# AI interprets elevated serum potassium (6.5 mEq/L) as hyperkalemia without considering hemolysis artifact

- **ID:** `medical/lab-result-hemolysis-false-elevation`
- **Domain:** medical
- **Category:** data_error
- **Error Code:** `LAB-HEMOLYSIS-003`
- **Verification:** ai_generated
- **Fix Rate:** 93%

## Root Cause

Hemolysis during blood draw or processing releases intracellular potassium, causing pseudohyperkalemia; true potassium may be normal; ignoring hemolysis index leads to unnecessary treatment (e.g., insulin, calcium gluconate) with iatrogenic risks.

## Version Compatibility

| Version | Status | Introduced | Deprecated |
|---------|--------|------------|------------|
| Roche Cobas 8000 | active | — | — |
| hemolysis index ≥ 2+ | active | — | — |
| CLSI guidelines H56-A | active | — | — |

## Workarounds

1. **Check hemolysis index on lab report; if ≥ 2+, request recollection with proper technique (no fist clenching, use larger vein); run `python -c "print('Hemolysis index: check >2+; recollect if elevated')"`** (95% success)
   ```
   Check hemolysis index on lab report; if ≥ 2+, request recollection with proper technique (no fist clenching, use larger vein); run `python -c "print('Hemolysis index: check >2+; recollect if elevated')"`
   ```
2. **Order venous blood gas for rapid whole blood potassium, less affected by hemolysis** (88% success)
   ```
   Order venous blood gas for rapid whole blood potassium, less affected by hemolysis
   ```
3. **If hemolysis index unavailable, repeat draw from opposite arm with minimal tourniquet time and avoid small needles** (85% success)
   ```
   If hemolysis index unavailable, repeat draw from opposite arm with minimal tourniquet time and avoid small needles
   ```

## Dead Ends

- **** — If hemolysis is due to difficult draw or improper technique, repeat may show same artifact; need to check hemolysis index first (75% fail)
- **** — Unnecessary treatment causes hypoglycemia; if potassium is actually normal, patient at risk of hypokalemia (90% fail)
- **** — True hyperkalemia can be asymptomatic; correlation with hemolysis index is required, not clinical judgment alone (80% fail)