Blood Quarantine Expansion Puts Surgeries on Hold

Nonemergency surgeries were postponed and hospital officials in parts of the South kept a close eye on blood supplies Monday after the American Red Cross expanded a quarantine issued when an unidentified white substance was discovered in bags of donated blood.

Federal health officials worked to identify the particles, which first were spotted in 110 bags of donated blood in Atlanta late last week, prompting the Red Cross to quarantine almost all of its inventory across Georgia and parts of South Carolina.

On Sunday, officials in Nashville quarantined about two-thirds of the agency’s blood supply for the Tennessee Valley region -- covering mid-Tennessee and parts of Illinois, Kentucky and Missouri -- after a similar substance turned up in 10 bags there. The quarantine applied to blood that was stored in bags manufactured by Baxter Healthcare Corp. of Deerfield, Ill., which also produced the collection bags in which the substance was discovered in Georgia.

Testing by the national Centers for Disease Control and Prevention indicated that the particles were not infectious, officials said. The Red Cross said it had received no reports of harm to any patients.

Red Cross officials in Atlanta have said the material may have come from the bags, and on Monday the agency switched to ones made by a different manufacturer. But Baxter officials said their tests show the material is probably a naturally occurring component of blood, perhaps tiny fibrin clots containing white cells and platelets. Baxter representatives said it is unclear why the substance -- variously described as globular or like grains of sugar -- should suddenly appear so prominently.

“We haven’t seen anything like this,” company spokeswoman Deborah Spak said.

The Food and Drug Administration said during a news conference that its own testing is preliminary. “At this point, it’s just too soon and we’re not ruling anything in or out,” said Dr. Jesse Goodman, director of the FDA’s Center for Biologics Evaluation and Research.

Mary Malarkey, case-management director in the FDA’s compliance office, said the problem appeared limited to the Georgia and Tennessee Valley regions, even though Baxter bags are used across the country.

Baxter, a pioneer in making gear for collecting and storing blood for transfusions, makes its bags at a factory in Puerto Rico. An anti-clotting agent is added to the bags before they are delivered to blood-collection agencies.

As the investigation moved forward Monday, the Red Cross in Tennessee extended the hours of blood drives and began receiving shipments from other regions to replenish its stockpile, which by morning had dwindled to a one-day supply. By afternoon, the number of donors in Nashville was well above normal, and Red Cross officials expressed hope that their inventory could be restored within a week.

Officials at several large hospitals in Nashville said their previous blood supplies, along with the shipments from other states, would allow them to operate normally for the time being. None reported canceling surgeries, but there was concern about the impact of a prolonged quarantine.

“Our concern is, will the Red Cross be able to meet their delivery requests in the next several days?” said Dr. Anne Neff, director of transfusion medicine at Vanderbilt University Medical Center in Nashville.

In Atlanta, doctors continued to postpone surgeries -- except for emergencies -- in which blood transfusions were likely to be needed. On Thursday, the Red Cross in Atlanta sent an alert to 140 hospitals in Georgia, plus some that it serves in South Carolina, urging them to hold off on nonemergency use of its blood.

“It has been a bit difficult,” said Dr. Steve Taylor, chief medical officer at Piedmont Hospital in Atlanta, where doctors have canceled more than 40 surgical procedures since Friday. The hospital was delaying nonemergency surgeries at least through today, Taylor said. He said the 70 to 80 units of usable blood on hand were adequate for emergencies, although new supplies were coming in.

“We’re still able to proceed with emergent cases,” he said.

Heart patient Gene Mullis was fast becoming a priority case. His scheduled quadruple-bypass operation at Piedmont was postponed Friday and again Monday. But Mullis’ doctor said the operation probably would go forward today.

“I never thought I’d be looking forward to it,” said the 54-year-old Mullis, who works for the Environmental Protection Agency in Atlanta. “It’s got to get done.”