PRINCIPLES OF MEDICAL LABORATORY SCIENCE

Medical Technology
– a.k.a Clinical Laboratory Science/ Laboratory Medicine/ Medical
Laboratoy Science.
– Application of diagnostic, preventive, and therapeutic medicine to
monitor and improve the management of Health condition.

Definition of Medical Technology:

1. Anne Fagelson
- Acc. To her, M.T is a Branch of Medicine.
- Concerned with performance of Laboratory determination and
analysis and treatment of disease and maintenance of health.
- She died from lab acquired infection.

2. Walters
- Acc. To Walters, M.T. Is a Health profession concerning performance
of lab analysis in view of obtaining info necessary in the diagnosis and
treatment of disease as well as in the maintenance of good health.

3. Ruth Heinemann
- Acc. To Ruth Heinemann, M.T. Is the application of principles of
natural, physical, and biological Sciences to the performance of lab
procedures which aid the diagnosis and treatment of disease.

R.A. 5527 = Philippine Medical Technology R.A. of 1969

An auxillary branch of laboratory medicine which deals with the examination of

tissues, secretion, excretion of the human body and fluids by various electronic,
chemical, microscopic and other medical laboratory procedures/ techniques
either manual or automated which will aid the physician in the diagnosis study
and treatment of disease and in the promotion of health in general.
What is Clinical Laboratory?
Facility that performes chemical and microscopic examinations of various
body fluids like blood and tissues.

Pathologist
– Director of clinical laboratory
– Licensed Physician
2 Areas of Pathology:
1. Anatomic- Diagnosis for surgical tissues
2. Clinical- Specializes in chemical microbiological procedures.

M.T – Interdisciplinary (Relating to more than one branch of knowledge)

• Hematology – study of blood cells (CBC)
• Clinical Chemistry – Using chemistry to evaluate a person's health. ex.
Sugrar level, cholesterol, etc.
• Medical Microbiology – Concerns with prevention, diagnosis, and
treatment of infectuous diseases. ex. Bacteria, Fungi.
• Clinical Microscopy – This section performs scientific analysis of non-
blood body fluids such as urine, semen, and stool.
• Immunology – concerned with immunity ex; Antigen, antibody
• Serology – Uses study of immunology to study diseases.
• Gen. Pathology – Field which seeks to understand the mechanisms of
injury to cells and tissues. Ex. Tumor, breast cancer etc.

HISTORY
Ebers Papyrus (1500 B.C)
• Oldest preserved Egyptian compilation of medical texts.
• 110 page long scroll contains the most complete record of Egyptian
medicine known.
• Most important medical papyrus yet recorded.
• Contains chapters on contraception pregnancy,eye and skin problem,
surgery burns, intestinal disease and parasite namely the...
 Hookworm – Book of Ebers papyrus describes the treatment of hookworm
disease and infection transmissible to human.

1. Vivian Herrick
M.T who traced the beginning of MT when intestinal parasite such as
taenia and ascaris were first identified.
2. Hippocrates
Father of Medicine.
Advocate the use of mind and senses as diagnostic tool.
Described 4 humors of the human body:
1. Yellow Bile – Serum (Only if you allow blood to clot)
2. Phlegm – a whitish layer now called buffy coat.
3. Blood – Red Blood Cells
4. Black Bile – Dark clot found at the bottom.
Serum- When blood is clotting
Plasma- The liquid portion.

Central Hippocratic Doctrine of Humoral Pathology

• All disease were due to the disorder of these 4 Humors/ Body fluid.
• Those times; Urine was the composite of these humors.
◦ Urinalysis
◦ Uroscopy
◦ Urine Flask

“ How Ancient People contributed in the Medical Field”

Greeks – Poured urine on the ground and attracted ants; diagnosed diabetes.
Hindu Doctors – Made scientific Observations.
3 P's of diabetes:
Polydipsia – Increase thirst
Polyuria – Frequent urination
Polyphagia – Rise in appetite
Chinese
Practiced immunization by inhaling powder in a small box to get immune
to the disease
Romans
Developed lab tools, forceps, scapels, specula, and surgical needles.
Indians
Practiced Toxicology
Rufus of Ephesus
Made first description of hematuria
Due to inability of Kidneys to filter blood.

