Return/Reissue Yellow Stuff

[Old Ohio Banker]

I would appreciate any thoughts or SOPs on how you would handle this:

A whole plateletpheresis is issued to the OR (with a "Store at Room Temp" conspicuously placed on the product). It is returned, unused about 4 hours later.

What is your return policy on these products or any "yellow" products?

If it comes back relatively quickly, I would think it a no-brainer to re-stock. When the timeframe of return reaches several hours, I become nervous about restocking the product for re-issue. But at >$500 a pop for the apheresis, it becomes supply/demand/financial to look at each case individually and make the decision on that basis.

Thoughts?

[rcurrie]

The yellow stuff always has been a gray area. We accept SDPs back into inventory as long as they haven't been stored on ice or in a refrigerator. There are no refrigerators out on the floor, so that is not a concern for us. We take the temperature, and as long as it is between 20 and 24 C,we take them back into inventory if they have not been out of the lab for over 24 hours. The AABB Standards say that platelets can go 24 hours max without agitation.

As far as the other yellow stuff, when plasma is returned, we take it back into our inventory if it has been stored in a cooler with ice. We ask, "Has this been kept in the cooler the whole time?" If yes, we take it back in as long as it hasn't been spiked, of course. The problem we run into is some techs think that thawing FFP requires you to cook the stuff to 37C. They put it in the thawer and come back 20 minutes later, when it is not only thawed, but warm enough to cook a 14-ounce ribeye to medium-rare. Then it goes out the door, and when it is returned 30 minutes later, surprise, surprise, it is only 20C rather than between 1 and 10C. It has been steadily cooled toward that temp by the ice, but when you start at 37C, it takes a while to cool down. So, when a tech tells me the temp of the FFP being returned is 20C, I ask what it was when they sent it out the door. Oh- they didn't check the temp when it was issued. Duh.

BC