This case involves a patient who received blood products while hospitalized and receiving a regimen of chemotherapy for a rare form of blood cancer. It was found that the blood products were contaminated with a virulent strain of harmful bacteria. The contaminated blood products, observed through a flow cytometry test, caused the patient to fall into severe septic shock within a day of receiving the tainted transfusion. In order to combat the infection, the patient was transferred to the intensive care unit, where he received around-the-clock medical support. In order to ensure that he was able to recover from the infection, the patient’s cancer treatment was discontinued for a period of months. This approach was instrumental in ensuring the patient’s survival, however, the lack of chemotherapy during his recovery was allegedly responsible for a recurrence of his cancer. In addition, the patient was no longer a candidate for a bone marrow transplant due to his infection.
Question(s) For Expert Witness
- 1. Are you familiar with the screening process at a blood bank and/or at a hospital lab to assure that contaminated blood products are not transfused into patients?
- 2. In general, if a patient with cancer receives contaminated blood products and becomes septic, does it compromise their candidacy for bone marrow transplant?
Expert Witness Response E-059088
I have been formally trained in this area as a fellow of the Royal College of Pathologists. Additionally, during my 5 year hematology fellowship training, I spent 6 months working full time at the IBTS (Irish Blood Transfusion Service) during which time, I routinely delt with issues relating to contaminated blood products. If a cancer patient receives a contaminated blood product, the outcome and subsequent limitations on treatment depends on the nature of the contamination. These are myriad and will influence outcome depending on etiology. For example, bacterial contamination of a blood product is almost universally fatal. There are other scenarios, where the contaminant is benign and does not influence the clinical outcomes. I have published extensively in the area of blood cancer, both in the clinical and basic science arenas. It is worth noting that contaminated products can be transfused without negligence.
Expert Witness Response E-000979
As a hematologist/oncologist experienced in the care of patients with blood cancer and others who require frequent blood transfusions, I am familiar with the screening process for blood banks. Certainly, sepsis can compromise a patient’s ability to receive future and additional therapy depending on the severity of the sepsis and its sequelae. I have published and lectured on the topic of blood cancer and its treatment. Depending on the screening process and the organisms being screened for, their could be justifiable instances where products could be transfused without negligence, but this would have to be a very exceptional circumstance and one typically only in situations involving certain screening for viral pathogens and not in cases typically involving bacterial pathogens.