Delayed Clonazepam Administration Results in Seizure

Case Overview

This case study delves into a situation involving a 28-year-old individual with a past medical history (PMH) of epilepsy, who was treated with clonazepam. The patient experienced a significant delay in receiving their medication, leading to a severe seizure and permanent brain injury.

This case raises critical questions about emergency departments’ standard of care when dealing with epileptic patients. It also raises questions about whether any deviation from these standards contributed to the patient’s condition.

Questions to the expert and their responses

Can you describe your experience evaluating and treating epilepsy patients on medications such as clonazepam?

As an emergency physician with thirty years’ experience, I’ve encountered numerous cases involving epilepsy patients. It’s worth noting that clonazepam is not typically used as a primary antiepileptic drug due to its high incidence of side effects and potential tolerance.

However, it’s crucial to review the patient’s records to understand why this was the chosen treatment.

What policies are in place for emergency departments to treat epileptic patients promptly?

Emergency departments should have robust protocols for treating epileptic patients at all times. Status epilepticus, which is a prolonged seizure, an acute, life-threatening medical condition requiring immediate therapy. Any delay in administering benzodiazepines would be considered a deviation from the standard of care.

About the expert

This expert is a seasoned professional in emergency and family medicine with over 30 years of experience. They are board-certified in family medicine, an active member of the Association of Emergency Physicians and the American Academy of Family Physicians, and currently serve as an attending physician in the emergency department at a VA medical center. Their extensive background includes roles as a medical director of emergency transport, an emergency department physician at various hospitals, and an assistant clinical professor of family medicine at a renowned university.