"Same Problem, Different County" read the headlines in Saturday's Warren Times Observer (8-24-2014), however the source of the problem may not be the same as proclaimed by the Somerset County district attorney, Ms. Lazzari-Strasiser. She said, "It's the prosecution's responsibility to make sure that the levels are correct. If this is the case, prescribing clinicians everywhere had better beware!
Ms. Lazzari-Strasiser is correct. The police have done nothing wrong. In Pennsylvania, a law enforcement officer has the legal authority to request (order) a blood alcohol level be drawn from any driver of a motor vehicle where there are grounds to believe he/she may be under the influence of alcohol. The only other individuals who have the authority to order lab tests in Pennsylvania are certain licensed healthcare professionals: physicians, nurse practitioners and physician assistants. Before my retirement from the VA, I was one of those prescribing clinicians. I am very interested in knowing when the legal decision was made that hospital labs are no longer responsible for providing accurate test results for the lab procedures requested by authorized individuals.
In the case of the blood alcohol levels used by the district attorneys in Warren and Somerset Counties as evidence to prosecute individuals for driving under the influence of alcohol, the lab tests were discovered to be invalid for use because the necessary conversion formula was not applied to the blood serum level which would give serum alcohol concentration (SAC) equivalency to a blood alcohol concentration (BAC). Let's take a closer look at this....
The law enforcement officers in, at least the Warren County cases, requested a blood alcohol level (BAC) be drawn by the Warren General Hospital (WGH) lab from the drivers suspected of driving under the influence (DUI) of alcohol. WGH lab did not indicate to the officer that a BAC would not be done nor did anyone in the lab ask the officer to change the request to a SAC which was, in retrospect, the procedure they were actually going to do. This in itself is not problematic since either whole blood or plasma (serum), if a conversion formula is applied, is generally accepted by Pennsylvania courts. The lab report received by the district attorney's office appeared to indicate that the requested BAC had been done. As it turns out, a BAC was not done by the lab, and by not informing the officer otherwise and by not labeling the lab results as an SAC, it gave every indication it had been.
If the declaration that prosecutors (and by inference, all clinical users of lab results) are responsible the validity of those tests results, are prescribing clinicians anywhere safe from a negligence lawsuit if they use them without questioning them?