Global Context (Middle Age 500-1500 A.D)

1. Isaac Judeus
▪ Formulated guidelines/ Rules in how to use urine as a diagnosis.

JERUSALEM CODE OF 1090

“Failure of physicians to examine patients urine was punishable by
public beatings”

2. Zaccharias Jansen and his Father Hans (1590's)

▪ Invented Microscope
3. Ruth Williams
▪ Believe that MT began on Medieval Period supported by the fact that
urinalysis was a fad.

- 14th Century -
4. Anne Fagelson
▪ Believed that MT started when a prominent Italian doctor at the
university of Bologna employed aksandra Gillani to performe
different tasks in the lab.
▪ Died due to lab acquired infection
- 15th Century-
▪ Discovered drugs such as Analine dyes used in staining
microogranisms
▪ to get stain color; bacterias should die

- 16th-18th Century -
5. Anton van Leeuwenhoek
▪ Father of Microbiology
▪ Saw bacterias and classified them as shapes “animalcules” refered
to him as microogranisms.
▪ Decribes
• Blood cells
• muscle fibers
• spermatozoa and protozoa
6. Athanasius Kircher
▪ Greatest of the early microscopist
▪ Blood of patients with plagues contained “worms” (looked in the
microscope.
7. Robert Hooke
▪ English Philosopher
▪ Publish the micrographia documents
8. Marcello Malpighi
▪ Founding father of Modern Anatomic Pathology
▪ known because of his contribution of embryology and anatomy.
▪ Italian microscopist
9. Jean Baptiste Van Helmont
▪ Introduced gavimetric analysis of urine by weighing of 24 hour urine
specimens.
10. Richard Lower
▪ Investigated and showed that blood transfusion from animal to
human is possible.
11. Frederick Dekker
▪ Proteinuria
▪ Observed that when urine is boiled with acetic acid, proteins
precipitated.
12. William Hewson
▪ Discovered that serum could be separated from blood clots.

13. Matthew Dobson

▪ A M.D. Who identified sugar in the blood and urine of diabetes
14. Francis Home
▪ A M.D. Who developed yeast for sugar in diabetic urine
▪ Mostly found in girls or woman.
- 19th Century -
• Era of Public Health
• Water treatment
• pasteurization of milk
• improvement of hygiene
15. Rudolf Virchow
▪ Father of Modern Pathology
16. Herman Von Fehling
▪ Differentiating reducing and non-reducing
▪ Blue – implies sucrose; no sugar
▪ Red, orange Yellow – reducing
17. John Snow
▪ Father of Modern Epidemology
▪ Studied Cholera Outbreak
▪ MAPPING- Due to contaminated water in the broad street.
18. Louis Pasteur
▪ Studied aerobic and anaerobic
▪ can prevent wine spoilage
▪ but failed to prove theory “Germ Theory of disease”
19. Robert Koch
▪ Provided experimental steps “Koch's postulates”
▪ Use to prove that specific microbe caused a specific disease.
▪ Discovered specific Disease because of 4 postulates
• tuberculosis – Mycobacterium tuberculosis
• cholera – Vibrio cholerae
• Anthrax – Bacillus anthracis

- Middle 1800's -
• Lab tests for the following were introduced
◦ Guys Hospital – First Hospital Lab in Britain.
◦ University of Michigan Hospital – First Clinical Lab set up in U.S.
History of M.T. In the U.S
1. Dr. William H. Welch
▪ Established a Lab at Belleure
▪ First Professor in pathology.
▪ 1st lab course
2. Dr. William Osler
▪ Openned 1st clinical lab in 1896

▪ Routine Exam
▪ to detest material parasites
3. Dr. James Todd
▪ Wrote: Clinical Diagnosis: A manual of lab method

4. John Kolmer
▪ Published the Deman for and training of Lab technicians.

State of Legislature of Pennsylvania (1918)

▪ Require all Hospitals to have adequate lab and employment a full
time lab technician.
WW1
• Important factor in the growth of clinical lab.
• Create a great demand for clinical lab tech.
• Assistants were taught to do some tests by the practicing physicians.

