{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T04:36:35Z","timestamp":1768624595496,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,7,15]],"date-time":"2019-07-15T00:00:00Z","timestamp":1563148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Aims\/Objectives<\/jats:title><jats:p>To review if ABO\/D grouping errors are more likely to occur with manual intervention compared to automation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Human errors in manual pre\u2010transfusion testing may result in ABO\/D\u2010incompatible transfusions and catastrophic outcomes. Accurate ABO\/D grouping is a critical part of pre\u2010transfusion testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective analysis of reports made to Serious Hazards of Transfusion (SHOT) between January 2004 and December 2016 where ABO\/D grouping errors led to the transfusion of an incorrect blood component to review if errors are more likely to occur with manual intervention compared to automation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 148 of 158 (93%) ABO\/D grouping errors, manual intervention took place. In the remaining 10, causes were not reported. No errors occurred with full automation. Interpretation errors occurred in 86 of 148 (58%) and 42 of 148 (28%) transcription errors, and in 20 of 148, wrong or no samples were selected. Of 148 errors, 21 (14%) resulted in ABO\u2010incompatible transfusion, with one death in 2004 due to an interpretation error in a manual ABO group. In 30 of 148 (20%), D\u2010positive red cells were given to D\u2010negative recipients, where three women of child\u2010bearing potential became sensitised and developed anti\u2010D. ABO grouping errors have reduced from 18 of 539 (3%) of total reports analysed in 2004 (3\u00b73%) to 3 of 3091 (0\u00b710%) in 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Where manual testing cannot be avoided, results should be confirmed using automated techniques as soon as possible, and a back\u2010up process should be available 24\/7. SHOT data confirm that manual interventions are prone to human error, especially in transcription and interpretation, and demonstrate a continuing need for appropriate serological knowledge and understanding by transfusion laboratory staff to underpin safety provided by automation and information technology (IT).<\/jats:p><\/jats:sec>","DOI":"10.1111\/tme.12616","type":"journal-article","created":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T02:49:37Z","timestamp":1563245377000},"page":"262-267","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Human errors in manual techniques for ABO\/D grouping are associated with potentially lethal outcomes"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2114-7031","authenticated-orcid":false,"given":"H.","family":"Mistry","sequence":"first","affiliation":[{"name":"Serious Hazards of Transfusion Office  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Poles","sequence":"additional","affiliation":[{"name":"Serious Hazards of Transfusion Office  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Watt","sequence":"additional","affiliation":[{"name":"Serious Hazards of Transfusion Office  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6751-7862","authenticated-orcid":false,"given":"P. H. B.","family":"Bolton\u2010Maggs","sequence":"additional","affiliation":[{"name":"Serious Hazards of Transfusion Office  Manchester UK"},{"name":"Pathology Department, University of Manchester  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the SHOT Steering Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,15]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Blood Safety and Quality Regulations(BSQR) SI 2005\/50 as amended2005. URLhttp:\/\/www.legislation.gov.uk\/uksi\/2005\/50\/pdfs\/uksi_20050050_en.pdf(Accessed 10\/5\/19)."},{"key":"e_1_2_7_3_1","unstructured":"Bolton\u2010Maggs P.H.B. Poles D.et al. Serious Hazards of Transfusion (SHOT) Steering Group (2015a)The 2014 Annual SHOT Report. 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