Report: Despite ELISA test being HCV positive, blood was issued

Aparna Banerji

Tribune News Service

Jalandhar, February 9

A day after an FIR was lodged against the BTO and lab technician of the Phagwara blood bank, the police said further investigation would continue in the case on Monday and the duo were yet to be arrested. The FIR, which includes the detailed probe report in the case, was filed at the Phagwara city police station on Saturday night by the Kapurthala Civil Surgeon following the CM’s directions.

Blood units no. 179 and 2922 — which were infected with HCV and HBsAG (Hepatitis B) positive blood had been issued to two patients by the blood bank following an inspection by the Drug Department on February 4. The bank, on February 6, had transfused mismatched blood to a 19-year-old patient (B positive blood was transfused to O positive patient).

The duo had been booked under Sections 307, 465, 466, 468, 471 and 120-B, IPC. While the entries in the records of the blood bank for blood samples (related to blood units numbers 179 and 2922) stated that the blood was reactive, the report submitted by the medical board following the rapid and ELISA tests of two donors’ and one recipients’ blood samples ‘confirmed the blood of both donors to be non- reactive’, hence, establishing ‘wrong entries’ had been made into the register – yet establishing ‘gross negligence’. While the civil surgeon and health authorities have stated that rapid tests conducted on both patients also tested ‘non-reactive’ – the case, hence, underlines the negligence prevalent at the blood bank.

Kapurthala Civil Surgeon Jasmeet Bawa said: “The order as per which tests are to be conducted is that the first rapid test is done and then ELISA is done for reconfirmation. But officials in this case conducted ELISA first which came reactive for HCV. But rather than discarding this blood, a rapid test was conducted which came out negative. This blood was then issued to patients. The repeat ELISA and rapid tests conducted by us on two donors and one recipient (another recipient couldn’t be traced) have tested negative for the HCV. But negligence has been established nevertheless.”

What probe report (cited in the FIR) states

A request has been given from the Kapurthala Civil Surgeon to Managing Director, Punjab Health System Corporation, regarding final probe report (dated 6/2/2020) submitted by board members in the case of issuing HCV positive blood by the blood bank, Civil Hospital, Phagwara.

Report of ELISA test performed on the blood samples recollected from the donors in the presence of the board members has been received. In both donor samples (i.e. related to blood bag number 179 and 2922) ELISA reports confirmed the blood of both donors to be non-reactive. However, considering the seriousness of the matter I (Civil Surgeon) am of the opinion that Ravipal, lab technician, who is responsible for testing the aforesaid sample and entered wrong entries in blood bank registers and Dr Hardeep Sethi, BTO, blood bank, who is responsible for overall supervision monitoring and functioning of the bank, have shown gross negligence.

The copies of ELISA report collected today are hereby sent to yours goodself for further action in the case please. Enclosures: test reports of two donors signed by the BTO, Kapurthala.

Board members Dr Manpreet Kaur Chatwal, Additional Project Director-cum-member Punjab State Blood Transfusion Council (PSBTC); Dr Sunita Joint Director-cum-member PSBTC, Blood Transfusion Services; Dr Sarika Duggal, Deputy Medical Commissioner, Kapurthala; Dr Prem Kumar, BTO, Civil Hospital, Kapurthala, and Dr Anupama Kalia, drug Inspector, Kapurthala, have written in their report that “the board members are hereby submitting the probe report and has come to the conclusion that the said negligence occurred at the end of Ravipal, lab technician, who is responsible for testing the aforesaid blood samples and Dr Hardeep Singh Sethi, BTO, blood bank, who is responsible for overall supervision, monitoring and functioning of the bank. Further today on 6.2.2020 during the course of the probe, the team came across (another) case of negligence by the same lab technician, Ravipal, and BTO Hardeep Singh Sethi, in-charge, blood bank, for issuing and transfusing B positive blood to the O positive Pardeep (19) admitted to the Ortho ward vide CR 1089 at the Civil Hospital, Phagwara, on 5/2/2020 at night, as Dr Hardeep Sethi was on night duty on 5/02/2020 as the EMO, which was brought into notice by the Hindustan Welfare Blood Donors’ Club, Phagwara.”

The Principal Secretary, Health, Punjab Government, Health and Family Welfare under Memo no. 17/07/2020-2C1/373 dated 7/2/2020. Director Health and Family Welfare Punjab and Managing Director Punjab Health Systems Corporation have also been notified.”