient Shipping Container
April through October

Diagram 1b

Frozen cool pack helps keep specimens from becoming too warm

Packing a Refrigerate/Ambient Shipping Container in summer

Reminder – Do not use dry ice to freeze the cool pack; if dry ice is your only option, then remove the cool pack from the dry ice three hours before use.

Packing Frozen Specimens

Note: Pellet dry ice is preferred. Block dry ice must be reduced to small pieces (1"-2") to minimize the chance of damage to bags and vials.

  1. Prepare the frozen Styro. The lid of the Styro will have a yellow label to indicate frozen specimens.
  2. Locate the frozen specimens and count the bags. Make sure all the bags have yellow labels.
  3. Record the number of frozen bags on the Specimen Control Document.
  4. Open the lid of the frozen Styro and place a 2-inch layer of dry ice in the bottom of the frozen Styro. To avoid burns, always wear cloth gloves and safety glasses when handling dry ice.
  5. Insert the yellow specimen bags on top of the dry ice. Add bags only up to the line marked on the yellow sticker inside of the Styro. Cover them with more dry ice. Do not overfill, leaving enough room at the top to put the lid on securely.
  6. Immediately place the yellow-labeled "Frozen" cover onto the Styro.

Under normal conditions, 5 lb, or 2.2 kg, of dry ice will keep the specimens frozen until they arrive at the laboratory.

Frozen Shipping Container

Diagram 1c

Frozen Shipping Container

Reminder – Do not fill the frozen styrofoam shipping container too full of specimen bags. Leave room for dry ice on top of the topmost specimen shipping bag and make sure the styrofoam lid fits tightly. On passenger aircraft, such as Delta or American, put 2.2 kg (5 lb) of dry ice in the Styro. FedExp or AirNet allow more, as there is a higher maximum weight for dry ice on a cargo aircraft.

Packing Stool Specimens

Mayo Medical Laboratories provides clients with special containers for stool specimens. We prefer that stool specimens be packed in these containers. Any substitute containers must have a screw cap and be leakproof. A special 10-lb Styro in its own box is used for shipping one or two stool containers. Large-volume stool containers must not be mixed with other specimens. They must be shipped in a separate Styro. Special stool containers may be located in the client’s freezer or refrigerator.

The procedure for packing stool containers is as follows:

  1. After packing all other specimens, couriers should discard latex gloves, wash their hands, and prepare a 10-lb Styro out in the transport vehicle (if there are more than two stool containers to pick up, use both Styros in a full-sized double 10-lb box set.)
  2. If the stool containers are in the freezer, put a 2-inch layer of dry ice in the bottom of the Styro. If the stool containers are in the refrigerator, put a cold cool pack in the Styro with two paper towels on top.
  3. Bring the stool container box into the lab. Put on a fresh pair of latex gloves before entering the lab.
  4. Prepare a Specimen Control Document for this Styro. Fill out the top portion of the document (company name, the name and city shipping from, and the date). Fill in the client’s name and account number.
  5. Write the number of containers packed in this Styro under the appropriate column: frozen or refrigerated.
  6. Pack the stool containers in the 10-lb Styro. Remember, no other type of specimen can be packed in the same Styro with stool containers.

Packing Muscle Biopsy Specimens

Mayo Medical Laboratories provides clients with special containers for muscle biopsy specimens. A special 10-lb Styro in its own box is used for shipping these biopsies in a small container, completely surrounded by dry ice. They must be shipped as packaged by the client and must not be opened unless specifically directed by the client or by Mayo Medical Labs (for example, to add dry ice in the case of a delayed shipment.)

Packing Critical Ambient Specimens

Mayo Medical Laboratories provides clients with special containers for critical ambient specimens such as bone marrow and some whole blood specimens that would be ruined if allowed to get too cold.

A 10-lb Styro inside a white fibreboard box (supply T668) is used for shipping these critical ambients, which are completely surrounded by six room-temperature cool packs. They must be shipped as packaged by the client, and should not be opened by the courier unless specifically directed to do so by the client or by Mayo Medical Laboratories. If the client has critical ambient specimens but does not have MML’s Critical Ambient white box, the courier should package those bags surrounded by six room-temp cool packs in a separate Styro and box.

