Is the referring laboratory still liable when it sends a test out to a reference lab?

Send-out testing is routine. Something falls outside your menu or your certification, so it goes to a reference laboratory and the result comes back into your report.

From the perspective of the clinician who ordered it and the patient affected by it, the laboratory they dealt with is you. That is enough to be named, and being named is what triggers defense costs whether or not you are ultimately found responsible.

The failures cluster at the handoffs rather than in the analysis. Specimen integrity in transit, including temperature and time limits. Identification and labelling errors that occur before the sample leaves. Transcription of the result back into your system. Delay in returning a time-sensitive result. Reporting a result without the reference laboratory’s interpretive caveats or reference ranges intact.

Several of those are entirely within your control, which is precisely why your own policy is the one being asked to respond.

Your form generally responds to your own acts and omissions, which covers the handoff failures above. What is less certain is a claim arising purely from the reference laboratory’s analytical error where you did nothing wrong but are named anyway.

The useful question for your broker is whether the policy funds your defense in that situation even where the ultimate fault lies elsewhere, since defense is the cost you will actually incur. Vicarious liability wording is the part to look at.

The send-out agreement is where recovery is decided, and it is often signed as an operational formality rather than reviewed as a risk document.

Look for an indemnity running in your favour for their analytical errors, evidence of professional liability at a limit proportionate to the volume you send, a waiver of subrogation, and clarity on which party carries the specimen while it is in transit. Many such agreements are silent or run the indemnity the other way.

Treat reference laboratories as vendors requiring the same certificate review as any other, using the checks in the vendor certificate entry, and keep evidence of chain of custody and transit conditions because that record is what defends the handoff allegations.

If the direction of travel is the opposite one, and you are bringing previously sent-out work in house, that is a change in scope with its own notification consequences, covered in the new test menu entry.