LAUSR

A 26-year-old, never-transfused, B Rhfemale had an uncomplicated first pregnancy and delivered a healthy B Rh + infant via cesarean. The patient moved to a different state during her second pregnancy, and the patient's and infant's medical records were printed and faxed to her new obstetrician's practice. Her physician noted cord blood results with a positive direct antiglobulin test (DAT) and apparent anti-E antibodies designated as “(E*)” (Figure 1). The patient was assigned a new diagnosis of anti-E alloimmunization and referred to the maternal-fetal medicine service. The antibody screen performed after this diagnosis was negative, and the transfusion medicine physician was consulted. Poor optical resolution of the scanned facsimile raised suspicion for documentation error. The pathologist called the outside hospital and confirmed the patient received Rh immune globulin (RhIg) administration at 28 weeks' gestation and had only passive anti-D antibodies detected at the time of delivery. The cord blood had a positive DAT, which the outside hospital flags with an “(H*)” for a high/critical result (Figure 1). Since the positive DAT was presumed