Dear Hospital Colleague:

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2008-03-17 Dear Hospital Colleague: As recently communicated, Canadian Blood Services in St. John s is preparing for Buffy Coat blood component production method implementation in August 2008. Buffy Coat technology allows bacterial detection as well as increased efficiency and quality in production of platelet components. We ask that hospitals take proactive steps with us now to ensure a smooth transition to our new Buffy Coat product line featuring bags by MacoPharma and. Canadian Blood Services in St. John s will be distributing MacoPharma/ storage containers for red cell and plasma components and storage containers for the pooled platelets. In compliance with international standards, the new blood bags require a different port design which has a different method of accessing the port and require a specific ¼ turn spiking technique for insertion/removal. Due to these two changes, some hospitals in other provinces have identified increased difficulty during insertion and/or removal of some transfusion sets or transfer sets. Transfusion and transfer sets typically used in Canadian hospitals have been evaluated for serviceability with the new and MacoPharma storage containers. Tables 1 through 3 (Attached 1) summarize two independent transfusion set studies and one transfer set study. The full reports may be obtained from www.transfusionmedicine.ca. Please take a moment to determine if your in-house transfusion set and transfer sets will provide you with your desired level of serviceability. If necessary, we encourage you to follow-up with your supplier for available alternatives. There have been no reported problems spiking the new platelet pool bag from and it therefore was not included in any spiking studies. Hospitals will need to evaluate the spiking technique that is currently used by nurses, physicians and laboratory staff. The use of the ¼ turn technique is essential with the new port design and hospitals using an alternate spiking method need to determine how best to disseminate this change of technique. Samples of the new red cell storage bags (Enclosed) along with an instruction leaflet, Procedure for Spiking New Buffy Coat Bags (Attached 2) advising you how to use the bags will enable you to evaluate your in-house transfusion set and transfer set if it does not appear in the attached tables. The bags should also be handy visual aid for Transfusionists to better understand impending changes and to assess the need for training. 1

Please share this letter and the accompanying materials with the relevant user community in your facility and have them complete the assessment and short survey (Attached 3). If you have any additional questions, or would like to receive further information please contact you local Hospital Liaison Specialist, Cheryl Doncaster at 902-474-8291 who will be happy to discuss these matters further. The completed questionnaire should be returned to your Hospital Liaison Specialist no later than the week of April 7 th, 2008. Sincerely, Michelle Rogerson Director, Product and Hospital Services Dr. Karl Misik Medical Director Enclosures: (i) Bag survey (ii) Procedure for Spiking New Buffy Coat Blood Bags Poster (iii) MacoPharma/ sample bags Cc: John Rumboldt, PT Representative Marilyn Collins, Manager, Provincial Blood Coordinating Program John Collins, Production Manager, CBS 2

Table 1. Summary of Canadian Blood Services Study Transfusion Compatibility between transfusion sets and bags were rated: very difficult, difficult, easy and very easy. Results including a rating of very difficult are marked as not serviceable. JC7627, JC7623 Smiths Industries, D-50 Smiths Industries, D-100 Smiths Industries, DI-50 Cardinal Health (Alaris) 79980E Cardinal Health (Alaris) 28080E Terumo TY*A2005020 Hospira (formerly Abbott) F668-12, 11994, 11994-48 Arizant (Ranger) 24360 BBraun NF5145 Deltec 21-0425-01 tested Pall SQ40S filter Pall SQ40SE filter tested * All MacoPharma bags used in Canada are of the modified port design. 3

Table 2. Summary of British Columbia s Provincial Blood Coordinating Office Study Transfusion Combinations of bags and transfusion sets were rated for serviceability. Combinations that were not shown to be serviceable are marked in grey. Straight (large filter) tested JC7781 Straight (small filter) tested JC2038 tested Y-type JC6720, JC6392 JC8723 (ISO Y-type) Smiths Industries, D-50 Smith Industries, DI-50 Smiths Industries, D-100 Ranger (Arizant)Y type Hospira (Abbott) Y-type tested 12435001 Hospira (Abbott) Straight 03039001 Pall SQ-40SE filter tested *All MacoPharma bags used in Canada are of the modified port design. 4

Table 3. Summary of Canadian Blood Services Study Transfer Compatibility between transfer sets and bags were rated from very difficult, difficult, easy and very easy. Results including a rating of very difficult are marked as not serviceable., 4R2243 4R2014 Medical Systems, TR-01 Pall, 732-32M Codan, B325 Hospira, 50-1933-R2-8/02, piercing pin, vented Hospira, 50-1933-R2-8/02, piercing pin, non-vented * All MacoPharma bags used in Canada are of the modified port design. 5