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Risk managers should not assume there is no need for action just because risk of liability from cord blood storage is relatively low, two experts agree. Jeannie Sedwick, ARM, risk manager with The Medical Protective Co. in Cary, NC, and a former president of the American Society for Healthcare Risk Management, and Greig Coates, MD, JD, an attorney with Mithoff and Jacks law firm in Austin, TX, believe risk managers should be prepared.
If your facility delivers babies, you should devise a policy and procedure for requests to store umbilical cord blood, they say. Your staff should be educated on why cord blood is stored, how the process works, and how they are likely to be confronted with the issue. Remind them that parents may alert them early they will be storing cord blood, or they may mention it for the first time in the delivery suite. Either way, your staff should be prepared to respond in a way that minimizes any liability risk.
Sedwick and Coates recommend the following:
• Explain to staff that such requests must be accommodated.
Even if you are uneasy about some aspects of cord blood storage, such as handing the blood over to a layman, refusing the request may be risky. Further, the liability risk is much higher if your staff refuse to cooperate because they are unfamiliar with the issue. The parents could sue, theoretically at least, on the basis that you discarded a substance that might have saved their child’s life in later years. "Educating your staff about this should be a priority," Sedwick says. "If a mistake is going to be made, it is much more likely that it will be made by staff who just aren’t familiar with storing blood."
• Use a chain-of-custody log.
Records should indicate when the baby was delivered, when the specimen was obtained, and when the specimen was turned over to a third party. That will help prove your staff handled the blood in a timely manner and document when your responsibility ended.
• Have the third party sign a release form.
When you give the blood to a parent, grandparent, or friend, have that person sign a release form indicating clearly the specimen is now that person’s responsibility and not the hospital’s. It also would be wise to include a warning that the specimen must be handled carefully.
"It can be a standard type of release form, with some information noting that this is an important blood product and emphasizing the need for rapid, safe transport," Coates says. "The release should leave no doubt that the safety of the blood is no longer your problem once that form is signed."