MD cancelled all BB order after patient expired

[code911]

A type and cross for 2 units was ordered from the ED the other night for a 31 yr old female with no prior BB history. She was typed O Pos and a positive screen. She expired before antibody workup was completed. Doc called BB to cancel the order. Do we still have to complete the workup eventhough the patient expired already? Your feedback is greatly appreciated.

[John C. Staley]

If you do finish the testing it will be for purely academic reasons and you should not bill anyone for it. That's my 2 cents worth.

[Malcolm Needs ☆]

Agree with John, UNLESS, you have evidence that it may be a very rare antibody that might be worthwhile keeping as a reagent!!!!!!!!!!!!!!!!!!!!..............but you still can't bill I suspect.

[David Saikin]

I agree with John and Malcolm

[PAWHITTECAR]

Ditto..I for one would finish the work-up. I don't think my curiosity would let me quit but I would not bill the patient for any testing performed after he/she expired.

[Deny Morlino]

I do not know of any mandate forcing the completion, but I agree with the other opinions... I would want to know the identity, but billing should not occur.

[Dr. Pepper]

Agreed. Satisfy your curiosity if you want but don't bill.

[MAGNUM]

By all means finish, but chalk it up to a learning situation, you cant bill.

[sblanchard]

Everyone would bill for the original T&S right? That testing was complete and was a valid order at the time of testing. I agree that I would not charge for an ABID workup.

[PAWHITTECAR]

Yes bill for anything completed prior to the call informing the BB that the patient expired.

[AMcCord]

Yes bill for anything completed prior to the call informing the BB that the patient expired.

Agree.

[LaraT23]

We generally finish the Type and Screen but then do not perform additional testing if the screen is positive. Our system does not charge for blood products until they are issued, so that billing problem is already solved.

[EDibble]

Yes bill for anything completed prior to the call informing the BB that the patient expired.

Agreed, and then, because we are a curious bunch, do our best to identify the antibody(ies).

[tricore]

IF she had received any blood I would have completed the work up. Lawyers are a funny group, even if the death had nothing to do with transfusion. If no blood received I would save the specimen (plasma/serum) for a student if you have any.

[AMcCord]

IF she had received any blood I would have completed the work up. Lawyers are a funny group, even if the death had nothing to do with transfusion. If no blood received I would save the specimen (plasma/serum) for a student if you have any.

 

Agreed.

[L106]

IF she had received any blood I would have completed the work up. Lawyers are a funny group, even if the death had nothing to do with transfusion. If no blood received I would save the specimen (plasma/serum) for a student if you have any.

 

I agree with tricore.  If the patient hasn't received blood, I agree with all others who said they would not charge for the Antibody Identification (even if they completed it to satisfy their curiosity.)

[Mabel Adams]

I would find it hard to justify the use of resources just for my curiosity but if you have the resources, go for it.  I agree with Michelle's point if it had been transfused.

[galvania]

Who exactly are you going to charge for the type and screen? I didn't think there were any banks in Heaven (or wherever else you think people go after death)

[John C. Staley]

Who exactly are you going to charge for the type and screen? I didn't think there were any banks in Heaven (or wherever else you think people go after death)

 

Insurance companies, govt. agencies and family generally are still available even when the patient moves on. 

[rravkin@aol.com]

Because we do not know the potential use in the future of any information we generate and because there would be know additional specimens collected, and because the specimen we do have is perishable I would lean towards completion of any testing to the extent of the blood bank performing the testing.

[SMILLER]

I agree with all you other posters here.  No point in doing any more testing if the patient is not going to be transfused. 

 

Our policy would be to not even do antibody ID testing for "academic" reasons.  If its not going to be reported (it was cancelled!) we are not going to do the testing.  There might even be a HIPPA (U.S.) or something violation in there otherwise.

 

Scott

[BrianD]

since the reagents and materials are already "in use" and that money is spent then i would finish the I.D. but it's not billable.   we apply something of a "finish-what-you-started" rule....i have seen a couple of dead patients start breathing again.

Edited June 25, 2013 by BrianD