Blood Money

Michael Piquion, a shy thirteen-year-old with a soft smile and eyes that dart timidly from strangers, sits in a Jackson Memorial Hospital room with walls decorated in pastels, polka dots, and Rugrats characters. With his left hand he grips a crimson cord connected to a plastic bag overhead that contains a pint of the blood that keeps him alive.

Michael isn't the kind of kid you'd imagine God would pick to punish. But he has been selected in some horrible genetic lottery to suffer from sickle cell anemia, a disease that has stolen his childhood and may kill him before he can have kids of his own. He doesn't dwell on it, though he wishes he could at least play in gym class or ride bikes after school. "I don't know why I have it," he says. "I know there's a lot of people with sickle cell, so I know it's not just me."

Every three weeks doctors replace a third of his blood to remove some of the crescent-shaped cells that were willed to him by his parents, who don't have the disease but carry the recessive gene. The sickle cells, which may have developed eons ago in humans as a response to malaria, can clog like a traffic jam when Michael is exercising. Such backups can kill him instantly or cause a stroke that would leave him a vegetable. He's nearly died twice already, but ambulances rushed him from his home in North Miami, veins in his head bulging like swollen river deltas and his face turning blue.

Michael's mom, Daniella, remembers watching him writhe in pain the first time. He was just three months old. "It was so sad to see," she says as she curls up on a recliner waiting for the transfusion to finish. "But you can touch him and see him. He's the same as other boys without this thing."

It's important to think of Michael when you learn about how the blood got to his hospital room. It's easy to forget about the people whose lives depend on the open veins of others when you delve into the nasty business of blood-banking in South Florida.

South Florida Blood Banks, the West Palm Beach-based nonprofit charity that supplied the blood to Jackson Memorial, has become a significant force in the regional blood trade recently, at least partially by employing corporate thievery, unseemly tactics to secure donors, and questionable accounting practices that seem more fit for Wall Street than Mercy Street.

Thanks to the population boom here and the ever-growing health care industry, the blood-supply business has doubled in South Florida in just the last three years. The blood banks now pull in a healthy profit and can afford to pay their top executives salaries in excess of a quarter-million dollars. If it hasn't already, South Florida Blood Banks is poised to become the leader in the blood trade from Miami to Port St. Lucie. The West Palm firm has successfully undercut its main competitor, Lauderhill-based Community Blood Centers of South Florida.

Though once allies, the two companies are preparing to make aggressive forays into each others' territories by opening new, multimillion-dollar collection and processing centers. The moves will escalate the tension between the two, which has already resulted in more than a half-dozen lawsuits and constant bickering over contracts to draw blood during the past decade.

While the U.S. Food and Drug Administration monitors the safety of blood banks, no government agency is charged specifically with overseeing the ways they secure deals to supply hospitals and recruit donors.

Dr. Charles Rouault, president of Community Blood Centers, says competition is inevitable, even among charities. "It's money. There's a great deal of it in blood-banking," he comments candidly. "Whenever money changes hands, there's going to be competition, whether it's prostitution, the business world, or charities."

On a recent Friday afternoon at Community Blood Centers, Rouault sipped a Coke from a crooked straw as his blood seeped from a needle in his arm, through a clear tube, and into a plastic bag hung below him. Wearing scuffed loafers and an oxford shirt with a rip below the armpit, the bespectacled and bald physician at first doesn't stand out among the donors in the blood bank's main building in Lauderhill. But when you look closer, you see scar tissue in the crook of his left arm that has built up from years of donating every two months. Like most repeat donors, he can no longer feel the needle entering his body.

When Rouault finishes and the needle is removed, technicians will drop the bag containing his blood into a device the size of a washing machine that will spin it at 2200 revolutions a minute for twenty minutes. Each part of the blood -- plasma, red blood cells, and platelets -- has a different mass, so the gravitational force will separate them into layers. Technicians will then squeeze the three components of Rouault's blood into separate containers. After the samples are tested for AIDS and other blood-borne diseases, bags full of the separate parts will be sent, likely within 72 hours, to hospitals that have requested new supplies. Pints fetch as much as $200.

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Eric Barton
Contact: Eric Barton

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