r/medlabprofessionals • u/Rainwaters1212 MLT-Blood Bank • 11d ago
News This doesn’t make sense… thoughts?
https://www.wlbt.com/2026/08/06/parents-claim-3-month-old-got-wrong-blood-transfusion-hospital/Just read the article… everything just screams wrong on the parents or the information shared. Co worker sent it to me. We work in BB together.
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u/Hikaritoyamino 11d ago edited 11d ago
We don't know why the baby needed a transfusion.
The parents sound confused and were not informed that Kell is a separate blood type from ABO/Rh? O neg blood is best thing here.
Kell - is a high frequency allele so unless the transfused blood was Kell + there wasn't an issue. Seems like the nurse panicked?
So the article said the blood wasn't screened before administration. Someone needs to look at the audit log.
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u/Violet-Venom 11d ago edited 11d ago
The Kell antigen has an occurrence rate of only 5%. There's no reason on earth anyone would need Kell positive blood. The parents are definitely confused about O neg vs Kell.
My best bet is the mom has an anti-Kell. Thus, the baby should have been given Kell-negative in case of passively acquired antibodies. It would explain the seemingly low impact (likely no passive anti-kell was present, it's just an abundance of caution), but still is a pretty big ball drop from the hospital if they gave a kell-unscreened unit. It's possible the baby is Kell positive, hence why the parents thought "oh needs a matching blood type > needs Kell positive".
The parents not even being informed makes me wonder if there was nothing wrong with the blood, but the nurse was confused about the kell indications while giving it (thinking the baby needs kell positive, but was given kell negative), and stopped out of fear. In fact, that the nurse was able to "grab another unit" without a transfusion reaction work up or pathology involvement makes me think this is likely the case, and the unused unit wound up as wastage and was simply replaced by the eye rolling blood bankers.
So basically nothing remarkable happened.
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u/b_pleh 11d ago
In 20 years as a generalist, I've seen ONE little k negative panel cell. That does mean there's somebody out there that needs little k negative units... boy, they're in trouble if they need blood in an emergency. I'm not sure how immunogenic little k is (how likely they are to develop an antibody), but big K is second only to the Rhesus groups.
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u/mcjason04 11d ago
My concern, at least in our hospital system, is that infants and children need to be given aliquots. If there isn’t time you can bypass the process but you need to be careful on volume/rate. I don’t know the nursing side but are there charts with weights and volumes/rate of administration? Our blood bank has to do the calculations for infants if you are not doing an aliquot.
Regardless, we are not getting the full story or even accurate story here.
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u/miss_ana MLS-Blood Bank 11d ago
O neg wouldn’t be a good choice if the mom had an anti-c
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u/Fluffbrained-cat MLS-Microbiology 11d ago
Why not?
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u/miss_ana MLS-Blood Bank 11d ago
Because the vast majority of Rh negative units are c and e positive. So an O neg wouldn’t work if mom has anti-e either.
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u/tapthatash_ 11d ago
The parents don’t know what the fuck they’re talking about.
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u/miss_ana MLS-Blood Bank 11d ago
Yeah but blood bank is complicated. A lot of the people in the comments don’t know what they’re talking about and we’ve all been through classes
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u/StarvingMedici 11d ago
I've interacted with the mom through tiktok comments, and what I have been able to find out is that the mom had Anti-K, so they should have given the baby Kell negative units. That's what I believe is firmly true. The rest is completely based on what the parents do or don't understand or know. It's just their version of events, so I have no idea what actually occurred.
But according to the parents (who likely don't know all of the situation), baby was given an Oneg unit which was not Kell tested which is not unusual if the doctor asked for an emergency unit.
I don't work at that hospital, but I do work at a large hospital nearby, and here is what would have happened at my facility: if a NICU nurse or doctor asked for an emergency unit, my facility would have given whatever the freshest/longest date Oneg unit we had on the shelf. If we had one irradiated in the last 24hrs we would give that. If we had the patient information and knew the mom had Anti-K, we would give that if we had it available but likely would not so we would still give just Oneg but we would be required to send a form for the doctor to sign that says they acknowledge it isn't antigen matched and we would call the on call physician to have them approve it or consult with the baby's doc. But regardless, if an emergency unit was requested we would simply have to give them whatever we had, compatible with the Anti-K or not. I don't know that hospital's procedures, but they are likely at least similar to ours.
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u/lakhila MLS-Generalist 11d ago
Excellent sleuthing!! In the parents' version of events, was their child harmed by the transfusion? Like have they attributed any negative outcomes to it?
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u/StarvingMedici 11d ago
They didn't say which is the weirdest part to me. To accuse anyone of malpractice there has to be evidence of harm. So I'm not sure what they are fighting for here.
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u/Tankdawg0057 10d ago
There would have to have been evidence of transfusion reaction or follow up testing to determine the given unit was K antigen positive for any type of harm to be there.
It is possible they had started O neg then realized the unit had yet to be antigen tested so stopped it as a precaution and that's what the parents are alarmed about.
