Posted by hmmm, a resident of Another Palo Alto neighborhood, on Sep 24, 2012 at 4:49 pm
I have a relative who gives a lot of blood through Stanford and I'm just wondering...
I've noticed when some technicians take blood (and here I'm speaking in general, I don't know if they do this at Stanford), a lot of times they'll take off their glove and palpate the vein with their bare finger, and they think then if they take a swipe with alcohol, that it sterilizes everything. But I've read about research that this does almost nothing, and they often don't even let things dry, which is key to the alcohol killing any germs at all.
Blood technicians don't usually wash their hands between patients, either. I've had draws where the skin was still broken in the area from a previous draw and a technician palpating the area actually made it sting from the salt of their fingers on the open spot (meaning, it had been awhile since they'd washed their hands).
Most nurses and technicians are okay if you ask them to please wash first, though often they'll just use the sanitizers, which help but are not as good as washing, and as a patient, I am often just trying to figure out what I need to be doing and focusing the healthcare, so I forget to ask until it's too late. I have asked that they use gloves to find the vein, but many complain they can't feel the vein through the glove.
I'm just wondering if in the midst of this terrible dispute, if there isn't something to be learned from it about improving practices for drawing blood. (I didn't say I'm expecting anyone to try, I'm just wondering it there is.) I know I would feel a lot more comfortable if technicians would palpate using a clean glove only and avoid using their hands which harbor microorganisms. If clean gloves are not allowing technicians to do their job by their design, perhaps they should be designed better, or Stanford/other blood collection places can investigate what other options would create the same level of protection.
My opinion in this situation of paying lawyers oodles of money is money down the drain and the bad will and destruction that comes from this kind of fight only hurts everyone. This is what insurance is for -- err on the side of covering the guy's bills, investigate and improve drawing practices and next time, they really will know for sure it couldn't be related.
I know I'll get flamed for saying it, but it's the right thing to do, and probably cheaper than paying the legal costs. (People always think organizations make decisions based on what is cheaper, but it's not so -- lawyers influence the decisions, and they often have a fairly self-serving perspective. For example, it turns out to be a lot cheaper when doctors apologize and take responsibility for mistakes, but lawyers tell people never to apologize...)
Posted by 100% bicycle commuter, a resident of Los Altos, on Sep 24, 2012 at 5:16 pm
@hmmmm. In my many years of donating platelets at the SBC, I've always found their practices to be precise and careful. Iodine is used unless one is allergic to alcohol. In either case, the sanitizer is rubbed for a timed period (watches are used). In the case of iodine (not sure about alcohol), two applications are used; the second is meant to leave a pool of iodine on the skin. The mechanical nature of the butterfly needles (and, for that matter, the finger piercers used when one's hemoglobin level is checked) is such that the needle tip is exposed for the first time only as the piercing is about to occur.
However, I bet what you say about some nurses in a hospital environment is sometimes unfortunately true. My guess is SBC maintains standards at the very top of the health care profession, but there are probably some non-Stanford places around here that do not.
Let me make another point. One doesn't pierce skin and draw blood without some small risk. I have donated well over a hundred times, and I'm proud of that. I take on some risk and experience physical pain to help others. Angry drivers out there: if you ever see me bicycling to work wearing an SBC bicycle jersey, try not to run me over: there are a lot of future blood recipients who will miss out on my blood.
Posted by kongjie, a resident of the College Terrace neighborhood, on Sep 25, 2012 at 10:18 am kongjie is a member (registered user) of Palo Alto Online
I have to agree with 100% bicycle commuter. SBC has a very strict routine regarding the disinfecting of the site of the blood draw as I have witnessed over the past 7 years of donating there. This of course doesn't mean that something wasn't done differently in this case, but that will have to be for the court to decide.
Posted by Richard Placone, a resident of the Barron Park neighborhood, on Sep 25, 2012 at 10:37 am
I have a very rare blood type- O negative that is a specific virus free, making it a high demand product. I've been giving blood at the Stanford Blood Center for over 20 years, monthly with either whole blood or platelets. I have never experienced any of the procedures listed in the lawsuit. I see staff constantly cleaning their hands, the center itself is immaculate, the swabbing of the vein area is always done using gloves and iodine. I too am sorry this patient has suffered an infection and the related medical expense. But if I understand this situation correctly, the infection is on the collar bone, resulting from a needle prick. How did a needle prick ever reach the collar bone? This causes me to wonder about the case. In any event, I fully support the SBC and urge others to consider making regular life saving donations. The fact that the center sells these products is a paper tiger - how else is it to support itself?
