Death following wrong blood transfusion - part III

Cases of negligence against medical practitioners are often decided in court on the Bolam test which states that; “if a doctor reaches the standard of a responsible body of medical opinion, then they are not negligent”. For a case of medical negligence against a doctor to succeed, it must be proved that there was a normal practice that the health worker did not follow but followed one that no other professional of similar skills would have taken under similar circumstances.
It is on this basis that the surgeon who operated on a mother, who was wrongly transfused with blood group B+ instead of an O+ blood, was not found to have acted negligently. A professor of medicine told court that the procedure undertaken in managing the patient’s condition in the circumstances she was admitted to hospital to the time of her unfortunate passing away was proper. A leading hematologist also told court that in emergency situations where one requires urgent blood transfusion, uncross-matched blood of the same group can be transfused in the circumstances. The patient’s antenatal card indicated that she was blood group B+.
To the family of the deceased the surgeon was negligent in not taking heed when information was availed before the operation that the mother was of blood group O+ and not B+, as was indicated on the antenatal card. To court this complaint was not tenable since the doctor was required and in observance of medical protocols, to have the deceased’s blood sample grouped and cross-matched for the operation, which was ordered for. Court was in no doubt that the doctor’s efforts in this regard were frustrated by the absence of the blood bank staff to attend to the request and yet the operation had to be performed immediately, given the condition the deceased was in. Court also noted that the surgeon had on numerous occasions requested the mother to carry out blood tests during the antenatal period but there was no evidence that these were done and results given to the doctor.
In a Supreme Court decision on a similar case, a doctor and the hospital in which the doctor was working were both found responsible for the death of a patient who died following a wrong blood transfusion. In this case the medical doctor mistakenly transfused a wrong blood group, leading to the death, eventually, of the patient. Lawyers for the family of the deceased attempted to use this case to convince court that the surgeon in this case was negligent.
Court, however, was of the view that in this particular case the surgeon acted prudently and the death of the mother was attributed to post delivery issues the medical team was confronted with. There was evidence that the hospital did not have sufficient units of blood group O+ that was needed to contain the excessive bleeding that was triggered by the abnormal position of the placenta. To court these factors were beyond the control of the surgeon.
To court the surgeon was faced with a situation of a patient bleeding to death for want of blood that was unavailable at the hospital and with no immediate hope of getting any other blood. There therefore arose a disparate attempt to save a patient’s life by resorting to transfuse the patient with one unit of blood group B+ that was found in the theatre, by the anesthetist. The decision to resort to the use of the unmatched and ungrouped blood found in the theatre was not a case of a mistaken transfusion as was in the Supreme Court case but rather a desperate and well intentioned attempt at saving life, the court ruled.
Court concluded that on the balance of probabilities the family of the deceased did not prove to the court’s satisfaction that the surgeon breached the duty owed to the patient and fell below the standard of care recognised by members of the surgeon’s profession.

About Bolam test

The Bolam test which states that; “if a doctor reaches the standard of a responsible body of medical opinion, then they are not negligent”. For a case of medical negligence against a doctor to succeed, it must be proved that there was a normal practice that the health worker did not follow but followed one that no other professional of similar skills would have taken under similar circumstances.