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In a letter to Dr John Cash, Dr Brian McClelland suggested the need for a peer review by the haemophilia directors, producing clear guidance as to a reasonable level of consumption of Factor 8.

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Dr Stanislaw Urbaniak increased the production of cryoprecipitate from 153 units to 425
units.

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The North East Thames Regional Transfusion Centre informed the Oldchurch Hospital that they had received donations from donors who had tested positive for viruses such as HIV.

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Dr Geoffrey Tovey reported a potentially infected donation to the Blood Products Laboratory.

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In a letter to Dr Roger Moore, Dr Patricia Hewitt of the North London Blood Transfusion Centre set out the test it applied for reporting cases to the Blood Products Laboratory. The letter stated that: "We only report cases to BPL when we have assured ourselves that a report from a hospital concerning hepatitis in a transfusion recipient is likely to be associated with the transfusion."

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Following the discovery of two batches of NHS Factor 8 which were implicated in symptomatic HTLV-3 infection in a haemophiliac, Dr Terry Snape wrote to Dr Napier requesting him to advise haemophilia directors to whom these batches were supplied to follow up with patients treated with the concentrates.

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The Expert Advisory Group on AIDS discussed the topic of the follow up blood donations previously given by donors who were identified as positive for HTLV-III. Recommendations of the Screening Sub-Committee regarding the follow up protocol were also discussed and agreed.

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The Chief Medical Officer's "Dear Doctor" letter set out the expectation on regional transfusion centres in England to notify and counsel donors who were found to be positive for HIV.

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A memo from Dr Martlew to Dr Harold Gunson showed that donors who were found positive in the three-centre trial of Hepatitis C screening kits prior to the introduction of Hepatitis C screening in September 1991 were not to be informed, followed up or counselled.

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The Yorkshire Regional Health Authority notified a donor that he had tested positive for Hepatitis. The donor's name was withdrawn from the active panel of donors and his consent was requested to notify his GP.

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A GP was notified by the National Blood Transfusion Service about a donor who tested positive for hepatitis.

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In his letter to Dr Harold Gunson, Dr Peter Flanagan set out the procedure for counselling donors who had tested positive for Hepatitis C.

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In a letter from Belinda Phipps to Dr Gunson, it was explained that no allowance for the cost of counselling was made in the South East Thames District Health Authorities' budget, as donors who tested positive were referred to their GP or a liver specialist for advice/counselling and costs to this service were minimal.

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In a letter to Dr Patrick Zentler-Munro, Dr Whitrowit of the South Thames Regional Transfusion Centre proposed to arrange for donors in distant areas to be initially counselled and further basic investigations performed by GPs.

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A memo from Dr Brian McClelland to Dr Perry described the events leading up to the recall of Factor 8 batch 023110090 implicated with HTLV-3. A potential implication was identified on 26 October 1984. Following some confirmatory tests, the decision to recall was made on 3 November 1984.

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Dr Brian McClelland wrote to Dr John Cash about the investigation into the potential implication of Protein Fractionation Centre Factor 8 with HTLV-3. It was concluded that the single batch 023110090 was "probably responsible for seroconversion...No other recent batches stand out as being distinctively strongly implicated".

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In a letter to Dr Richard Tedder, Dr Brian McClelland explained that approximately 4,000 donors contributed to an implicated batch of Factor 8 and sought advice on the possibility of getting these donors screened.

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In a letter to the British Medical Journal, Dr William Maycock claimed that a large number of doctors did not "appreciate that both plasma and serum carry a risk of homologous serum jaundice, and that this disease is rather more than a 'transfusion reaction'. There is a small number who believe that the disease may follow the use of serum, but never that of plasma!"

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The Department of Health and Social Security, Scottish Home and Health Department and Welsh Office issued guidance to record of every transfusion to be made in a patient's case notes in addition to the details recorded in the transfusion laboratory, and that patient records must show the serial number of containers of blood or blood products.

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The Department of Health and Social Security issued a circular requesting health authorities to review record-keeping and stock control arrangements in regional transfusion centres and hospital blood banks. The circular also demanded that records "must permit the tracing of any unit of blood from collection to transfusion or disposal."

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