
This case involves a woman who sustained serious injuries after being mistakenly attacked by a police dog. The woman was bitten in her left leg and was left with open wounds and a fractured ankle. Several weeks later, she developed osteomyelitis in her ankle. She was prescribed IV antibiotics for 6 weeks via a peripherally inserted central catheter (PICC) line. During the woman’s first week of treatment, the antibiotics were administered in the hospital with no complications. During this time, her blood work remained normal. She was then discharged home and instructed to self-administer the medication. The woman was to receive assistance from an infusion care facility and a home health nurse every few days. The day after her first home dosage, the woman’s blood was drawn and was again relatively normal. Her antibiotic level was 20.0 ug/mL, which was deemed high as per the LabCorps reference interval but was within the normal range for the hospital’s interval. Her blood was drawn again one week later, at which point her blood urea nitrogen (BUN) and Creatinine levels were abnormal. Her antibiotic level was also critically high. The woman had called the home health nurse and several days prior indicating that she had been vomiting but was told to continue using the medication. The pharmacy called the woman the next day to tell her to stop taking the medicine. However, the woman was never instructed to go to the hospital. Two days later, the woman’s blood was drawn and her lab values were dangerously high. She was sent to the hospital and diagnosed with acute renal failure. The woman required long-term dialysis treatment to recover.