This case involves a 49-year-old male who presented to the hospital with an infected foot that resulted in the amputation of the toe. Imaging studies showed that the infection may have spread to the bone and osteomyelitis was a possible diagnosis. The patient was started on vancomycin and had a PICC line placed for the administration of the medication. Soon after the vancomycin was started the patient became dizzy, diaphoretic, short of breath, and complained of a burning sensation in his chest. A code was called and the patient was intubated and resuscitation efforts lasting approximately 40 minutes. Unfortunately, the patient remained in asystole despite all efforts with epinephrine, atropine and calcium gluconate. He was pronounced dead 5 days post admission with pulseless electrical activity/cardiac arrest. According to autopsy reports, the cause of death was ischemic cardiomyopathy in which there is significant left ventricular interstitial fibrosis. Contributing factors included pulmonary edema and early bronchopneumonia associated with an acute anaphylactic response.
Question(s) For Expert Witness
The issues are whether or not the allergic response should have been anticipated and whether or not the responses to the reaction were appropriate.
Expert Witness Response E-004703
Anaphylaxis is a medical emergency that may require resuscitation measures such as airway management, supplemental oxygen, large volumes of intravenous fluids, and close monitoring. Administration of epinephrine is the treatment of choice with antihistamines and steroids often used as adjuncts. A period of observation for between 2 and 24 hours is recommended for people once they have returned to normal due to concerns of biphasic anaphylaxis.
About the author
Michael Talve, CEO
Michael Talve stands at the forefront of legal innovation as the CEO and Managing Director of Expert Institute. Under his leadership, the Expert Institute has established itself as a vital player in the legal technology arena, revolutionizing how lawyers connect with world-class experts and access advanced legal technology. Michael's role involves not only steering the company's strategic direction but also ensuring the delivery of unparalleled intelligence and cutting-edge solutions to legal professionals. His work at Expert Institute has been instrumental in enhancing the capabilities of attorneys in case preparation and execution, making a significant impact on the legal industry's approach to expert consultation and technological integration. Michael's vision and execution have positioned the Expert Institute as a key facilitator in the intersection of law and technology.
