PT  - JOURNAL ARTICLE
AU  - Thomas Wesley Williamson
AU  - Kathleen M. Kenwright
AU  - Linda L. Williford Pifer
TI  - Post-analytical Error in Fatal Post-Cesarean Necrotizing Fasciitis and Sepsis: A Case Study
AID  - 10.29074/ascls.29.1.3
DP  - 2016 Jan 01
TA  - American Society for Clinical Laboratory Science
PG  - 3--8
VI  - 29
IP  - 1
4099  - http://hwmaint.clsjournal.ascls.org/content/29/1/3.short
4100  - http://hwmaint.clsjournal.ascls.org/content/29/1/3.full
SO  - Clin Lab Sci2016 Jan 01; 29
AB  - This is a case study of a 28 year old morbidly obese pregnant female with severe pre-eclampsia. She delivered at 32 weeks gestation by emergency cesarean section, and was discharged at three days post-surgery. The patient developed sepsis secondary to necrotizing fasciitis. She had been released from the hospital without her final complete blood count (CBC) having been reviewed by the attending physician, although it had been available for approximately 24 hours prior to her departure. The final CBC contained persuasive data suggesting that an adverse outcome could be highly probable. Discussion as to how this ultimately lethal post-analytic error might have been avoided, and perhaps prevented in the future is undertaken.ABBREVIATIONS: CBC - Complete Blood Count, C-section- Cesarean section, HELLP- Hemolysis Elevated Liver enzymes and Low Platelet count, NICU- Newborn Intensive Care Unit, NRBC nucleated red blood cells, Ob/Gyn - Obstetrician/Gynecologist,, TJC - The Joint Commission, WBC - White Blood Cells