Bad Blood
Rollin Tobin had heard about contaminated blood, and now he faced hip replacement surgery. The worried 59-year-old public safety director for Southfield, Mich.--"Jerry" to everyone who knew him--arranged to donate his own blood in advance to protect himself. According to court documents, Tobin even had three units drawn--about 3 pints--though he was told two would be enough. But during the operation last November 12 at Southfield's Providence Hospital, a fourth unit was requisitioned from the hospital's inventory. After surgery, Tobin's blood pressure started dropping; two hours later he was back for exploratory surgery. He died at 7:30 the next morning of massive clotting caused by Yersinia, a toxic bacterium in the fourth unit. "What he most feared what he tried to prevent--is what happened," says attorney George Googasian, who is representing Tobin's widow in a suit against the hospital (which refused to comment on the case). The donor of the contaminated unit was infected, says the American Red Cross, whose Madison, Wis., center supplied the blood. There is no practical screening test for Yersinia.
Blood experts and public health officials contend the blood supply is safer than it has ever been. That is accurate. But patients like Jerry Tobin are a reminder that "safer" is not safe enough. And a five-month U.S. News investigation involving more than 150 interviews, 16 Freedom of Information Act requests and nine government databases shows that transfusions are far riskier than patients are led to believe. Toxic bacteria, though alarming, are not the biggest hazards. About 4,200 units of blood infected with viruses that cause hepatitis slip through undetected every year. Food and Drug Administration Commissioner David Kessler has told Congress that between 90 and 460 units harboring HIV get through. And the chance of an allergic reaction to a transfusion is as high as 1 in 25.
Clerical errors and other mistakes further expose patients to contaminated, mistested or mislabeled blood. Many patients who get bad blood aren't told. And "recalls," typically taking place months or years after the fact, don't work. Highlights of the U.S. News investigation:
Blood banks know that more than 100,000 individuals may have received blood harboring the virus that causes hepatitis C--which can lead to chronic liver disease--but have not alerted them.
By March 1994, almost a year after the FDA sued the American Red Cross to improve safety at its blood centers, critical problems were still unresolved.
Many hospital patients are not informed of transfusion risks. And only about 1 hospital in 8 obtains specific patient consent for transfusions.
Official reports may drastically understate blood problems. One reason: Most of the nation's 2,400 blood banks do not ship interstate and thus are not required to be federally licensed--or to report mistakes to the Food and Drug Administration. Those banks appear to commit a large proportion of the serious errors.
Americans have long believed the blood supply to be safer than it is. In a 1983 joint statement, for example, the Red Cross and two trade groups representing most other blood banks--the American Association of Blood Banks and the Council of Community Blood Centers--put the risk of getting AIDS from a transfusion at about 1 in a million. In fact, it was at least 1 in 660--and up to 1 in 25 in high-exposure cities like San Francisco. The chance of infection by the virus that causes hepatitis C--then known as non-A, non-B hepatitis--ran as high as 1 in 6, according to a 1985 report by Congress's Office of Technology Assessment.
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