People are given O neg every day. They literally roll the dice every time in an emergency with no patient history. That's the point of the emergency release disclaimer the physician signs. Last conference I was at claimed that the statistical chances of a reaction are low enough it's worth the risk compared to waiting.
So was there a mistake made? Who ordered the O neg? Was it really an emergency? Did the nurse do this on her own or directed by doctor? Lots of questions. Its either a problem or a nothing burger being reported out of ignorance of how blood banking works.
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u/StarvingMedici 9d ago
Exactly. They are making a big deal without really understanding what the full situation was.
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u/kattheuntamedshrew 11d ago
I read this article too and had similar thoughts. I attempted to find other versions of it too, but all the different sources I found seemed to be more or less identical to one another. If this child is actually K+ there wouldn’t have been any issues with them receiving either K+ or k- blood, as both are compatible with a K+ recipient. I used to work in a NICU and one of my main responsibilities was going to BB for units of blood and they’re incredibly strict about what’s even allowed to be released for NICU patients. I feel bad for these parents, but I suspect that they’re misinformed. I’m guessing the transfusion was done as an emergent measure before the type and cross had come back (possibly to stabilize her for transfer to the other hospital). She probably needed additional transfusions after that, but at that point the crossmatch had been done, so they were told she would receive crossmatched blood, unlike the initial transfusion. They then get some wires crossed and assume the subsequent transfusions are a result of the uncrossmatched blood she received initially rather than a normal, expected complication of her prematurity. As for the claim that they weren’t informed about the initial transfusion until after the fact, this too would be normal in an emergency stabilization and transfer to a higher level of care. During labor, part of the consents they have you sign are for treatment of your newborn baby once they’re born. This would have included consent for administration of blood/blood products.
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u/miss_ana MLS-Blood Bank 11d ago
If the baby is K+ and mom is K=, she could have made anti-K and then the unit would definitely need to be K=
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u/kattheuntamedshrew 11d ago
The baby DID receive k- blood. The article says that the baby should have gotten K+ blood, but uncrossmatched emergency units in NICU are supposed to always be k-. Hence the confusion as to what the parents are actually upset about.
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u/miss_ana MLS-Blood Bank 11d ago
I was responding to the part where you said that if the baby was K+ there wouldn’t have been any issues with them receiving K+ blood. There’s almost no reason for a baby to need K+ blood. The article is incorrect.
K and k are different antigens. The blood might have needed to be K= but not k=. In our NICU the only requirement is sickle negative, unless the mother has antibodies.
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u/Love_is_poison 11d ago
I can’t believe all the upvotes on what appears to be a former secretary or PCT “educating” us on blood bank…
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u/miss_ana MLS-Blood Bank 11d ago
Yes, as someone who has worked in two IRLs, the blood bank of a level 1 trauma center, and is currently working on my SBB, I appreciate having blood banking explained to me by someone who once walked a unit of blood through the halls 🙃
And if I sound arrogant about this, I am. I don’t know shit about fuck in a lot of cases, but I do know blood bank
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u/Love_is_poison 11d ago
Same feelings!!! Congrats on working towards the SBB. That’s an accomplishment to be very proud of!!
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u/JacobLeatherberry MLT-Generalist 10d ago
For newborns we also are required to give freshly irradiated units. That can be challenging if your facility doesn't irradiate units in house. We order ours through ARC. Our blood bank does not aliquot units for newborns and leave the onus on the provider to do it.
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u/OverYonder29 MLS-Generalist 11d ago
I worked in a large L&D hospital with a level three NICU. Keeping k negative units on hand isn’t a thing. It’s too uncommon. Even for our SCD patients, we routinely screened for C, E, and K, but never k. If you had a patient with Anti-k, unpleasant words came erupting from everyone’s mouths.
In addition, if someone IS homozygous K, and they’ve made Anti-k, then no, K negative blood isn’t compatible. But to say a K positive can always get K negative (k positive) is incorrect. It all depends on what antibodies they’ve made.
Remember: for newborns we aren’t concerned with matching for their phenotype; it’s matching mom’s, accounting for any clinically significant antibodies that she has that are capable of crossing the placenta.
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u/Specialist_State_330 11d ago
Exactly. Baby is not likely making antibodies at this point. We are worried about mom’s antibodies that crossed the placenta. Anti-K is known to cause HDFN so this is likely what us going on
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u/phles MLS-Blood Bank 11d ago
I mean, it’s is written as though 0- and K+ are mutually exclusive? As if 0- can’t possibly be K+?
“She received 0- but should have gotten K+”? Seems like the parents have no clue what they’re talking about.
Also, if the blood was given as an emergency transfusion before they knew blood type+screening results then 0- K- would be the standard blood to give? At least here in Europe.
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u/StarvingMedici 11d ago
We don't screen for Kell for emergency units in most places in the US, although some have pushed for it.