Posted by LongTimeDonor, a resident of Mountain View, on Sep 25, 2012 at 10:46 am
I have been donating at SBC for over 30 years. I've watched the innovations that have added to the safety to donors and phlebotomists over the years, especially during the scary early phase of the AIDS/HIV epidemic. The plebs are the best in the business, they never miss, and I have a particularly difficult vein. I've never seen a lapse in protocol, or touch a donor without gloves on.
I've never had any trouble with donations other than eventually developing a topical allergy to the iodine prep/cleaning solution.
While I sympasize with the patients, I find it difficult to believe that they could have "picked up" an infection at SBC. I would NEVER consider donating anywhere else.
Posted by carol, a resident of Menlo Park, on Sep 25, 2012 at 11:55 am
I've donated blood there for many years & find the staff to be extremely conscientious with their hand-cleaning & glove changes & my skin disinfection.
While visiting a staph infection patient at Mills Hospital, about 3 years ago, a woman came in to change the drip IV line and got annoyed when I asked her to wash & glove. The infection site was where a port had been removed @ Sequoia Hospital.
I too don't understand how the claimant's infection got to his collarbone.
Posted by Scott, a resident of Menlo Park, on Sep 25, 2012 at 12:41 pm
I donate there regularly. It's a decent organization and they do a good job with safety procedures.
Here are some relevant quotes from the Blood Center website:
"Stanford Blood Center is a not-for-profit community blood center."
"Stanford Blood Center is dedicated to minimizing costs to patients but acknowledges that the ultimate cost of blood can be high." (They list some of them. I won't copy them all here, but you can see them at Web Link.)
The Blood Center does not pay donors for giving blood, although I believe some places do. I know that, if I need blood, I'd prefer it came from a volunteer at a non-profit blood center, rather than from someone who gave because he needed the money.
Mr. Carcione, the lawyer for Mr. Bui, is suing. Even if he doesn't win his case, he'll increase the cost of blood. Defending against lawsuits is expensive. Mr. Carcione is quoted in the article as accusing the blood center of profiting by selling the blood of their volunteers. But, since the organization is a non-profit, by definition, they don't profit from the community service they provide. I don't know all of the facts. I suppose the jury will have to decide. Meanwhile, in the same vein as Mr. Caricone's jibe at the blood center, let me point out, that unless he's doing this pro-bono, he is the one who is actually trying to profit from the blood of others.
Posted by Susan, a resident of Mountain View, on Sep 25, 2012 at 1:17 pm
I also have been a faithful SBC dodor for over 20 years. I have also donated at other facilities in other cities and have NEVER seen better or more consistant protocol than at SBC. I have special blood as well and feel honored to be so close to such a good and caring facility.
Posted by Laurie, a resident of Another Palo Alto neighborhood, on Sep 25, 2012 at 2:51 pm
I agree w/ the response by Scott of Menlo Park, but some of his attorney quote merits elaboration.
("Mr. Carcione is quoted in the article as accusing the blood center of profiting by selling the blood of their volunteers. But, since the organization is a non-profit, by definition, they don't profit from the community service they provide. I don't know all of the facts.")
I wish to add: The fees that nonprofit blood centers like SBC charge for providing blood products from volunteer donors to patients in hospitals and clinics they serve are calculated solely to cover their own costs of collecting, testing, processing and delivering the blood products.
I speak as a physician with over 15 years experience as former Medical Director of the Northern California Region of one of the largest nonprofit blood collection organizations in the country. (After retiring I was also a volunteer instructor in the Transfusion Service at Stanford Medical Center, and am familiar w/ SBC.)
I certainly am sympathetic to the donor who suffered this unfortunate and rare complication of blood donation.
Posted by member, a resident of Menlo Park, on Sep 25, 2012 at 3:33 pm
I use to donate, but over time my veins gave out. My doctor and various clinics advised me NOT to donate anymore due to 'scarring' of my veins. But I still volunteer(I am one of those that gives you fluids and things to eat) and I know quite a few people that have given 20+ years and more WITHOUT any problems. This is the 1st I have heard of this situation. I have ALWAYS found the staff to be very conscientious about the procedures that are in place.
