Medical malpractice cases occasionally arise out of decisionmaking about blood transfusions. Blood transfusions involve the administration of whole blood or blood products through an intravenous line (IV) to replace blood lost at surgery or due to hemorrhage following traumatic injury. The procedure is surprisingly common; nearly 5 million patients require blood tranfusions each year in the U.S. Complications are rare but can be serious.
According to the National Institutes of Health (NIH), serious complications of blood transfusions include allergic reaction, infection with hepatitis B, hepatitis C, HIV or Variant Creutzfeldt-Jakob disease (vCJD), iron overload, hemolytic reaction and graft-versus-host disease (GVHD). These complications are rare.
More commonly, complications arise out of a delay in administering blood. Blood loss can be detected by imaging, vital signs, lab values or estimating blood loss during surgery. If a patient loses sufficient blood volume without prompt and adequate replacement, the patient can suffer hypovolemic shock and die.
The New England Journal of Medicine recently published a study, about blood transfusions for acute upper gastrointestinal (GI) bleeding, that shows that aggressive transfusion can be dangerous as well. This study compared an aggressive transfusion strategy (transfusion when hemoglobin fell below 9) with a more cautious strategy (transfusion when hemoglobin fell below 7). The more cautious strategy nearly doubled the survival rate of patients (absolute mortality, 5% vs. 9% with aggressive treatment). Thus, the authors suggested that blood transfusions should be withheld in patients with an acute upper GI bleed until the hemoglobin level drops below 7.
Medical negligence cases can arise under Ohio law with any unnecessary delay in diagnosis or delay in treatment. These delays can be caused by a doctor or nurse when they delay in detecting signs of bleeding or delay in administering blood products once profound blood loss has occurred. Typically, when medical malpractice results in a delayed blood transfusion, the result is wrongful death or complications of hypovolemic shock such as stroke, kidney damage, heart attack or amputation due to ischemic changes of extremities and gangrene.
