Shrugging off from responsibility to confirm patient’s blood group and thereafter requisitioning matching blood did no good to the doctor and hospital in this case. Read on to know what transpired.
Irrefutable Facts
The patient received treatment from the doctor for kidney disease for approximately 4 months. As his condition worsened, the doctor recommended hospitalization for dialysis.
Accordingly, the patient was admitted to the hospital and placed under the care of two doctors. Blood and urine investigations indicated the need for a blood transfusion. However, when the hospital sent patient’s blood sample to the blood bank, they failed to mention patient’s blood group on the requisition form.
Consequently, blood bank performed the mandatory blood grouping and cross-matching, and provided 5 bottles of A+ve blood. The patient was transfused with this blood and was subsequently discharged.
Unfortunately, his condition deteriorated, leading to readmission to the hospital. Once again, the two doctors recommended blood transfusion and requested B+ve blood from the blood bank.
Patient’s condition continued deteriorating, and he was shifted to a different hospital for further management.
The hospital and doctors were sued by the patient. It was alleged that hospital staff administered 5 bottles of A+ve blood instead of B+ve without properly verifying correct blood group.
It was further alleged that hospital discharged the patient on the same day instead of providing him with adequate treatment.
It was also alleged that there was manipulation regarding the date of discharge, suggesting that it was falsely recorded at the hospital as discharged on following day.
Hospital’s Plea
It was stated by the blood bank that the hospital had submitted patient’s blood sample for the first time without indicating the blood group on the routine blood transfusion request forms.
Consequently, the technician at the blood bank performed a cross-matching of the sample blood, which was identified as A+ve. This information was documented in the patient’s cross-match and issue report, which was then provided to the hospital along with the blood bottles.
It was further stated by the blood bank that during the second blood requisition, the test results indicated that the blood sample belonged to the B+ve blood group. It was duly recorded in the form, and the hospital was already aware of the patient’s blood group by that time.
It was stated by the hospital that it had requested B+ve blood, but the blood bank supplied A+ve blood.
It was also stated that the hospital had no role in the entire process, from blood sample collection to the issuance of blood by the blood bank. It was stated that the information on the ‘Label of Blood Bag’ and the ‘Patient’s cross-match and issue report’ was compared and verified to ensure safety measures. Additionally, special consent was obtained from the patient and attendant.
The treating doctor submitted they he was not involved in the blood requisition process and therefore were unaware of the patient’s blood group. As the patient required a blood transfusion, a necessary blood sample was taken and sent to the blood bank for grouping.
Court’s Observations
The court observed that according to the rules of the regulatory authority, it is the primary responsibility of the in-charge officers and attending doctors to ensure compliance with mandatory provisions during a blood transfusion. One such provision is to mention patient’s blood group on the requisition form.
The court noted that the doctor failed to adhere to this protocol.
In the absence of reliable and acceptable medical records, the court could not conclude definitively whether the hospital staff administered the blood after verifying and following the mandatory provisions outlined in the Drug & Cosmetic Act and the rules made thereunder.
Upon reviewing medical records, the court held that the blood bank had performed the necessary sample testing and cross-matching of patient’s blood.
Hence, the court did not hold the blood bank negligent but instead held the hospital and the doctors negligent.
Prevention Is Better Than Cure
- Transfusing the wrong blood is not an error in professional judgment but a clear case of medical negligence. Appropriate protocols should be in place during the process, including positive patient identification, excellent communication, accurate documentation, and thorough staff training to prevent wrong blood transfusions. In this case, the court suggested using electronic transfusion management systems and barcode technology to further enhance safety measures.
- It is the bounden duty of the hospital / treating doctor to coordinate with the blood bank and procure proper blood for the patient. The patient’s attendants may insist / request to procure blood by themselves. In such instances, the hospital / doctor should appropriately guide the attendants, assuming they are not well-versed in medical matters.
Source : Prafulbhai Natwarlal Tank & Anr. v/s Dr. Sanjay N. Pandya & Ors.
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