Blood Transfusions and the Risk of Contamination

When we think of incidents that could lead to charges of medical malpractice, the list might include misdiagnoses, anesthesia errors, and surgical negligence. But, what about blood contamination? Transfusion-transmitted infections may not be as common as other types of negligent-associated maladies and injuries, but the impact on the victim can be just as devastating. Exposure to contaminated blood through transfusions can lead to myriad diseases, each with its own potential side effects, including death. Given the safeguards in place to preserve the integrity of blood, just how does it become contaminated? Also, what are some of the diseases that can be contracted through contaminated blood?

 

How Does Blood Become Contaminated?

Considering the safety protocols that are in place in the medical field, it seems inconceivable that donated blood can be dangerous. After all, the blood goes through a number of tests before it is considered safe for use. Even with all of the safety checks in place, though, there is always the potential for human and equipment error. Even the American Cancer Society admits that current blood tests are still not 100% accurate.

When contamination occurs, any blood borne pathogen that might go undetected has the potential to be transmitted to a patient. The list of blood borne diseases is as daunting as it is long, and includes parasitic diseases like malaria and Chagas disease, and viral diseases including HIV, Dengue fever, West Nile Virus, and Hepatitis A, B and C, among others.

Hepatitis is the disease that is most commonly transmitted through blood transfusions. Often, people who have hepatitis do not show any outward symptoms, but it is a particularly vicious disease that can cause liver failure, or even liver cancer.

Gram-negative bacteria is also a risk, and causes infections such as meningitis and pneumonia. Increasingly resistant to antibiotics, gram-negative bacteria, such as Escherichia coli (E. coli), has the potential to contaminate the blood donation of a person who is not showing any symptoms of illness.

 

Storage Issues

Even if the blood itself does not contain any contaminants when it is donated, the handling of the blood after the fact can cause it to become contaminated. The risk is especially high with blood platelets. In fact, according to the Center for Disease Control and Prevention (CDC), the greatest risk of transfusion-transmitted infection is in platelets that become contaminated with bacteria. The reason for that is the blood platelets are stored at room temperature for 5 days, which puts the product at risk of bacterial growth. The CDC estimates that bacteria contaminates about 1 in every 1,000-3,000 units, and that 1 in 100,000 patients develop sepsis as a result. The CDC cautions, however, that the risk is potentially higher given that blood transfusion-related infections are often under reported.

Though hepatitis is the most commonly contracted disease relative to transfusions, bacterial contamination poses the greatest risk to patients. Sepsis is a risk, but infection from gram-positive bacteria, such as Staphylococcus aureus, is more common. Bacteria on the skin’s surface attaches to the needle as it penetrates the skin, and then passes through the blood as it is collected.

The risk of contracting a transfusion-related illness is lower than it’s ever been, but the system is still not perfect. It is difficult to determine how many of the approximately 98,000 annual medical malpractice deaths can be attributed to blood contamination, but thanks to continuing improvements in the medical community, the number continues to drop. It’s conceivable that eventually that number could be zero.

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