1920's
• Administrative units of clinical lab-in large hospitals were directed by a
chief physician.
1922
• ASPC (American Society of Clinical Pathologist) was founded.
• Encourage cooperation between attending physicians and pathologist.
• Established code of Ethics for technicians
• People should work in the supervision of the physicians
• Refrain from making oral or written diagnosis.
• Advising physicians on how patients should be treated.
American Society for Clinical Laboratory Sciences
• Formulated a subgroup of ASCP (American Society of Clinical Pathology)
• Recognition of non-physicians clinical lab scientists as professionals.
1923
• University of Minnesota issued a course bulletin entitled “Courses in MT
for Clinical and Lab technicians”
• 1st to offer a degree level programs 1923
1936
• The American Board of Pathology was established.
1950
• MT. In U.S sought professional recognition from the government if their
educational qualifications through licensure laws.
WWII (Marked a great effect on Laboratory Medicine)
Result develop of:
• Use of blood transfusion = closed system of Blood collection.
• Instrumentation was advanced
• automation in the laboratory.
• Quality control programs.
◦ Reduced the occurrence of errors in the laboratory.
◦ Ensure accuracy and precision in the laboratory results.

Laboratorio Municipal de Manila (1887)

• First Lab in the Philippines.
• Clinical, food samples, water sample.
• Not good om studying outbreaks
• Gen. Antonio Luna (employee of the hospital)
◦ employed as Chemical expert
 ◦ pioneered: forensics, environmental studies, and water testing.

Bureau of Government Laboratory (1901)

• Philippine commission act. no. 156
• Had a science laboratory, chemical section and serum lab for production
of vaccines.
• BIOLOGY LAB: use to develop new methods for diagnosis, treatment,
prevention of human and animal diseases.
• CHEMISTRY LAB: food and plant composition and minerals were
investigated.
• Paul Freer (1st director of this Bureau)
• Now not seen because of WWI.
• Now you can see as: NIH-UP-M aka. “National Institutes of Health in
the University of the Philippines in Manila”

Japanese Era WWII

Dec. 07, 1941 – Officially started WWII in the Philippine context.
The Americans helped Philippines by bringing U.S. Army. Also brought the
healthcare teams which helped in adding knowledgee of the Philippines.

26th Medical Laboratory of the 6 th U.S. Army (6th infantry division of the U.S
Army)
• 1st clinical laboratory
• situated at: 208 Quirada st. Sta. Cruz, Manila
• Now you can see as: Manila Public Health Laboratory

February 1944
• HS graduates were provided w/ 1st year training to work as lab technicians.
June 1945
• Staff on the 6th U.S army left the facility.
• Clinical Lab was endorsed to the national department of health.

Dr. Pio de Roda

 • Filipino doctor and a dislocated staff of the 26 th U.S army.
• He pressured the remains of the lab with the help of Dr. Mariano Icasio
(1st health officer of Manila)
• Lab was later on named as : Manila Public Health Lab
1947
• Training program for individuals aspiring to become lab workers was
offered by Dr. Pio de Roda, in collaboration with Dr. Prudencia sta. Ana
• Dr. Prudencia trained and taught mostly H.S. Grad and paramedical grad.
Dr. Briones
• Health City officer of Manila
Willa Hilgert Hedrick
• Founder of Medical Technology Education in the Philippines
• An American Medical Practitioner and a missionary of the 7 th day Adventist
• Who helped him build M.T. School are:
◦ Dr. Reuben Mansalaysay
◦ Rev. Warren
◦ Mrs. Antoinette Mckelvey – Prepared the course curriculum and
established the 1st complete lab in microbiology, parasitology, and
histopathology at Manila Sanitarium Hospital.
1956
• Mrs. Jesse Umali: 1st student to graduate from the Philippine Union
College
▪ First to offer a 4 year BSMT through its sister establishment (Manila
Sanitarium Hospital)
▪ Now: Adventist University of the Philippines

1957-1958
• UST offered an elective course of Pharmacy leading to the bachelor of
Science in Medical Technology.
• Dr. Antonio Gabriel and Dr. Gustaro Reyes of the Faculty of
Pharmacy

• Rev. Lorezo Rodriguez- Decided to offer M.T. As a course

June 14, 1961

• Full recognition of the 4 year BSMT course.
◦ BSMT (Bachelor of Science in Medical Technology)

