Wednesday, January 6, 2016

How Would You Fake Lab Results?

I feel like I'm going to owe an apology to How to Get Away with Murder as this will be the second time I've called them out in the last couple of months for medical inaccuracies-- or let's just say my personal issues with some of the medical stuff they're floating out there.

You can see my first issue here.

One of the male characters in How to Get Away with Murder, Nate, has a wife who is terminally ill with cancer and wants help committing suicide. She first approaches Annalise Keating, the lead character and attorney to help her get her hands on some pills that will do the trick. And why wouldn't Annalise? She is after all sleeping with her husband.

Over the course of a couple episodes, Annalise does get her hand on some pills, actually gives them to the husband who then gives them to his wife who does commit suicide. Actually, it is a little unclear to me who gives her the pills but the husband is accused of murdering his ill wife.

Unfortunately for Nate, there's a district attorney who's been gunning for him and would like nothing more than to see him in jail. So, even though the wife has been cremated, there's some residual blood left over that she wants tested for the presence of this drug.

Nate approaches a sympathetic hospice nurse to switch out the blood samples so the drug doesn't show up.

Well, probably not very realistic and I'll tell you why.

Keep in mind the whole set up for this trade out is that the blood is already in the lab and the patient is deceased. This part of the scenario is actually plausible. Labs do hang onto specimens after patient's die for a number of reasons.

The first thing to know about labs is it's the one place nurses do not go. I've never been inside a lab-- except on a tour. There's generally a door where you can drop off specimens but you're generally not permitted to enter. So, how does this nurse gain access to the specimen to switch it out?

One, it's going to be odd for a nurse to be snooping around the lab. I mean, notably odd. That's something a lab tech is going to remember.

The other issue is the labeling of the specimen. Even if the nurse gained access to the lab, found the specimen, and was going to replace it (say with her own blood)-- she would need a new label back dated to the time of the "real" specimen. You can hand write out labels but this is very rarely done and I think would raise suspicion as well.

So, the only great way to switch out blood to keep the drug tainted blood from the lab is to do it at the time of collection. Someone draws blood from another person that they know has "clean" blood and puts the patient's label on it. Unfortunately, this isn't a possibility because the patient has died.

There is a way to work this scenario to have it be more realistic-- I just don't think this is the best way.

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