Unit 4: Forensic Phlebotomy

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Course Objectives
Define forensic and legal blood draws and their unique requirements.
Explain chain of custody protocols that ensure sample integrity.
Recognize ethical considerations in DNA and genetic collection.
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 #: 586-2604-26


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
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  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
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  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
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