In Case A8, if the family had decided to sue, assess whether the four elements needed to succeed in a negligence case would be met.

The four elements needed to succeed in a negligence case:

  1. Duty of care

    Yes. The patient was owed a duty of care.

  2. Breach of standard of care

    It's open to discussion as to whether negligence occurred. Standard of care is primarily determined by the general practice of the profession and would depend on what the court decides about the specifics of the case. For example:

    • Was the laboratory's policy for supervising students typical for the profession?
    • Was not noticing an abnormal volume in tests using gel cards outside the range of what a reasonable, average technologist would notice under similar circumstances (reading student-performed tests)?
    • Was the lack of a policy specifying expeditious follow-up testing of patients with positive antibody screens  - who had only a type and screen ordered for surgery that was unlikely to require transfusion -  inconsistent with general practices for the profession?

    Since the specific issues of the case are not present in blood safety standards, such a law suit would be influenced by the testimony of expert witnesses on each side and their credibility.

  3. Injury or loss

    Yes. The patient suffered a hemolytic transfusion reaction (which also contributed to the timing of his death).

  4. Causation

    Yes. The hemolytic transfusion reaction resulted from the pipetting error  and would not have occurred but for the missed patient antibody.