Faulty blood bags

Reputation of English blood transfusion service has been unjustly damaged

EDITOR,--I wish to comment on recent reports of faults in some of the blood bags used by the English National Blood Authority.1 Several of the points made have been misleading and may have given rise to inappropriate public and professional concern.

Firstly, international and published experience confirms that minor defects in plastic blood bags occur infrequently but regularly and that virtually all such defects are screened out during routine quality assurance programmes before blood is issued to hospitals from regional blood transfusion centres. Exceedingly rare (certainly with an incidence of less than one in a million blood transfusions), a defect remains undetected and causes bacterial contamination and consequential septicaemia in the recipient.

Secondly, the English National Blood Authority is to be congratulated for having introduced blood bags from a second supplier into England. This much needed break of the longstanding monopoly on the supply of blood bags must already have saved the NHS in England substantial amounts of money and considerably enhanced the security of quality systems. The competition thereby created must be generating savings approaching £1m a year, much of which will be coming from the original monopoly supplier.

Thirdly, the notion that the authority's second supplier of blood bags (Tuta, Australia) provides products of inferior quality is false. The Scottish National Blood Transfusion Service rejected the proposed monopoly by Baxter in 1966 and for almost 30 years has been purchasing blood bags from both Tuta and Baxter. We have used many millions of both blood bags and have no doubt that Tuta produces a high quality product that, in terms of blood safety, competes equally with the product from Baxter. Both manufacturers have had occasional problems with quality but have always responded expeditiously and in close collaboration with their customers. If doubts have arisen then both manufacturers have had no hesitation in replacing (at no cost to the NHS) any suspect batches of blood bags.

Finally, it is unusual, but not unique, for a product to be recalled from hospital blood banks. Of much greater concern, however, is the perception that this event was deliberately seized on to damage further the public image of the blood transfusion service in England; this is regrettable.