## Facts

- During Minnesota National Guard basic training at Fort Benning, Georgia, D.B.S. required emergency surgery at Martin Army Community Hospital in August 1983 and received blood transfusions.
- In 1983, no HIV test existed; blood-supply protections depended on donor education and voluntary self-deferral rather than definitive laboratory screening.
- In April 1983, the Military Blood Program Office (MBPO)—responsible for military blood-bank policy—adopted FDA/AABB donor-screening recommendations for military use.
- D.B.S. later married N.A.S.; they had children including C.R.S. (born 1987).
- In early 1989, D.B.S., N.A.S., and C.R.S. tested HIV-positive; later testing identified at least one donor whose blood had been used in D.B.S.’s transfusions as HIV-positive.
- Plaintiffs sued the United States under the FTCA alleging negligence in (1) adopting and applying donor-screening measures and (2) failing to identify and notify transfusion recipients under 1986 Army Surgeon General guidance labeling certain recipients as high-risk and directing notification.
- The district court granted summary judgment for the United States on the ground that the discretionary-function exception barred the claims.

## Issues

1. Whether decisions about donor-screening measures for the military blood supply involved judgment or choice rather than violation of specific, mandatory directives.
2. Whether those screening decisions were grounded in policy considerations protected by the FTCA discretionary-function exception.
3. Whether the Army’s implementation of 1986 high-risk identification and notification guidance was discretionary and policy-based, or instead mandated by specific, enforceable requirements.

## Decision

- The court of appeals affirmed summary judgment for the United States.
- The court held that MBPO’s choice to adopt the FDA/AABB screening recommendations involved discretionary, policy-based judgments shielded by 28 U.S.C. § 2680(a).
- The court held that the 1986 notification guidance lacked specific, mandatory instructions on how or when to notify, leaving discretionary implementation decisions protected by § 2680(a).
- Because the challenged conduct fell within the discretionary-function exception, the FTCA waiver of sovereign immunity did not apply and the court lacked subject-matter jurisdiction over the claims.

## Legal Principles

- Under the FTCA, the discretionary-function exception bars claims based on acts or omissions involving (1) judgment or choice and (2) judgments of the kind grounded in social, economic, or political policy.
- Government conduct is not discretionary when a statute, regulation, or directive specifically prescribes a mandatory course of action; absent such a mandate, officials retain discretion.
- Policy-laden medical and administrative choices—such as balancing public-health risk, feasibility, costs, logistics, and resource allocation—are the type of decisions the exception protects, even if allegedly negligent.
- A directive that states an objective (e.g., “identify and notify”) without prescribing concrete methods, timing, or procedures generally leaves implementation to discretion and remains within § 2680(a).

## Conclusion

The Eighth Circuit concluded that both the military’s 1983 blood-screening policy choices and its later implementation of transfusion-recipient notification guidance required discretionary policy judgments and were therefore barred by the FTCA discretionary-function exception, warranting affirmance of summary judgment for the United States.


C.R.S. v. United States, 11 F.3d 791 (8th Cir. 1993)