Forensic and Legal Blood Draws

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Course Objectives
  1. Define forensic and legal blood draws and their unique requirements.
  2. Explain chain of custody protocols that ensure sample integrity.
  3. Recognize ethical considerations in DNA and genetic collection.
  4. Apply proper procedures in both hospital and mobile phlebotomy settings.

Course Content
Course Creator: Nichelle Volker RMA
Total CE Hours: 1 Credit Hour 
Pace Course #: 586-2416-25


Key terms
  1. Chain of Custody
  2. Implied Consent
  3. Informed Consent 
  4. Judicial Consent
  5. Forensic Blood Draw
  6. Evidentiary Sample
  7. Genetic Privacy
  8. Legal Liability

Outline:
  • Introduction
  • Phlebotomist’s Responsibility in Forensic Draws
    • Impartiality and neutrality
    •  Accuracy in collection, labeling, and documentation
    •  Evidence credibility in court
  •  Critical Errors & Their Consequences
    • Mislabeled samples
    •  Missing signatures or incomplete custody forms
    •  Compromised chain of custody
    •  Ethical violations of patient rights
  •  Legal Foundations
    • Implied consent laws
    •  Warrants for blood draws
    •  HIPAA exceptions in forensic cases
  •  Step-by-Step Protocol
    • Verify
      • Warrant, consent, court order
    •  Identify 
      • Confirm patient identity (2 valid forms)
    •  Document 
      • Date, time, case reference, phlebotomist ID
    •  Collect 
      • Proper equipment, non-alcohol skin prep, gray-top tubes
    •  Label 
      • Full name, DOB, time, initials
    •  Seal & Sign
      • Tamper-proof seals, chain-of-custody forms completed
    •  Transfer 
      • Secure transport, every handoff documented
  •  Mobile Forensic Phlebotomy
    • Role and settings (jails, checkpoints, mobile units)
    •  Benefits (faster evidence, stronger custody)
    •  Challenges (safety, neutrality, quality control)
    •  Law enforcement phlebotomy programs
  •  Genetic Testing & DNA Collection
    • Difference between toxicology (what’s in the blood) and DNA (who it belongs to)
    •  DNA sources: blood, buccal swabs, hair, tissue
    •  Collection standards: PPE, sterile technique, sealing, custody
    •  Legal/ethical safeguards: HIPAA, GINA, informed consent
  •  Phlebotomist’s Role in DNA/Genetic Testing
    • Consent verification
    •  Proper collection (blood, swabs)
    •  Labeling, sealing, and custody documentation
    •  Maintaining neutrality and privacy
  •  Professionalism & Safety
    • PPE and biohazard disposal
    •  Neutrality in law enforcement settings
    •  Safety in volatile environments (roadside, jails, trauma bays)
    •  Golden Rule: “If it’s not documented, it didn’t happen.”
  •  Lesson Recap
 
References: 
  1. (2023, February 13). Chain of Custody. National Library Of Medicine. Retrieved August 14, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK551677
  2. (2023, May 1). Understanding The Collection And Analysis of Blood Samples In DUI Cases. Law Offices Of Cavanaugh & Cavanaugh. https://www.cavanaughattorneys.com/blog/2023/may/understanding-the-collection-and-analysis-of-blood
  3. (n.d.). How Common Are Forensic Lab Errors in Ohio Criminal Cases? Moermond & Mulligan, LLC. Retrieved August 14, 2025, from https://www.mmdefense.law/blog/how-common-are-forensic-lab-errors
  4.  Eaton, E. K. (2022). A Fundamental Guide To Phlebotomy (1st ed.). NHCO-National Healthcare Organization.
  5. (2019, October 15). Was the Salt Lake City cop who arrested a nurse over a blood draw just a 'fall guy'? Advisory Board. Retrieved August 14, 2025, from https://www.advisory.com/daily-briefing/2019/10/15/scapegoat
  6. (n.d.). INTERPRETATION OF IMPLIED CONSENT LAWS BY THE COURTS. Office Of Justice Virtual Law Library. Retrieved August 15, 2025, from https://www.ojp.gov/ncjrs/virtual-library/abstracts/interpretation-implied-consent-laws-courts
  7. (2024, April 10). Implied Consent Law in DUI Cases. Eisner Gorin LLP State & Federal Criminal Defense. Retrieved August 15, 2025, from https://www.egattorneys.com/implied-consent-law-california
  8.  (2024, November 4). Understanding Your Rights : Blood Draw Search Warrant In DUI. Meltzer & Bell, P.A. DUI & Criminal Trial Lawyers. Retrieved August 15, 2025, from https://www.meltzerandbell.com/news/understanding-your-rights-blood-draw-search-warrant-in-dui-cases
  9. (n.d.). Law Enforcement Phelbotomy Toolkit. National Highway & Traffic Safety Administration. Retrieved August 15, 2025, from https://www.nhtsa.gov/sites/nhtsa.gov/files/documents/14222-phlebotomy_toolkit_final-032819-v1a_tag_0.pdf
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  13. (2020, February 19). Maine Forensic Phlebotomy Program Guidelines. Maine Forensic Phlebotomy. Retrieved August 17, 2025, from https://www.maine.gov/dps/sites/maine.gov.dps/files/inline-files/MaineForensicPhlebotomyProgramGuidelinesRev.10-2020_0.pdf
  14. (2023, September 7). Toxicology Procedures Manuel. Department Of Forensic Science. Retrieved August 17, 2025, from https://dfs.virginia.gov/wp-content/uploads/220-D100-Toxicology-Procedures-Manual
  15. (2025, August 1). Case Guard. Chain of Custody: Why It Matters for Law Enforcement, Healthcare, and Government. Retrieved August 18, 2025, from https://caseguard.com/articles/what-is-chain-of-custody-and-how-businesses-can-use-it/
  16. (2025, August 1). Phlebotomist - Forensics. California Forensic Phlebotomy. Retrieved August 18, 2025, from https://www.californiaforensicphlebotomy.com/
  17. (2024, May 20). Law Enforcement Phlebotomy Programs. National Highway Traffice Safety Administration - Between The Lines. Retrieved August 18, 2025, from https://ndaa.org/wp-content/uploads/May-2024-Law-Enforcement-Phlebotomy-Programs-Dobbs-1.pdf
  18. (2022, November 1). Phlebotomists patrol with Las Vegas police. Fox5Vegas. Retrieved August 18, 2025, from https://www.fox5vegas.com/2022/11/01/phlebotomists-patrol-with-las-vegas-police-suspected-duis-lawyer-answers-questions-about-blood-drawing-process
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  21. (2025, August 24). Deoxyribonucleic Acid. National Human Genome Research Institute. Retrieved August 21, 2025, from https://www.genome.gov/genetics-glossary/Deoxyribonucleic-Acid-DNA#
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  31. Clayton, E. W., Evans, B. J., Hazel, J. W., & Rothstein, M. A. (2019). The law of genetic privacy: applications, implications, and limitations. Journal of law and the biosciences, 6(1), 1–36. https://doi.org/10.1093/jlb/lsz007
  32. (n.d.). The Genetic Information Nondiscrimination Act of 2008: "GINA". US Department Of Labor. Retrieved August 24, 2025, from https://www.dol.gov/agencies/oasam/centers-offices/civil-rights-center/statutes/genetic-information-nondiscrimination-act-of-2008
  33. (n.d.). What is informed consent? Medline Plus. Retrieved August 24, 2025, from https://medlineplus.gov/genetics/understanding/testing/informedconsent/
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