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Various toxicities: 24 case reports In a retrospective study of 31 medicolegal cases from 1 January 1994 to 31 December 2019 in South Korea, 24 patients [sexes not stated] were described [including two fetuses and a 6-month-old infant; ages of the remaining 21 patients not stated], of whom 22 patients developed multisystem toxicities, opioid use disorder due to abuse, masking of compartment syndrome or masking of small bowel perforation following medical malpractice (inappropriate drug choice, neglect of observation or prescribed overdose) or administration of fentanyl, ketorolac, morphine, nalbuphine, pentazocine, pethidine, remifentanil, sufentanil or tramadol. The remaining two patients developed fetal hypoxia following in-utero exposure of pethidine, tramadol or fentanyl [durations of treatments to reactions onsets not stated; not all routes, dosages and outcomes stated]. Of these, 22 patients received therapy with fentanyl via IV, transdermal (50 µg/hr) or unspecified route, pethidine, ketorolac, morphine, nalbuphine, pentazocine, remifentanil, sufentanil or tramadol for abdominal pain, postoperative pain, traumatic pain or while performing diagnostic tests. The mother of the remaining two patients received pethidine 25mg at intervals of more than two hours, tramadol or fentanyl for labour pain. One of these patients had underlying elevated intracranial pressure due to intracranial bleeding, and another patient had a history of pentazocine hypersensitivity. Following the administration of the aforementioned therapy, 22 of these patients developed anaphylaxis (n=1), respiratory depression (n=15), opioid use disorder due to abuse (n=1), decreased consciousness and hepatic encephalopathy (n=1), masking of compartment syndrome (n=1), masking of compartment syndrome and small bowel perforation (n=1), perforated diverticulitis and abdominal distention (n=1) or exacerbation increased intracranial pressure and respiratory depression (n=1). The remaining two patients developed fetal hypoxia following in-utero exposure of pethidine (n=1) and tramadol and fentanyl (n=1). Further, nine of these patients exhibited vegetative state (n=4), quadriplegia (n=3), opioids dependency (n=1) and permanent peroneal nerve paralysis due to delayed diagnosis of compartment syndrome (n=1). One patient with fetal hypoxia, developed neonatal ischemic encephalopathy after the birth. Thereafter, nine of these 24 patients died due to the side effects (n=7) and sudden cardiac death caused by severe arrhythmia (n=2) [aetiology not stated]. These side effects were initially thought to be due to medical malpractice. However, following the medicolegal judgement, the medical malpractice in the form of inappropriate drug choice, neglect of observation or prescribed overdose was confirmed in 13 patients, and the medical malpractice was ruled out in the remaining patients. Kim J, et al. Medicolegal consideration to prevent medical malpractice regarding opioid administration: An analysis of judicial opinion in South Korea. Journal of Pain 8034970