Inferences and Legal Considerations Following a Blood Collection Tube Recall.


Rodda LN(1)(2), Pearring S(1), Harper CE(3), Tiscione NB(4), Jones AW(5).
Author information:
(1)Forensic Laboratory Division, Office of the Chief Medical Examiner, 1 Newhall St, San Francisco, CA 94124, USA.
(2)Department of Laboratory Medicine, University of California, San Francisco, CA 94143, USA.
(3)Alabama Department of Forensic Sciences, 2026 Valleydale Rd, Hoover, AL 35244, USA.
(4)Palm Beach County Sheriff's Office, West Palm Beach, FL 33406, USA.
(5)Division of Drug Research, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85 Linköping, Sweden.


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.