Deck 29: Medicolegal and Ethical Aspects of Providing Blood Collection and Transfusion Services

Question 1

How does the doctrine of informed consent protect the donor?

A) By providing a pamphlet of donor risks to the donor on his or her way out the door
B) By not requiring his or her signature
C) By requiring that information be provided to the donor in a manner that he or she can understand and ask questions about, if so desired
D) None of the above

Answer 1

C

Question 2

Blood banks are federally regulated by which of the following?

A) AABB
B) Commission on Laboratory Accreditation
C) American Medical Association
D) FDA

Answer 2

D

Question 3

What was the reason for the negligence verdict in the district case Belle Bonfils Memorial Blood Bank v. Denver District Court (1988)?

A) Lack of an HIV-confirmatory test for specific unit transfused
B) Clerical error by reference laboratory (site of testing)
C) Lack of standard protocol for implementing new HIV testing on available components
D) Lack of quality control for HIV test kit

Answer 3

C

Question 4

In regard to donor histories, the federal government has put an emphasis on in the hope of acquiring more descriptive information from persons who may be infected with HIV.

A) self-administration of questionnaires
B) face-to-face oral questions
C) humiliation tactics
D) none of the above

Question 5

Which of the following situations is grounds for a plaintiff claim under invasion of privacy?

A) Public disclosure of embarrassing facts
B) Placement of plaintiff in a "false light" in public
C) Intrusion on plaintiff's seclusion
D) All of the above

Question 6

How is battery conceptualized in transfusion medicine?

A) A patient develops a fever after being transfused.
B) A donor claims never to have agreed to be stuck by a needle.
C) A donor develops a hematoma after phlebotomy.
D) A patient develops an antibody 2 months after being transfused.

Question 7

What kind of cases stimulated state legislatures to enact protection for blood banks through so-called blood shield statutes?

A) TTAIDS
B) TTH
C) TT syphilis
D) TT sepsis

Question 8

Many transfusion-transmitted acquired immunodeficiency syndrome (TTAIDS) lawsuits have been dismissed because of:

A) inability to prove negligence.
B) lack of precedence.
C) blood shield statutes.
D) statute of limitations.

Question 9

What is the meaning of tort reform?

A) Prospective immunity for hospitals from excess liability because of charitable acts
B) Revision of transfusion-associated litigation to include licensed registered nurses as defendants
C) Protection of specialty practices from punitive or excessive awards by state legislatures
D) None of the above

Question 10

What body of government is authorized to pass laws?

A) U.S. Congress
B) U.S. Supreme Court
C) State courts
D) All of the above

Question 11

In the case of Kozup v. Georgetown University Hospital (1987), what were the circumstances surrounding the court's decision to rule in favor of the defendant?

A) The death of an infant was not transfusion related.
B) Parents did not object to transfusion at the time of infusion.
C) Parents had signed a transfusion consent form.
D) The District of Columbia courts had a blood shield statute in effect.

Question 12

What would be the plaintiff's claim for a case involving a donor or defendant who intentionally donated HIV-positive blood for transfusion purposes?

A) Wrongful death
B) Battery
C) Tort
D) Manslaughter

Question 13

In transfusion services, who is liable for the actions of employees as determined by federal law?

A) Chief technologist
B) Blood bank supervisor
C) Laboratory director
D) Physician

Question 14

Liability for negligence includes all of the following except:

A) there was a duty owed to the injured party.
B) the duty was not met; the injured party was harmed.
C) failure to meet the duty was indirectly responsible for harm suffered by injured party.
D) some measurable (compensable) harm occurred (called damage).

Question 15

A blood bank technologist working in an Army medical center discovers that a colleague from boot camp who donated blood is HIV-positive. While at a nightclub on base, the technologist discloses this information to his sergeant. Within 24 hours the donor's commander confronts the donor with this rumor. By law the donor can file suit against the donor center for .

A) battery
B) negligence
C) tort
D) loss of privacy

Question 16

What is the rationale surrounding the Doctrine of Charitable Immunity?

