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    Suggested precautions
    Facts of the case
    Patient's allega...
    Doctor's defense
    Findings of the ...

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Table of Contents   
Year : 2008  |  Volume : 1  |  Issue : 1  |  Page : 1
Separate and specific consent for blood transfusion in planned interventions

 
   Suggested precautions 
  1. Take separate and specific consent for surgery/ procedure; and for transfusion of blood, if anticipated.
  2. In emergencies and in cases where blood transfusion could not have been anticipated, blood transfusion even without consent is permissible. The exception to this rule is patients who have given advance directives prohibiting blood transfusion.
  3. It is safe and advisable to take consent for transfusion of blood for all surgeries/ procedures along with consent for surgery/ procedure, rather than not taking it.
  4. Hospitals must always procure blood from government-recognized blood banks.
  5. Hospitals must develop and maintain proper protocols to ensure that the necessary checks have been done by the blood bank and that the blood is accordingly certified.
  6. Preserve copies of certificates certifying that the mandatory testing of blood has been done by the blood bank, in medical records of the patient.
  7. Blood banks must strictly check blood and certify accordingly, as prescribed by law.



   Facts of the case Top


The patient underwent hysterectomy and was transfused two units of blood in the postoperative period. The blood was contaminated with HIV virus and hence the patient contracted AIDS and died.


   Patient's allegation/s of medical negligence Top


  • The allegation against the hospital (OP) was that blood was transfused without obtaining consent of the patient for the same.
  • The common allegation against both the hospital (OP) where surgery was performed and the blood bank (OP) that supplied blood was that they had failed to test blood before transfusion, which resulted in transfusion of HIV-infected blood to the patient.



   Doctor's defense Top


  • The hospital's (OP) defense was that consent for surgery given by patient must be interpreted to include consent for blood transfusion. Moreover, blood was required in an emergency situation and hence consent for transfusion could not even be attempted.
  • On the allegation of contaminated blood, the hospital's (OP) defense was that as the blood bank (OP) was government approved and since the blood was appropriately certified by the blood bank (OP), liability on account of contamination would lie with the blood bank (OP). The hospital (OP) also stated that blood was obtained by the relatives of the patients on their own and the hospital (OP) had no role to play.
  • The blood bank (OP) in its defense completely denied having supplied blood to the patient or to the hospital (OP).



   Findings of the court Top


  • The court found specific directions in the clinical note and nurse's note of the hospital (OP) for reserving one bottle of blood. This proved that blood transfusion was anticipated before surgery. The fact that no separate consent of the patient was taken for blood transfusion was not disputed. The court held that it was necessary to take specific and separate consent for transfusion of blood in all interventions where blood transfusion is anticipated, and failure to do so would be negligence.
  • The court also found documentary evidence that blood was supplied by the blood bank (OP).
  • It was held by the court, taking into account the facts of the case and medical literature produced on behalf of the patient, that the patient had contracted AIDS only due to contaminated blood.
  • Hence both the hospital (OP) and the blood bank (OP) were found to be negligent.



 

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