◦ BMLS (Bachelor in Medical Laboratory Science)

 ◦ cmo 13 s 2017 memorandum order

◦ BSMLS (Bachelor of Science in Medical Laboratory Science)

Mrs. Purificacion Sunico-Suaco

• Undertook feasibility study for the offering of the BSMT course.
• 1st Batch grad in 1962
• U.P. Offered a similar course
◦ B.S. In Public Health
◦
MEDICAL TECHNOLOGY PRACTICE
Philippine Medical Technology Act of 1969
(R.A 5527 Section 2)
1. Examine Clinical Samples
2. Blood Banking procedures & Techniques
• Related to Blood transfusion
• Blood typing
• Cross matching
3. Parasitologic, mycologic, microbiologic
4. Histopathologic and cytotechnologic
5. Clinical Research – involving human beings on Animals requiring the use
or application of medical technology knowledge and procedure.
6. Preparation and standarzation of regeants, standards, stains, others.
1. These are exclusive for the use of their laboratory.
7. Clinical Lab (quality control) – Quality assurance
8. Collection and Preservation of specimens.
◦ Collection- Phlebotomy
1. Venipuncture
2. Skin puncture/ Capillary Puncture
3. Arterial Puncture
◦ Preservation – Since some doctors wants additional tests.
1. Refrigerate (2-8 degree Celsius)
2. Freezing- serum; plasma
Medical Technology Practice that may not be exclusive to Medical
technologists alone:
• Microbiology
• Biologist
• Chemists
• Sanitary Engineers

A license must first be acquired before the practice becomes legal

Board of Medical Technology Code of Ethics (by. Prof. Rodolfo Rabor) revised
version.

As I enter into the practice of Medical Technology, I shall accept the

responsibilities inherent to being a professional; I shall uphold the law and shall not
engage in illegal work nor cooperate with anyone so engaged; I shall avoid associating
or being identified with any enterprise of questionable character;
I shall work and act in a strict spirit of fairness to employer, clients, contractors,
employees and in a spirit of personal helpfulness and fraternity toward other members
of the profession;
I shall use only honorable means of competition for professional employment or
services and shall refrain form unfairly injuring, directly or indirectly, the professional
reputation, projects or business of a fellow medical technologist; I shall accept
employment from more than one employer only when there in no conflict of interest;
I shall perform professional work in a manner that merits full confidence and trust
carried out with absolute reliability, accuracy, fairness and honesty; I shall review the
professional work of other medical technologists, when requested, fairly and in
confidence whether they are subordinates or employees, authors of proposals for
grants or contracts, authors of technical papers or other publications or involved in
litigation;
I shall advance the profession by exchanging general information and experience
with fellow medical technologists and other professionals and by contributing to the
work of professional organizations;
I shall restrict my praises, criticisms, views and opinions within constructive limits
and shall not use the knowledge I know for selfish ends; I shall treat any information I
acquired about individuals in the course of my work as strictly confidential, and may be
divulged only to authorized persons or entities or with consent of the individual when
necessary;
I shall report any infractions of these principles of professional conduct to the
authorities responsible of enforcement of applicable laws or regulations, or to the
Ethics Committee of the Philippine Association of Medical Technologists as may be
appropriate.
To these principles, I hereby subscribe and pledge to conduct myself at all times
in a manner befitting the dignity of my profession.

Roles and Responsibilities of Medical Technology

Professionals.
1. Perform Clinical Laboratory Testing
– A grad of BSMLS who is capable of performing basic to advanced lab
tests.
2. Perform special procedures
- Including Operation of Advance diagnostic equipment; molecular and
nuclear diagnostic.
3. Ensure Accuracy and Precision of Result
- Impacts the interpretation of results by the physicians to provide
 treatment.
4. Be Honest in Practice
- Must be honest in the conduct of test procedures to come up with
accurate and precise result.
5. Ensure timely delivery of Results
- Aware in the urgency of delivering results especially in cases that require
urgent treatment.
- Take note of STAT or source of request (ER or OR)
6. Demonstrate Professionalism
- Aware of the laws and regulations governing the practice
7. Uphold Confidentiality
- confidentiality of a patient's information is one of the core duties of a M.T.
- keep patients information private.
8. Collaborate with other Health Care Professionals
- project fails because people fail to cooperate w/ other oftenly
- Success lies not in the availability of highly sophisticated instruments but
because of teamwork.
- Having a non collaborative and incompetent member may result to
potential dire repercussion
9. Conduct Research
- Discover new knowledge and revisit old ones.
- further development of the field and future reference for patients care.

