Expert: Ronald Levy, M.D. - 12/17/2007

Question
hi. i couldn't find an expert in this area. a large bruise has developed after my blood count. it is quite painful and i've had it for 4 days since the blood count. also, i noticed the procedure caused me more discomfort and pain than usual. i've never experienced any bruising after a blood count before. what does it indicate? is this malpractice?

Answer
I assume you mean that you had your blood drawn for a lab test. The most likely casue of this is that you didn't hold pressure on the needle site so a small hematoma formed. This is not usually (but can be) painful. As the hematoma absorbs (and spreads out through the subcutaneous tissue) you get a large mottled bruise that is any color from green to purple. This will go away within a week. The best way to prevent this is, instead of the nurse putting a gauze in your elbow and having you bend it, compress the gauze against your elbow crease and hold your arm over your head for 3 minutes. You will not have a bruise.

This is certainly not malpractice. Even if you were stuck multiple times (or even if they hit the artery by accident), it would not be malpractice. For malpractice to occur three things must happen. 1) There MUST be a deviation from the standard of care, 2) the act must be the proximate cause of the injury and there must be a long term injury. Your case does not seem to meet any of these requirements. Complications or bad outcomes do not necessarily mean malpractice.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston