Blood transfusions save countless lives around the world, with an estimated 85 million units of red blood cells transfused each year.
However, blood transfusions do involve risks – and blood transfusion mistakes can have life-threatening consequences.
Risk of blood-borne infection due to blood transfusion
Thanks to thorough donor and blood screening procedures, it’s very rare for blood-borne viruses, bacteria or parasites to be transmitted through transfused blood. However, the risk does exist.
For example, international studies suggest a 1 in 300,000 risk of contracting hepatitis B from donated blood, and a 1 in 350,000 risk of contracting West Nile Virus.
The risk of getting HIV through transfused blood is extremely low. However, cases of HIV infection through transfused blood have occurred in South Africa. Although blood is properly screened, the virus may not be detected if a donor is in the early “window phase” of infection, before testing returns a positive result for the virus.
Risk of blood transfusion mistakes
More common risks involve mistakes by a medical practitioner or nursing staff, such as giving transfusions to the wrong patients or transfusing the wrong blood type.
Being transfused with an incompatible blood type can cause acute haemolytic transfusion reaction. This is when the patient’s antibodies perceive the transfused red blood cells as a threat and attack them. It can cause acute kidney failure and even death.
Other rare, adverse reactions to blood transfusions include fever, iron overload, allergic reactions and transfusion-related acute lung injury (TRALI). During or within six hours of a blood transfusion, TRALI may result in breathing difficulties and even respiratory failure.
Responsibilities of the doctor
The National Health Act (2003), which governs blood transfusions in South Africa, stipulates that medical practitioners have the following responsibilities1:
- transfusing blood only when it is medically indicated
- warning patients of the potential risks inherent in blood transfusions and informing them of the available alternatives
- obtaining and documenting the patient’s informed consent
- correctly identifying the patient and units of blood to be transfused
- ensuring that appropriate compatibility tests have been performed
- ensuring that the blood has been correctly handled prior to and during transfusion
- ensuring that the blood has not passed its expiry date
- permitting responsible persons to administer blood to the patient
- transfusing blood at the proper rate
- observing and monitoring the patient at the commencement of, and during the transfusion
- effectively managing any untoward transfusion reaction
- retaining blood samples as required
- reporting untoward reactions or death.
When blood transfusion mistakes constitute medical malpractice
Doctors are expected to use their medical knowledge and patients’ medical information to determine when blood transfusions are advisable, on a case-by-case basis.
Failure to do this, or to adhere to any of the responsibilities outlined under the National Health Act (2003), may constitute medical malpractice or negligence.
For example, a patient harmed by a blood transfusion may have a medical malpractice claim if:
- the medical practitioner failed to obtain the patient’s informed consent
- the medical practitioner didn’t adequately explain the risks involved
- an administrative error or improper testing led to the wrong blood type being transfused
- a blood transfusion was given when it wasn’t necessary
- a blood transfusion was administered improperly
- infected blood was transfused due to improper screening.
Personal injury claims for blood transfusion mistakes
If you believe you or a close family member is a victim of medical malpractice involving a blood transfusion, you may be able to claim compensation from the responsible party.
Depending on the circumstances, a medical malpractice case may be filed against the medical practitioner who performed or ordered a blood transfusion, the hospital where the infusion was administered or the blood donation service that supplied the blood.