Inferences and Legal Considerations Following a Blood Collection Tube Recall

Area of Science:

• Forensic Science
• Clinical Chemistry

Background:

• A manufacturer recall in 2019 involved evacuated blood collection tubes missing sodium fluoride and potassium oxalate.
• This incident prompted concerns regarding its impact on forensic toxicology, particularly for blood-alcohol concentration (BAC) interpretation and drug stability.

Purpose of the Study:

• To evaluate the implications of the recalled blood collection tubes on forensic analysis.
• To review the literature on the stability of ethanol in blood samples and the role of sodium fluoride.

Main Methods:

• Literature review of current practices and ethanol stability in stored blood samples.
• Analysis of potential issues arising from the absence of anticoagulant and preservative in blood samples.

Main Results:

• The absence of an anticoagulant (potassium oxalate) would lead to immediate clot formation, making sample preparation impossible.
• The stability of certain drugs like cocaine and 6-acetylmorphine is compromised without an enzyme inhibitor (sodium fluoride).
• Current literature lacks a clear consensus on the required amount of sodium fluoride for preserving ethanol stability in forensic blood samples from living subjects.

Conclusions:

• While the absence of anticoagulant is readily detectable, the impact of missing sodium fluoride on ethanol stability in forensic samples requires further clarification.
• The findings highlight potential analytical challenges and the need for standardized protocols in forensic blood sample collection and analysis.