Inferences and Legal Considerations Following a Blood Collection Tube Recall

• Published in: Journal of analytical toxicology Vol. 45; no. 2; pp. 211 - 214
• Main Authors: Rodda, Luke N, Pearring, Sue, Harper, Curt E, Tiscione, Nicholas B, Jones, Alan Wayne
• Format: Journal Article
• Language: English
• Published: England 13.02.2021
• Subjects: Anticoagulants; Automobile Driving; Blood Alcohol Content; Blood Specimen Collection - instrumentation; Chromatography, Gas; Cocaine; Ethanol; Forensic Toxicology; Humans; Morphine Derivatives; Product Recalls and Withdrawals - legislation & jurisprudence; Sodium Fluoride; Specimen Handling; Substance Abuse Detection - legislation & jurisprudence; Substance Abuse Detection - methods
• ISSN: 0146-4760; 1945-2403; 1945-2403
• DOI: 10.1093/jat/bkaa056

In mid-2019, medical, forensic and legal communities were notified that a certain shipment of evacuated blood sampling tubes were recalled by the manufacturer. This recall order described that the preservative sodium fluoride (100 mg) and anticoagulant potassium oxalate (20 mg) were missing from a small batch of 10-mL evacuated tubes. This gave cause for concern for possible implications in criminal justice (e.g., in drink-driving offenses) when blood-alcohol concentrations are interpreted. In reality, the lack of an anticoagulant would have been immediately obvious during sample preparation, owing to the formation of a large clot in the tube when received. Certain impairing drugs (e.g., cocaine and 6-acetylmorphine) are unstable in blood and tend to degrade without an enzyme inhibitor, such as sodium fluoride, present. In reviewing available literature related to current practices and the stability of ethanol in stored blood samples, there does not appear to be a clear consensus regarding the amount of sodium fluoride preservative necessary, if any at all, when blood is taken from living subjects under sterile conditions for typical forensic ethanol analysis.