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Young Mom Wins Settlement in Dosing Error Case

A patient expects to receive the highest care when checking into a hospital, whether it’s to the emergency room for an injury or to labor and delivery for the birth of a child.

A patient does not expect to receive substandard care from medical residents who are being trained in their profession. They do not expect to experience medication dosing errors that can be life altering and even fatal.

Due to a dosing error by an anesthesia resident, a young mother who had just given birth now requires lifelong monitoring for cardiac-related complications.

The 30-year-old patient, with a history of neurocardiogenic syncope or fainting, delivered a healthy infant via elective cesarean section.

After the delivery, the staff anesthesiologist exited the room and left an anesthesia resident to care for the patient.

When the patient’s blood pressure began to drop, the resident decided to administer ephedrine to restore blood pressure. She could not find the ephedrine, so she decided to use neosynephrine, choosing a dose of 500mg (10 times the usual dose) without diluting it.

After receiving the medication, the patient experienced hypertension or high blood pressure, tachycardia or rapid heart beat, and pulmonary edema, a buildup of fluid in the lungs that can lead to heart failure. She was transferred to the intensive care unit for an extended stay and requires lifelong monitoring for cardiac-related complications.

The patient filed a malpractice claim against the anesthesiology resident. The claim was settled for nearly $500,000.

Attending physicians need to know the limitations of the residents they are supervising to ensure that they do not put a resident in an overly vulnerable position, or a patient at risk. Does the resident know what is expected in a given situation and does he or she demonstrate the skill of knowing when to ask for help or confirmation? In this case, the resident did not ask for help before administering the wrong dosage of medication.

The two medications mentioned in this case are in the same therapeutic class and can be used to treat similar conditions, but their doses are significantly different. In this case, it was the dosing that was in error.

To prevent this type of error, medical institutions should :

• Limit the number of medications in the same therapeutic classes
• Ensure that all clinicians in a position to handle those similar medications are trained regarding various dose ranges
• List accepted doses of medication on the packages
• Have another trained health care provider serve as double check.



For more on patient safety, see the library of articles by Daytona Beach medical malpractice attorney.




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