Bad Blood
Problem: Of the 30,000 problems blood banks have reported to the government since 1990, more than half occurred in screening or in checking donor records. About 1,000 people with HIV and 46,000 with hepatitis donate infected blood each year.
3. The blood is tested. The Food and Drug Administration requires blood banks to check for HIV, syphilis and hepatitis B. Most do five other tests as well: for hepatitis C; HTLV-1, which can cause leukemia; HIV-2 (a strain that's rare in the United States) and two other potential indicators of hepatitis.
Problem: Glitches in testing--such as performing tests incorrectly or misinterpreting results--account for just 3 percent of all mistakes reported but are the most serious since they can lead to the release of contaminated blood.
4. The blood is separated. Most donated whole blood is separated into red blood cells, plasma, platelets and other "products," each with specific uses red cells to raise a patient's level of blood oxygen and platelets and plasma to promote clotting, for instance.
Problem: Since these separate products are usually transfused into different patients, one infected donor can infect two or three patients.
5. The blood is distributed. Most blood products are destined for transfusions in local hospitals. Blood banks that collect more blood than needed locally often sell the surplus to other blood banks.
Problem: Some usable blood never makes it off the shelf. A recent survey of 2,154 blood banks showed that in 1991 more than 1.2 million blood units had passed their expiration date and had to be thrown away. And 8 percent of mishaps involve blood that's lost, spilled, sent to the wrong place or otherwise improperly shipped.
6. Transfusion. There are some 4 million transfusions a year, each averaging about four units of blood.
Problem: Transfusion mix-ups in hospitals may occur 20 times more often than reported. Blunders include patients receiving blood that is not meant for them including other patients' self-donated "autologous" blood.
7. The bill. blood banks charge hospitals from less than $30 per unit to $120 or more, depending on the blood product and local medical costs. Patients typically pay hospitals double or triple the blood bank charge.
Problem: Already under pricing pressure, blood banks are reluctant to institute new safety procedures. Many hospitals are also curbing patient self donation programs because of the expense. Don't be afraid to donate Whatever the risks from transfusion, blood donors have little to fear. Sterile equipment is used to draw blood. Bad reactions are uncommon. And healthy repeat donors perform a public service by making the blood supply safer. They are less likely than are first-timers to carry blood-borne viruses.
BLANCHE SCHWARZER, 67 VANCOUVER, WASH. TRANSFUSED DECEMBER 1990. SUFFERING FROM PROGRESSIVE LIVER DISEASE. Before having surgery to repair a weakened abdominal vessel, Blanche Schwarzer donated three units of her own blood and lined up family and friends willing to donate if necessary. She thought she was safe. Yet she still received a unit of red cells from the Red Cross blood center in Portland, Ore. Symptoms of hepatitis appeared. She contends in a lawsuit--which is being challenged-- that the blood was infected with the virus that causes hepatitis C. (The Red Cross claims the donor tested normal.) Schwarzer has suffered progressive liver problems and has recently been hospitalized.
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