Packing "Other Materials"

Sometimes materials that do not fit into Mayo Medical Laboratories specimen bags or specimen containers must also be packed and transported. Examples include a box of glass slides or X-ray films in a large envelope. Following are instructions for preparing these materials:

  1. Write the number of items and a description of each item on the Specimen Control Document under "Other Material."
  2. Place the materials in the appropriate Styro, usually ambient/refrigerated. It may be necessary to use an extra box.
  3. Place envelopes inside of the Styro if they fit. Do not place envelopes alongside the Styros in the box.
  4. Ship X-ray films or envelopes that do not fit in the Styro via FedEx in a separate X-ray envelope. Mayo Medical Laboratories provides special X-ray envelopes to couriers and clients who request them. The supply number is T531.

Labeling Culture Specimens

You will see a blue “C” sticker on the bag and batch sheet of any “culture” specimen. In this case, place a blue “C” sticker on the Styro containing the culture and also on the outside of your berry box. Be sure not to obscure any other labels on the box.

C sticker on Styro and berry box.

Properly-placed C stickers

General Instructions for Packing Specimens

  • Never take the lids off both Styros at the same time. When both lids are removed, it is easy to mistakenly place the lids on the wrong Styros.
  • Never overfill a Styro or compress the specimens. If the lid will not fit securely on a Styro, use another box.
  • Complete a specimen control document for each box, logging only the specimens in that box.
  • Count the number of bags and enter that number on the Specimen Control Document.
  • If specimens are not in Mayo Medical Laboratories bags or containers, ask a lab staff person to repackage them. Couriers should pack extra bags in case clients have used up their supplies. (Clients may order supplies by following their normal reorder process.)
  • If the temperature of a specimen does not match its label (for example, if a specimen with a pink refrigerated label is in the freezer), ask a laboratory staff person how it should be transported. If it is in the wrong bag or container, ask the person to repackage it.
  • Do not leave a box containing specimens in an unlocked car. Always enter a facility carrying the box.
  • Do not place any documents, packages, envelopes, etc., outside of the Styros in the box.

Pack extra cool packs

Put at least 3 extra cold cool packs and a dozen paper towels in the refrigerate/ambient Styro of another berry box. It may be necessary to ship more than one refrigerated Styro.

Refrigerated specimens cannot be shipped without a cold cool pack, so it is very important to have extras.

For additional assistance or questions regarding specimen packaging, supplies, or shipping, please contact Mayo Medical Laboratories at 800-533-1710 or visit our Web site at

Safety in the Lab

Mayo Medical Laboratories packaging materials are designed to protect everyone who handles them. However, couriers should always take special precautions in a laboratory:

  • Wear latex gloves in the laboratory. Cover any cuts or scrapes with a bandage.
  • Wash hands before leaving each laboratory.
  • Open-toed shoes are not acceptable in the laboratory areas.
  • Do not put the box down in a spill (wet) area.
  • Do not touch any specimen bag or container that appears soiled. Ask a laboratory staff to place the specimen(s) in another bag for safe transportation.
  • In the event of a cut or puncture to the skin in the lab, tell laboratory staff immediately.

Packing the Courier Vehicle

Pack the courier vehicle with the following items (more about some of these items later):

  • Extra dry ice with cloth gloves and safety glasses
  • Box of latex gloves (provided by Mayo Medical Laboratories)
  • Paper towels
  • Clean-up kit
  • Packaging tape
  • Class 6 Infectious Substance shipping container (Supply T570)
  • Mayo Medical Laboratories stool containers in a 10-lb Styro
  • Double 10-lb box sets with cool pack and dry ice
  • Specimen Control Document (be sure to pack extras)
  • Airbills
  • "Mayo Medical Laboratories Shipment Alert Procedure" instruction card for calling Mayo Medical Laboratories to report the shipment
  • Mayo Medical Laboratories phone number 800-533-1710; ask for the Transportation Department; phone coverage is available 24 hours a day, 7 days a week

Always pack the boxes with the cool packs and dry ice just before leaving. Cool packs can freeze if left in a very cold car and dry ice can evaporate if left in a very warm car.