10. Involvement in Health Promotion Programs

– Actively involve in reaching out to the community.
– Cooperate with other health care professionals in health
promotion campaigns.
– Implement pre-planned programs of health promotion
campaigns.
– Offer free lab tests beneficial to the community (Medical
Commission)
– Collaborate with other health care professionals.
– FOCUS:
1. Hygiene
 2. Community Sanitation
3. Waste Segregation
4. Disease Prevention
Defining the Practice of other Laboratory Personnel
1. Pathologist
1. Head of the clinical laboratory
2. Responsible to Affix his signature in every result form.
3. A duty registered physician who is esspecially trained with
• Gross(macroscopic examination) and microscopics and
interpretation of tissues, secretions and excretions of the human
body and of its functions.
• Diagnose diseases, follow its course
• Determine the effectivity of treatment
• Ascertain the cause of death.
• Advance Medicine by means of research.
2. Medical Technologist
• Front Liner of the Laboratory diagnostic
• Person who engage in the work of medtech under a supervision of:
1. Pathologist
2. Licensed Physicians authorized by DOH
• If results were not affixed by signature of M.T. It is considered invalid.

3. Medical Laboratory Technicians

• 70-74%
• Assists M.T.
• Qualified only to assist.
• A person certified by and registered with the professional regulatory
board of M.T.
4. Phlebotomist
• Is someone trained to collect/ draw blood samples either through a
skin puncture, venipuncture or arterial puncture.
• In the Philippines: This practice is part of the usual specimen
collection done by a M.T.
• In Abroad: He/she refers to a specifically trained person who is
 responsible for draining blood sample from patients.
▪ HS grad ( trained on the Job/ Have gone through a phlebotomy
training
▪ May take exams form ASCP, AMT, NHA, NCA, or American
Society of phlebotomy technicians
• May be given expanded responsibilities
5. Cytotechnologist (Cell processor)
• Abroad: A lab practicioner who examines human specimens to
detect cancer cell or diseases.
• Most common specimen examined is the genital smear for cervical
cance (papa nicolau test pap smear)
• Other body fluids/ tissues may also be examined for abnormal
changes. (Color, size, shape, thus providing clues to a possible
disease.)
• Philippines: Cytologic examinations may also be performed by MT's
assigned in the histopathology section of the laboratory.
6. Histologic Technicians/ Histotechnicians (HT's)
• Routinely: Prepare, process, and stains.
• Biopsies and tissue specimens for microscopic examinations by a
pathologist.
◦ Microtome- use to cut
◦ staining- adding color to sample
• Can only be found abroad.
• To be a histotechnician,
▪ 12 month training program
▪ classes include coursework subjects
▪ Anatomy, Biology, Chemistry, Lab mathematics, medical
ethics, and terminology.
7. Histotechnologist (Tissue Processor)
• HTL – Performe all aspect of the job that HT's do and other more
complex processing, staining, or identification procedure.
• May initiate or develop new procedures, evaluate quality control data
or operations electron microscope.
• In Abroad:
8. Specialist
• A CLS/MT who has worked for a number of years in a specific
discipline and has extensive knowledge and experience in that area.
• Abroad: One may take an exam to demonstrate his/her expertise in
discipline.

9. Cytogenetic Technologists
• Refers to study of the structure of human chromosomes and their
genetic content in relation to health and disease diagnosis
• Cytogenetic technology- A highly complex area in clinical lab that
provides the diagnosis inherited and acquired chromosomal
disorders.
10. Nuclear Medical Technologists
• Works alongside nuclear physicians
• Apply their knowledge of radiation physics and safety regulation to
◦ Limit Radiation exposure
◦ Prepare and administer radio pharmaceuticals
◦ Use radiation and detection devices.
11. Toxicologist
• Design and conduct body studies to determine physiologic effects of
lab animals, plants and human tissue through biological and
biochemical techniques.