Wrong blood transfusion for sickle cell anaemia patient at The Middlesex University Hospital
Mr A has suffered with sickle cell anaemia his whole life. The disease intermittently causes "crises" that must be treated by hospital admission and blood transfusions.
In March 2015, Mr A was admitted to North Middlesex University Hospital with symptoms of a sickle cell crisis. Midway through the blood transfusion of three units of blood to treat the crisis, Mr A began to suffer severe physical symptoms throughout his body including /tremors, fever, vomiting, severe pain and a burning sensation. He started falling in and out of consciousness. Mr A has blood type O Rhesus Positive but he was given a transfusion of group B Rhesus Negative blood. A naturally occurring anti-B in group O individuals makes them react very badly to group B cells.
An investigation carried out by the hospital Trust identified human error as the cause of the wrong blood type being given. A biomedical scientist had overridden a computer system warning when the incorrect blood type was issued and this resulted in the wrong blood being transfused. The report also identified a lack of competency on the part of nurses in administering transfusions in accordance with hospital policies, resulting in missed opportunities to identify the error before the blood was transfused. It also identified failings in observing the patient to identify problems early once the transfusion had commenced.
Of even greater concern was that the investigation also revealed that since March 2013 and prior to Mr A's transfusion, two other transfusions of incorrect blood type had occurred at North Middlesex University Hospital.
Following the error, Mr A was transferred as an emergency to the Intensive Care Unit at University College London Hospital for further management. He was treated with a full automated red cell exchange to remove the offending group B cells from his circulating blood and treated with intravenous steroids.
Mr A made a gradual recovery from the physical side effects of the transfusion, but now suffers from ongoing psychiatric problems that affect his ability to function day to day and to work. His psychiatric condition is made worse by the fact that due to the nature of his sickle cell anaemia he will continue to require blood transfusions throughout his life. Each time he needs a transfusion, he becomes extremely anxious that another error may occur.
Mr A instructed Fieldfisher to investigate the care he had received at North Middlesex Hospital. We instructed haematology and psychiatry experts to comment on the case. The haematology expert was highly critical of the care provided to Mr A. The Trust has made an admission of breach of duty in respect of the care provided to Mr A during the blood transfusion. The claim will now be quantified to reach a suitable settlement.