‘Patients not at risk’ over blood delays
A report in the Irish Medical Times, based on a letter written by a consultant to management at the hospital, said blood that was not cross-matched was being given to patients because of inadequate staff, equipment and facilities in the hospital’s laboratories.
According to the report, the letter also expressed concern at the hospital’s ability to supply patients with adequate blood products in an appropriate timeframe.
“Hospital management were recently made aware by a senior medic that uncross-matched blood had to be given to patients during obstetric emergencies on more than one occasion because proper, tested blood supplies were not available,” the report said.
It also claimed that in one emergency reported to hospital management, a patient had to be given five units of uncross-matched blood. Uncross-matched blood means the patient’s blood group was not determined in advance of a transfusion.
Concern was also expressed that, should the laboratory have difficulties with staffing or other problems, it was imperative they prioritised work to provide an appropriate service, which was unsatisfactory and unsafe, according to the Irish Medical Times.
A statement from the NEHB said it wished to make clear “that properly tested blood supplies are, and always have been, available for all emergencies at Our Lady of Lourdes Hospital, Drogheda”. The board said it was standard practice in an emergency bleeding situation that transfusion begins with uncross-match O negative (flying squad) blood.
“This may be followed by group- specific blood, pending the cross-matching of patient-specific blood,” the statement said.
It went on to say that a consultant obstetrician/gynaecologist at the hospital had written to hospital management on November 14 last “outlining concerns at delays in the availability of blood products during one obstetric emergency”.
“This incident was fully reviewed in accordance with the hospital’s risk management process. It transpired that a breakdown in communications and a misunderstanding between two hospital departments had caused a delay in the availability of cross-matched blood in this specific incident. However, as per standard practice, outlined above, the patient received appropriate blood in the interim.”
The board said laboratory resources had not contributed to the delay and that internal communications processes in the hospital had been reviewed.
Meanwhile, Irish Blood Transfusion Board medical director Dr Willie Murphy said it was “a fairly widely used practice to use O negative in an emergency without cross-matching, because O negative is a universal donor.” It is acceptable in almost all instances, even by patients of a different blood group. He said the only problem with using uncross-matched blood was if the patient had anti-bodies from a previous transfusion or a previous pregnancy. “In that case, the mortality rate is about 3%,” he said.
