How Are CRPS Cases and Routine Blood Draw Linked?
Routine blood tests are common practice within the healthcare system. Blood tests detect a number of illnesses, infections, pregnancy, and keep track of patient health. While mildly unpleasant, a routine blood draw should be no risk to the patient.
What happens when errors occur during a blood draw?
Unfortunately, there are instances where the outcome of a blood draw results in CRPS. However, very few discussions happen in any forum about what goes wrong in these cases. The Shaked Law Resource provides factual legal articles that offer information readers in search of information post-accident won’t find anywhere else. Within this article, we’ll provide readers with information they need to be aware of, in the event a routine blood draw results in serious injury such as CRPS.
We’ll answer the following important questions linking CRPS cases to errors in blood draw:
- What are the steps to a safe blood draw?
- Why is CRPS “The Suicide Disease”?
- What help is available for CRPS patients?
Sometimes errors occur due to the carelessness of the phlebotomist, a medical professional with the special licensing needed to draw blood. Sometimes the error is the result of a registered nurse who fails to use proper technique to perform the blood draw. However, any mistake that occurs during a blood test puts the patient’s safety at risk. In cases where nerve damage is outcome of a blood test error, CRPS can occur.
In the medical profession, any act that occurs as a result of the intentional recklessness of the healthcare professional may be malpractice. If the nurse performing blood draws is aware that their actions could cause harm, but act regardless, they are committing medical negligence. In the event that a jury would find the act of the healthcare professional “unreasonable” under the circumstances under which it was committed, they could find that person liable for medical malpractice. Healthcare professionals, under their license, are liable for the safety of each and every patient in their care.
What are the steps to a safe blood draw?
In order to properly perform a blood draw in both office and hospital settings alike, there are several steps that must be followed in order for the procedure’s outcome to be safe, quick, and as painless as possible. If these steps are not performed in order, or a step is ignored, missed, or treated without the proper attention paid to it, a patient can sustain irreparable injury to the arm and/or hand.
The nerves in the arms and hands are extremely delicate and must be treated with care. Improper handling of a needle or an improperly sized needle used on a patient (the elderly and minors are at risk for improperly sized needles if the healthcare professional is not careful) can result in CRPS, leaving the patient in agony for a lifetime.
A blood draw requires organization, attention to detail, and sterile working conditions.
The nurse must be sure everything necessary is present and within reach. All supplies necessary to perform the blood draw should be in reach prior to performing the blood draw. This includes the appropriate size needle. For children and the elderly, a “butterfly” needle is necessary to avoid injury. AccuVein is a consideration if the first attempt to draw blood fails. This technology allows a nurse to visualize veins in the arm for precision blood drawing. Supplies usually necessary for a blood draw include: alcohol wipes, Vaccutainers (vials) for collecting blood samples, gauze pads, and latex free bandaids. When everything is within reach of the nurse, they should still double check the area to ensure no supplies are missing.
When a nurse performs a blood draw, the procedure must begin infection control.
Proper hand washing helps to avoid the risk of spreading infection. This is extremely timely, as epidemics such as coronavirus raise questions about patient safety. Using hand washing as one form of infection control prevents illness from spreading!
- Proper infection control techniques as per OSHA. Every medical professional that comes into contact with patients or hazardous materials (blood, bodily fluid, excrement). These individuals must have OSHA certification before they interact with patients. Hand washing is invaluable and a requirement.
- Apply a tourniquet to the patient’s upper arm in order to locate a vein. This step is time sensitive. Locating a vein can be difficult on the elderly, heavier patients, and children. However, this is not a reason to neglect the duty of care or become lazy.
- The healthcare professional must remember to double check everything prior to performing the test.
During the blood draw:
- Apply the tourniquet to the patient’s upper arm to prepare the blood draw. Clean the area for the blood draw with an alcohol wipe from the inside to the outside of the arm, ensuring no bacteria comes in contact with the area. Gently hold the patient’s elbow with one hand while using care to perform the procedure. When the needle is secure, perform the blood draw in the correct order. To avoid misdiagnosis, each vial has a different colored top. For medical professionals this is of utmost importance. Misdiagnosis can occur if the tests receive the wrong color vial or are not in the correct order.
After a blood draw, the following steps ensure proper healing:
- Remove the tourniquet from the patient before drawing the last vial. There is an inherent risk of nerve damage, CRPS, and/or hematoma if the tourniquet remains on the patient’s arm for too long. It should always be removed before the last vial of blood is drawn to allow the pressure in the arm to gradually return to normal. The fingers should never turn blue during a blood draw, and the nurse performing the draw must keep their eye out for this. If this occurs, the nurse must stop, remove the tourniquet and needle right away, and a doctor must immediately assess the situation.
- Apply pressure, band-aid, raise the patient’s arm. It’s a common misconception that the arm must be in the downward position after a lab draw. This position can cause blood clots and nerve damage, resulting in CRPS. In reality, nursing students learn to put the patient in a “Statue of Liberty” position. That is, arm above the head, if the patient is able, for 60 seconds. This allows the blood not to pool in the crook of the arm, the source of most blood draws..
Why do CRPS patients consider it the “Suicide Disease”?
Patients who sustain CRPS after medical malpractice such as an improperly performed blood draw have one of the highest rates of suicide in the world. The pain caused by Complex Regional Pain Syndrome has been the subject of multiple documentary films, due to its moniker as the “Suicide Disease”. Even celebrities, such as pop superstar Paula Abdul suffer from CRPS and choose to share their anguish with the world in a series of posts.
The epidemic of patients who are diagnosed with CRPS and subsequently commit suicide months or years after, is not a coincidence. The link between CRPS and suicide has been scientifically proven to be factual. The pain and suffering caused by this disease is absolutely unbearable, and most patients will find they have no quality of life after being forced to survive with little to know known pain control for it. Opioids are addictive and physical therapy when the body has already been through pain and suffering is difficult or impossible for many patients.
What help is available for CRPS patients?
There are clinical trials on the horizon for CRPS. Doctors conduct research every day to further treatment and pain relief for CRPS patients. However, CRPS has the classification of a rare disease in recent years. This is leaving little in the way of treatment outside of clinical trials that “may” or “may not”. The Food and Drug Administration explains that a disease is rare if:
“[…]A disease is considered rare if fewer then 200,000 people in the United States have it.”
There are only several other diseases in medicine with pain that are on par with the pain of CRPS. These other extremely rare diseases: Marfan Syndrome, Amplified Musculoskeletal Pain Syndrome, and Scleroderma, are three diseases that inflict “suicide inducing” pain. These diseases are rare, and not a result of Medical Malpractice. When not a direct link to malpractice, CRPS is highly uncommon, and very difficult to diagnose.
What happens when CRPS is the result of a blood draw?
Millions of Americans visit their doctor’s office every year for routine lab monitoring. It could be to seek diagnosis for symptoms of illness or part of a yearly physical exam. Aside from the discomfort of the needle prick, a blood test performed properly does not pose any health risk to the patient.
In the event, though, that a routine blood draw goes wrong, legal consult is necessary. There are very few lawyers who can handle the complexity of a CRPS case. Shaked Law Firm’s team of legal experts, lead by founder Sagi Shaked, is the only law firm in Florida capable of trying and winning cases of CRPS resulting from Medical Malpractice.