All of our neonates receive group O irradiated, leuko-reduced red cells. They receive AB platelets and plasma. Have never had a problem. Also many times sickle cell patients get group O, if necessary to match their phenotype (if they have an antibody). Also if there are short dated O's on the shelf anyone can get them.. I think your medical director needs to have a discussion with the physician who refuses to take what the Blood Bank gives and explain that the Blood Bank makes decisions based on availability and inventory control. What would this doc do in an emergent situation where you are issuing uncrossmatched O units?