NEW safeguards are being urged to cut the number of hospital patients
who die because they are given the wrong blood transfusions.
Dr Brian McClelland, director of Edinburgh and South-East Scotland
Blood Transfusion Service, estimates that at least one blood transfusion
in every 550,000 has a fatal outcome because of such mistakes.
He and Ms Patricia Phillips, medical audit co-ordinator of the
Scottish Blood Transfusion Service, report in the British Medical
Journal today a survey they carried out over a two-year period in UK
hospital haematology departments.
In the study, 245 out of 400 laboratories responded.
A third of these reported a total of 111 incidents in which the wrong
blood was administered, resulting in six patients dying, and 12 others
suffering illness.
Dr McClelland said last night: ''That is not an alarming level and
doesn't suggest Britain is any worse than anywhere else. But we can't be
complacent.
''It is probably an underestimate, since it is unlikely that all the
other hospitals were error-free, and we would like a reporting system to
monitor and reduce the level of risk.''
This would preferably be a non-punitive system, like the near-miss
reporting system for pilots, to encourage people to be open about errors
and suggest ways they could be avoided, he said.
Most of the errors had occurred at the last stage, with the wrong type
of blood being picked up for a particular patient. Others involved the
wrong patient sample being put in the compatibility tube for matching
but there was no evidence of error in typing blood in the first place.
At worst, being given the wrong blood can result in the cells being
destroyed by the body's immune system, causing damage to the kidneys ;
or the clotting mechanism might be impaired, leading to serious bleeding
problems.
In practice, most of the errors reported had no ill-effects.
Only a third of unmatched transfusions are incompatible with ABO blood
groups, and a tenth of those are fatal.
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