When asked what a Phlebotomist does, some people may believe they just draw blood. However, a deeper look into this exciting career reveals there are many interesting facets to Phlebotomy not often considered by those outside the field. There are particular instances when Phlebotomy is used to uphold the law.
Consider the following:
A woman stumbles into the Emergency Department. She complains of arm and leg pain. During triage, the nurse notes the smell of alcohol on the woman’s breath. After triage, she is placed in a wheelchair and taken to a room to be seen by the Emergency Department Physician.
Suddenly, an ambulance pulls into the Emergency bay, transporting two victims of a car accident. Highway Patrol officers soon follow. The passenger is taken directly to surgery. Once stabilized, the driver begins to speak with the officers. He says he and his wife were struck by a red car which ran a light. The car then left the scene.
Meanwhile, the Physician begins seeing other patients. After examining the woman who smelled of alcohol, he asks how she hurt her arm and leg. She says she can’t exactly remember but thinks her brand new car may have struck a tree. Her car is red.
Unfortunately, this occurs regularly. Drinking and driving killed 37,261 people in 2008. Someone is killed in a drunk-driving crash every 45 minutes in the United States alone.
In this particular case, a possible hit-and run accident has occurred. Both occupants of the car have been injured, one severely. The Highway Patrol officers conduct an investigation and determine there is enough evidence to lead them to believe the woman may have been under the influence while driving. The woman is subsequently arrested. Based on probable cause, the Highway Patrol then requests the medical staff to draw the woman’s blood to determine her blood alcohol level. Referred to as DUI or DWI, it is a crime in all 50 states to drive with a blood alcohol level of 0.08 or higher.
The blood alcohol concentration, or BAC, level can be determined by breath, urine, saliva or blood collection. Blood collection is the most reliable test. Blood alcohol testing, as well as urine, is often ordered to confirm positive breathalyzer results
It is very important to determine the blood alcohol level in a timely fashion. Blood is absorbed into the body in what can be described as a curve. After consuming, the blood alcohol level rises. Usually the highest BAC (alcohol content) level is within thirty minutes of drinking, although this can stretch to sixty minutes Generally the higher concentration of the drink, the faster it is absorbed. If too much time elapses, the body begins to absorb the alcohol, dropping the level. A timely draw ensures the most accurate depiction of the actual blood alcohol level at the time of impact. Known as a plateau, if the rate of absorption is equal to the rate of elimination, the blood alcohol level can remain the same for up to two hours.
If the woman refuses to submit to testing, forty-one states have Administrative License Suspension laws. This allows a suspected drunk drivers’ license to be removed if they fail or refuse to take a chemical test.
Each state has its own Implied Consent Laws. This determines who can collect a suspected drunk drivers’ blood, and in what manner. Normally, Phlebotomists are among the qualified personnel, and blood draws usually have to occur in a hospital setting.
There are strict procedures that must be followed during the blood collection process. Should results be needed in a court of law, it is important to maintain a proper chain of custody. Once the blood sample has been collected, a document must be signed and dated, as well as the receipt time. This places someone in charge of the blood sample, and any time the sample changes hands proper documents must be signed and dated. There are also strict procedures on where the blood can be kept as well as how it is to be stored during transport. If procedure is not followed or if a chain of custody is broken, the evidence could be considered non-admissible in a court of law.
The prosecution must be able to prove:
The person that drew the blood
The person that drew the blood was qualified to do so
When the blood was drawn, and what time it was drawn
The circumstances under which the blood was obtained
The Technician or Technologist in the Lab who analyzed
The qualifications of the person who analyzed the blood
That the sample was accounted for during the testing period
That the machines on which it was tested were properly maintained and calibrated
That the method of testing was considered acceptable in the field
That the sample was preserved before testing and after
By carefully following procedure as well as chain of custody during the collection process, the Phlebotomist provides accurate results that may be used as evidence in a Court of Law. This allows the State to fully prosecute those who have broken the law.
There are many situations where legal testing may be needed. The results may be used in cases where alcohol or drugs may have played a role in a fatal car crash. Insurance companies may use the results as part of a life insurance application. A person’s parole may be revoked and they may be sent back to prison, if results determine drug use. As part of a random drug test, or a ‘with cause’ drug test, an Employer may terminate a worker whose test results indicate drug use. Even in death, results can determine if alcohol or drugs were involved.