- This topic has 14 replies, 9 voices, and was last updated 1 year, 1 month ago by
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PI work as a Pathologist in a hospital lab. A patient’s blood sample shows some delayed positivity for Rh (Positive/Negative blood group determiner). So we confirmed with a confirmatory test (Du with gelcard) in our blood bank, and reported Positive. Turns out, the previous labs had reported the patient as Negative group. So for assurance, we sent a sample to another Tier 1 lab, where they reported our results itself. The patient was furious and demanded my handwritten assurance with signature which I can’t deny as a doctor. Later, for my paranoid brain I sent it to another Tier 1 lab, and they reportes contrary to ours. I called the Pathologist personally regarding this and they advised repeat.
My question is, should I call back the patient and the report? This will involve them to move legally based on similar events in our region, where if a doctor hints that he might be wrong, the patient files a claim for negligence. -
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NYou should reply on disclaimers that there are many external factors which may cause different results or different test results.
You work in a hospital. Your hospital should deal with this with legal team. Why are you personally dealing with this?
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DHi. I’m a Delhi based lawyer. How many days apart were the several reports? The general defence we take in such matters is that test reports days apart cannot be compared medically, especially if the patient is suffering from some medical condition. There are various factors that come into play that lead to contrary reports and doesn’t always amount to deficiency in service and medical negligence.
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PHi. Thank you for your interest. Let me add the details I omitted to make the post simple.
Basically, this scenario happens in two rare conditions which we are aware of.
1. A rare ‘weak D’ blood group which gives negative first, but positive in confirmatory test (But ours shown delayed reaction in both).
2. A condition called ‘mixed field reaction’ where the patient has both blood types in their body because of a ‘mixing’ that moght have occurred due to a previous transfusion, abortion, delivery, etc. (This requires the requesting clinician to note the appropriate history in the form).Coming to your questions, all tests were done on tha day of collection itself. A second test was done after 7 days in a seperate sample. Thanks in advance.
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BHow can a human have both +ve and -ve like a Schrodinger’s cat? Don’t you have clear guide lines on result determination?
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POk let me explain. (Copied from my another reply):
Basically, this scenario happens in two rare conditions which we are aware of.1. A rare ‘weak D’ blood group which gives negative first, but positive in confirmatory test (But ours shown delayed reaction in both).
2. A condition called ‘mixed field reaction’ where the patient has both blood types in their body because of a ‘mixing’ that moght have occurred due to a previous transfusion, abortion, delivery, etc. (This requires the requesting clinician to note the appropriate history in the form).The testing is standard agglutination tests based on antigen-antibody reactions. But in such rare <1% cases, the tests may be insufficient and require other big tests. Rarely, the patients use the opportunity to sue and we have to get legal help.
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Rcase is an example of thing which my Biology teacher used to say “Biology my friend is a science of exceptions”
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IYou should definitely report to patient. I get it that your priority is not to get a case, but this is a medical issue not something you did – so you should inform him of everything jud the way you did here, and then it’s definitely not negligence. It doesn’t sound like negligence at all the way you put it.
Probably check with a lawyer yeah, for exact negligence law. Check with a lawyer who you pay, you can’t really rely on anyone giving free advice on Reddit, that too without a 100% context which is impossible unless the lawyer cross questions you to ensure he or she is getting every relevant piece of information
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