A) State legislatures are more lenient toward select specialty areas of medicine with regard to excessive legal damages.
B) Courts provide immunity from excess liability for nonprofit organizations.
C) Blood collecting facilities entice donors by agreeing to donate 5% of plasma revenues to their favorite charity.
D) None of the above

Question 17

All of the following are emerging concerns of transfusion medicine except:

A) red blood cell substitute.
B) standards of preoperative blood collection and reinfusion.
C) crossover of autologous (unused) units.
D) antibody testing procedures.

Question 18

Why are physicians selected as the "respondent superior" in negligent cases?

A) Physicians give the order to transfuse.
B) Physicians are considered expert witnesses in transfusion-related deaths.
C) Federal regulations can be applied to medical malpractice.
D) None of the above

Question 19

What would be the effect of redefining blood banking outside the realm of medical practice in litigation cases?

A) Physicians would no longer serve as the respondent superior.
B) Blood bank personnel would take the role of the defendant.
C) Expert medical testimony would not be needed to establish standard of care.
D) Transfusion facilities would be excluded from the blood shield statute.

Question 20

The is an example of a voluntary standard, as related to transfusion medicine.

A) Clinical Laboratory Improvement Amendments of 1988
B) Journal of the American Medical Association
C) AABB Standards
D) Code of Federal Regulations

Question 21

In the absence of federal law, what justification can provide precedence for future decisions.

A) State
B) City
C) Either of these
D) None of these

Question 22

Which of the following species of organisms are known to infect red blood cells in storage?

A) Escherichia coli
B) Enterobacter species
C) Yersinia species
D) All of the above

Question 23

Lawsuits against blood collection agencies for improper donor screening can be ruled in favor of the blood center if which of the following occurs?

A) Facilities could show that they had implemented written procedures.
B) Facilities could show that they and had properly trained employees.
C) Facilities could show that employees followed standard procedures and that proper documentation of each screen occurred.
D) All of these.

Question 24

Civil cases involving TTAIDS in the 1980s, when plaintiffs argued infected patients were insufficiently warned of the hazards of transfusion, were unsuccessful in their litigation efforts because:

A) patients gave verbal consent.
B) the statute of limitations was in effect.
C) scientific knowledge was limited, as stated by experts.
D) hospitals were protected by blood shield statutes.

Question 25

How must a standard operating procedure (SOP) be written in order to stand up against legal scrutiny?

A) SOPs must be consistent with quality principles
B) SOPs must comply with recognized authorities, regulations, and statutes.
C) SOPs must include a method of measuring and recording how persons actually follow those procedures.
D) All of these

Question 26

What is the legal basis for lawsuits filed as a result of a transfusion?

A) Civil actions for tort and tort liability
B) Criminal actions for tort and tort liability
C) Civil actions for manslaughter
D) None of the above

Question 27

Lawsuits against blood collection agencies for improper donor screening can be ruled in favor of the plaintiff if which of the following occurs?

A) Facilities cannot show that they had implemented written procedures.
B) Facilities cannot show that they and had properly trained employees.
C) Facilities cannot document that employees followed procedures for proper documentation of each screen.
D) Any of these

Question 28

All of the following injuries from component collection may be grounds for a civil suit except:

A) a hematoma.
B) nerve damage.
C) a sudden fall.
D) severe donor reaction.

Question 29

Which of the following best describes strict liability?

A) Manufacturers are liable when it can be proven the consumer did not misuse the product.
B) Manufacturers are legally liable for all harm that occurs through use of a product.
C) Manufacturers are legally liable for the duration of the warranty period.
D) None of the above

Question 30

Who determines the professional standard of care in negligence lawsuits?

A) Jury
B) Judge
C) Expert witnesses
D) Defendant

Question 31

Donors who were protected in the past from subpoena in cases of transfusion-transmitted diseases now may be questioned by the court. How might the donors identity be handled?

A) Completely protected
B) Partially protected
C) Must appear in open court
D) Any of these

Question 32

Plaintiffs have prevailed in TTAIDS multimillion-dollar medical malpractice suits against physicians for which of the following arguments?

A) There is a lack of standard protocol for implementing new HIV test kits.
B) The patient did not need a transfusion based on clinical data.
C) The patient did not give informed consent.
D) The patient was health illiterate and therefore could not comprehend the need for transfusion.