How sensitive is visual examination in detecting gross abnormalities in the appearance of blood products issued to patients for transfusion?

American Red Cross took a a precautionary measure by issuing a statement on Jan. 31 requesting hospitals in its Southern Region to voluntarily suspend use of certain blood units collected recently in Georgia and Northern Florida. This was prompted by the finding of white particles in some blood products. Microscopic examination of the white particles indicates they were not infectious agents. Since the initial statement by the Red Cross, additional statements have been made (see update by FDA/CBER on Feb. 7). The issue remains under investigation.

ADDENDA Feb. 9, 2003

In response, a blood bank supervisor at a major medical center in Southern California wonders how many of the affected units were used. If any were used, it would suggest a lack of sensitivity in the "visual examination" test we rely on in our industry. He thinks it would be valuable to learn what the sensitivity of this examination is in the real world rather than in the research lab environment. Comments from the e-Network Forum are invited.

Editor's NOTE: For other ideas about the visual inspection, see the earlier forum issue on detection of hemolysis.

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Ira A. Shulman, MD
CBBS e-Network Forum Senior Editor & Moderator

W. Tait Stevens, MD
CBBS e-Network Forum Editor & Moderator

Elizabeth M. St. Lezin, MD
CBBS e-Network Forum Associate Editor & Moderator

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