HIV+ blood: Liability probed
2003-03-05 18:11
Special Report
An Mpumalanga clinic that serves a population of less than 40 000 people has reported that 70% of its patients are HIV positive.
Pretoria - The Pretoria Academic Hospital and national blood service have yet to decide whether or not to pay for the antiretroviral treatment of a 13-year-old boy apparently infected with HIV in a transfusion last year.
Both institutions were busy with investigations in this regard, officials said.
Johan Stoop's family, meanwhile, reportedly wanted to obtain legal advice on the liability of the two institutions.
A legal expert said on Wednesday liability would arise only if negligence was proven.
"If all the protocols and procedures were adhered to, a successful claim would be unlikely," said Prof Christa van Wyk, attached to the University of SA's legal faculty.
She said there was no such thing as an absolutely risk-free blood transfusion. Medical practitioners had a duty to inform their patients of the risk - even if slight.
"If people are informed, they can make informed choices."
If a patient was not forewarned and contracted HIV in a transfusion, a case could possibly be made out for negligence on the basis that informed consent was not obtained, Van Wyk said.
Stoop from Bethal in Mpumalanga is believed to have been infected with HIV when he received a blood transfusion in October after an operation to his right leg.
According to the Beeld newspaper, the SA National Blood Service learnt in January the blood donor had been HIV-positive, and informed the hospital.
Stoop's parents were told on Monday he had tested positive for the virus.
Sympathetic, but not liable
Blood service medical director Dr Robert Crookes said the organisation was sympathetic towards the boy's plight, but could not be held legally liable.
Normally in such cases, the service would discuss the matter with its medical insurer, the hospital and the doctors who treated the patient. He would not say what exactly the procedure would be in Stoop's case.
"There will the a process to evaluate the matter, and in fact that is already under way."
The service did everything possible to prevent the transmission of HIV, Crookes added. Two tests for HIV were conducted on all donations.
It was possible, however, that the virus would not be detected if the blood was donated in a window period which varied from person to person.
The service relied on its donors not to give blood if they were at risk of having contracted the virus. "We rely on the honesty and integrity of our donors," Crookes said.
Five cases of HIV infection through blood transfusions had been reported between 1997 and last year in the area covering Gauteng, Free State, Northern Cape, North West, Limpopo and Mpumalanga. About three million donations were tested in the same period.
"In general, our blood supply is very safe. It is in most cases more harmful not to receive blood than to receive it," Crookes said.
'Needed blood'
It was the responsibility of every patient's doctor to weigh up the risk against the benefit of a blood transfusion, he added.
Pretoria Academic Hospital spokesperson Amelia Lodi said the hospital would investigate what happened in Stoop's case before taking any final decision on possible assistance.
"What happened is very unfortunate," she said. "He needed blood to stay alive."
Lodi said the boy's family were not able to afford R900 a month for antiretroviral drugs. An orthopaedist at the hospital has paid R900 from his own pocket for the first month's treatment.
Calls were made on Wednesday for a rethink on the management of blood transfusions in view of Stoop's experience.
"This case provides public health with a challenge to deal with the whole process of managing blood transfusions in the context of the HIV/Aids pandemic," the National Education, Health and Allied Workers Union said in a statement.
It called for an investigation into what happened and how this could be prevented in future.
"We further demand that if there is proof that indeed public health is responsible for the infection, then it must pay for antiretroviral treatment. In fact, a policy decision on this matter must be made."
The Democratic Alliance said the matter highlighted the need to ensure that blood supplies were safe.
"Extra precautions need to be taken in South Africa due to the very high Aids prevalence in our population," DA Gauteng health spokesperson Jack Bloom said.
Anyone knowingly providing HIV-contaminated blood to the transfusion service should be prosecuted for attempted murder, he added.
- SAPA