Posted by sorry Sharon, a resident of the Midtown neighborhood, on Sep 25, 2012 at 7:04 pm
Speaking of predatory, Sharon.
That is why this is going to trial-we will then see the evidence. Ridiculous to state that there is no evidence. Plus we have sharons previous comments about the plaintiff when this story broke-so we know where she is coming from
Posted by Nonprofit, a resident of another community, on Sep 25, 2012 at 9:22 pm
A nonprofit organization can make profit. What do you think happens to those high medical fees you or your insurance co. pay at the hospital. Nonprofit means no INDIVIDUAL officer in the corporation should profit from its activities.
You have to stay on your toes and not be afraid to remind staff to wash or change gloves. Hand sanitizer does not work on hands that have material (dirt, blood) clinging to the skin -- it can cause bacteria to be missed. I suppose it gives them a place to hide.
Posted by Laurie, a resident of another community, on Sep 26, 2012 at 12:50 pm
My apologies to Sharon ('Midtown resident) and anyone else offended by the wording of my comment. As a 'real physician', I intended to offer sympathy, not assign blame or take sides.
While I'm here, in response to 'Nonprofit' - your definition and use of the term 'Profit' in this context seems ambiguous. I say 'Yes' to the stricter use referring to gains to officers of the corporation. Not quite so easy with its more general use, as in your opening sentence: "A nonprofit organization can make profit". I hope you meant "A nonprofit organization can BUDGET to bring in excess income over cost (to prepare for unforeseen drops in revenue or increases in costs, which almost always happen in my experience). Such budgeting is legitimate and common, and does not mean 'profit'. Any 'excess' for that year remains in the budget. No individual officer of the corporation gains.
This thread is a good example of some of the limitations of online discourse we're all subject to. Healthy, but sometimes risky. As in life.
Posted by Scott, a resident of Menlo Park, on Sep 26, 2012 at 12:58 pm
The last line of Laurie's post is as follows:
"I certainly am sympathetic to the donor who suffered this unfortunate and rare complication of blood donation."
This statement contains an unwarranted assumption. I sympathize with Mr. Bui's plight, but I think it is far from proven that his misfortune is a result of his blood donation at Stanford. Based on what was mentioned in the article, it will take some pretty strong evidence, none of which appears to have been presented so far.
@ Sorry Sharon. You post anonymously, and your attacks on Sharon seem unfair. Sharon strikes me as having made valid, relevant posts in this thread. I went back to the comments on the previous article (Web Link) to see if Sharon had made attacks on Mr. Bui and/or his legal advisors. Basically, Sharon believes strongly that our system allows personal injury lawyers to profit at the public expense, and wants to see some kind of penalty for frivolous lawsuits. Personally, I don't think that would be a practical solution, but Sharon has the right to be frustrated and it's a proposal to consider. "Sorry Sharon," in this thread and "Friend of Bui" in the previous one anonymously attack Sharon's character, but don't address the substance of Sharon's posts. A smug "She's up to it again" seems to be the level of their arguments. It's nothing but cheap personal attacks.
Posted by sorry Sharon, a resident of the Midtown neighborhood, on Sep 26, 2012 at 2:17 pm
Scott, both you and Sharon are posting anonymously also, so what is your point? You and Sharon ate entitled to your opinions and so am I, so what is your point? I stand by my criticism of sharons previous comments (and thanks for finding them, so that I could verify her unfounded allegations against bui), so what is your point?
also when you consider the fact that Sharon provides no proof for her claims, I am not sure what your point is. Do you also disagree with my point that the jury will decide the issue and that Sharon has no idea what the evidence in this case is? But I am sure Sharon appreciates the self-defense!
Posted by Jan H., a resident of the Old Palo Alto neighborhood, on Oct 10, 2012 at 2:31 pm Jan H. is a member (registered user) of Palo Alto Online
Forgive the analogy, but I had a dog who contracted osteomyelitis through a compound fracture in his leg; and then the infection was confined to the spot where bone had chipped away. It took surgery, a bone graft, and months of oxycillin to eradicate it
However, it is very difficult to contract, and requires exposure of the affected bone, as in a compound fracture.
I have donated blood at Stanford, and found them to be very professional. They never had the problems with AIDS or HIV in their blood supply, back when the Red Cross and others did, because their standards were higher.
I do not doubt that Mr. Bui has osteomyelitis, and I hope he is able to e cured of it soon. But I do not believe he got it from donating blood.