We do allow our physicians control over the transfusion reation, the nurse alerts the doctor and the doctor will decide wheather it is a transfusion reation or not, they know the patient better then we do and if it is from a medication they gave to them/anything else in that nature. Once the nurse has alerted the doctor and they decide to call it a transfusion reaction, they then call blood bank, give us all the information we write it down, they fill out a form, bring us all the blood products/bag/saline/lines that were being used. they draw a new sample and we perform our testing on the before and after sample, also doing a new type and screen on the newly drawn sample. once we our finished, we need a pathologist approval before we issue anymore products