Three years after an initial audit identified systemic problems at Jamaica’s National Blood Transfusion Service (commonly referred to as the Blood Bank), insiders and labor representatives are sounding the alarm that the dangerous gaps in operations have never been fixed — and have likely grown far worse, putting public health at severe risk.
A confidential 2023 internal audit conducted by Jamaica’s Ministry of Health and Wellness, obtained exclusively by the Jamaica Observer, lays bare dozens of high-risk failures across every core function of the Kingston-based facility. The audit, which assessed operations between March 2022 and March 2023 as part of the ministry’s routine annual risk-based oversight, examined everything from blood supply planning and donation processing to compliance with Caribbean regional health standards, record-keeping, and inventory management.
Auditors uncovered a cascade of critical violations that directly threaten patient safety. Among the most alarming findings: 79 blood donors who tested positive for infectious diseases had their results never marked on official processing records, meaning there was no clear tracking of which blood units should have been discarded. In another incident spanning three months in 2022, 995 bags of collected whole blood had no independent review of their processing records, and four contaminated units were only marked “Do not use” in pencil with no formal follow-up.
More than 900 whole blood units collected during that same period were not tested for pathogens within the mandatory 24-hour window after collection, with delays ranging from one to 10 days. Additional gaps included 1,027 blood request forms missing key details such as the requesting medical officer’s name, signature, registration number, and blood unit expiry date; 25 forms with incorrect laboratory identification numbers; and a poorly maintained inventory system with no evidence of required daily physical counts, leaving 246 daily inventory reports unsubmitted for review.
Sixty-seven blood units and components were released to clinical settings with no formal request on file, and informal telephone requests for blood were never logged. Form adjustments were made regularly with no documentation of which staff member made the changes. Records also showed a 386-unit discrepancy between the number of blood units logged as released and the number verified as released, with no explanation for the unaccounted for units.
On the administrative side, 22 out of 25 reviewed standard operating procedures (SOPs) had expired between April 2022 and March 2023. One core SOP for blood collection has remained stuck in draft form since 2018, 10 SOPs were never signed, reviewed, or approved by responsible leadership, and the facility has no active steering committee to guide organizational decision-making. The Blood Bank also failed to adhere to the Caribbean regional requirement that SOPs be reviewed annually, instead following an unscheduled three-year review cycle that violates regional standards.
Last week, frustrated Blood Bank workers spoke to the Observer on condition of anonymity, with others conveying their concerns through their trade union representative. Insiders said they decided to speak out after years of failed attempts to push leadership to address the gaps, with public frustration boiling over following a recent incident: an infant born with cancer reportedly contracted syphilis via a blood transfusion at Kingston’s Victoria Jubilee Hospital.
A senior Blood Bank source argued that persistent systemic flaws like those that led to the infant’s infection stem from unqualified personnel being placed in critical roles, particularly in the Quality Control Department. “Because of the lack of experience in the Quality Control Department, the Blood Bank started to struggle. They should have been implementing strong measures to ensure that the system functions at the highest level. What happens is that people are learning on the job,” the source explained.
The insider called for an independent special audit to assess whether any of the 2023 report’s serious flaws have been fixed, and to trace how many contaminated blood units may have already entered the public supply. “You may come to now find that by going back through all the documentation that you have more than one positive unit of blood that may have left the Blood Bank, and we need to find out how widespread the problem is,” the source added. “Somebody needs to be held accountable.”
Multiple attempts by the Observer to get official comment from Blood Bank leadership and Health and Wellness Minister Dr Christopher Tufton were unsuccessful. Tufton is scheduled to deliver his 2026/27 Sectoral Debate address to Jamaica’s House of Representatives the day after the Observer’s reporting.
St Patrice Ennis, general secretary of the Union of Technical, Administrative & Supervisory Personnel (UTASP), which represents Blood Bank employees, told the Observer that staff warnings about operational failures have been ignored for years. “For a prolonged period various members of staff have written complaints and expressed concerns about the operating procedures at the Blood Bank and had warned about the potential for the occurrence of this kind of situation,” Ennis said, referencing the infant’s syphilis infection.
Ennis said he is outraged by the incident, noting that no official has yet given public assurance that current blood testing and distribution processes are free of dangerous flaws. “While we may know of this incident, we can’t say with certainty that this is isolated. They [staff members] expressed that the procedures were not being followed and the warnings for the potential of such occurrence were ignored. These problems are solvable problems, and that is what makes it frustrating and makes one feel angry. These are problems that can be solved and not at any great expense,” Ennis said.
“We know what is to be done and it is just to hold people accountable. Until we start to do that we are going to have recurrences of problems and we are going to seem alarmed only when it reaches the public domain. We are not even sure if after that case which we are talking about, if proper measures have been put in place to correct it. This can affect any one of us,” he added.









