Thank you Malcolm. We also think this was very bizarre. We noticed this appeared as soon as our night temperatures were near freezing, our "cold" patients usually come in and give us extra work during these times...it is going to be a long winter if this keeps up! The WARMs we believe are due to the heart patients on certain drugs &/or disease states. We noted about 5 years ago in the month of January, we had similar issues with three heart patients (not WARM & COLD Autos, but WARM AUTO), one of these patients had a valve issue that caused hemolytic anemia, surgery was performed, after a few months we did not see this patient in blood bank but saw here H/H was good, she continued without blood for about a year and a half, when she came in for another surgery, the antibody screen is it was negative. It paid off giving her specific antigen negative blood.