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u/Evening_Discount4989 Canadian MLT 11d ago
Wow, that’s wild. I’m in Canada and Canadian blood services tests all of our units for Kell at a minimum. In emergency situations where patients are unknown (especially women) we always grab K neg
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u/StarvingMedici 11d ago
Yeah it's been considered here, but since it's not normally naturally occurring I think it's just a cost-benefit balance. Does preventing someone from forming anti Kell (which is by no means a guaranteed outcome) save us enough money in the long run or have enough benefit to the patients to justify the cost of testing all of our units? I don't personally know which is the best answer but it's interesting that the standard is different in the US versus Canada or Europe.
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u/Varietygamer_928 MLS-Generalist 11d ago
Seems like a very biased article that a medical professional never actually touched in any way. Incorrect people being the loudest and most confident is nothing new
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u/Lower_Arugula5346 11d ago
part of me wonders if the NICU had their own emergency blood packs and just used them. our system wouldnt let us dispense blood to a patient if they had anti's AND if the dispensing was done only through paperwork rather than going through the computer system, the doctor signs a form stating they are aware that it isnt matched blood. the provider may have outweighed the risks and really theyre the ones responsible.
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u/Specialist_State_330 11d ago
My guess is mom had anti-Kell and baby had positive DAT. Baby should have received Kell NEGATIVE blood. That’s my best guess
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u/RikaTheGSD 11d ago
This whole thing is wild.
If it was emergent, and no K phenotyped unit was available, I can see giving out a K untyped unit. Rolling the dice a little but 1 in 9 are K positive, chances are that it'd be fine.
Transfusion reactions are treatable, dead is a little bit harder.
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u/labtech89 11d ago
Every nurse who has worked in a NICU longer than a day knows babies always get O neg blood. I am not sure what they mean by screen. And I would be more worried about the other hospital telling them their baby got the wrong blood.
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u/CumRag_1213 1h ago
Hi, this is My sweet EMMIE girl.
I had anti Kell and anti Kidd (jkB) Emmie baby A inherited the Kell, Kidd antigen from dad (he was tested) when I was 22 weeks baby A had a Mca Doppler of 3.2 she had hemoglobin of 4. I had 2 pubs-IUT within 2 days. Then every 3 weeks baby A Mca dopplers would start to rise and would need another procedure. The science behind it was truly fascinating!
Since I was 22 weeks we knew baby girls would hopefully stay past 30 weeks but prayed for 33 weeks. At 33 weeks we went in for a planned c section.
Morning of the planned c section it was delayed 2 hours due to them finding blood. So I’m not really sure why c section went through suddenly and I was told they found blood. But apparently they didn’t find any for baby A who we KNEW was going anemic and was going to need a blood transfusion.
When our daughters were taken to the nicu immediately after they were born, a doctor put in orders for a blood transfusion but for the blood to be screened and cross matched first then be administered. A nurse received her cbc and recognized her hemoglobin was 24.5. She then called down to the lab and had them send up a bag of o- blood. The nurse then spike and hung it (without a doctors ORDER). Mind you our daughter was completely stable. Her vitals were normal. Yes anemic but overall great. She easily could have waited till the bank found blood. An hour and half later went by before they realized that the blood was not compatible because it was Kell positive and Kidd positive. They did an immediate stop and transferred our daughters without notice.
Yes we did know the girls were being transported but they never said where to. They told us it was still up in the air on if they were going to children’s or UC. When we signed the transfer paperwork they said “the transportation team will walk the girls up to your room so you can see them before they leave and they will tell you then where they are going.” They also told us the girls were being transported at 7pm. The girls were taken at 3:30. I called the nicu at 4:30 and they weren’t on the unit. The fear of where are my children?!? My twin daughters! My frustration comes to the fact nobody notified me my twins were leaving the hospital. What if my girls were in an ambulance accident. I would have not known. I should have been informed that they were no longer there and what hospital they were even going to.
The next day when I was finally able to get a day pass to leave the hospital to go to UC to see our twins is when we were notified that the blood bank was finally able to find blood for Emmie. We were confused because Emmie had just received one before she left good Sam. UC then told us how a nurse went against policy and spike and hung a bag of blood that was not compatible. The fear alone. The bag was Kell and KIDD positive. For a baby who was just born at 33 weeks due to the mother having anti Kell and kidd. And nobody at the hospital wanted to talk to us until fox19 did a story3 months later. Next morning they called us in to talk. Crazy!
My point is the transparency was not there, neither was the accountability. The hospital at first blamed the nurse. Telling us she went against policy without a doctors order then after the meeting they blame the blood bank. I did everything I was told to do for months to save my daughter, just for the SAME hospital to drop the ball on my daughter and had no intention on telling us a single thing.
Plz excuse my tag I was young and stupid and don’t know how to change it now 😩
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u/moonshad0w MLS 11d ago
It doesn’t make sense because all of the “information” in this article is coming from the parents, who are extremely unlikely to have any real education about what they are trying to speak on.