A 55-year-old female was transported to the floor after recovering from a surgical procedure. An epidural catheter with morphine was placed for post-operative pain control. Upon arrival, the patient complained of nausea and a headache prompting the on-call physician to prescribe, “Demerol 75mg every three hours for pain.” The preprinted medication orders from anesthesia stated “No narcotics, sedatives, or other respiratory depressants to be given during infusion of epidural medication and for 12 hours after epidural is discontinued except by order of anesthesia.” The nurse had not reviewed this order prior to obtaining and administering the new order for Demerol, a narcotic. Twenty minutes later, the patient was found unresponsive and aggressive resuscitation efforts were implemented, resulting in intubation and mechanical ventilation of the patient. When brain activity was not found, the family made the decision to take the patient off of life support and the patient died shortly thereafter. The patient’s family filed a lawsuit claiming negligence in administering the medication. A verdict was entered against the nurse for nearly $4 million.   What lessons did you learn from the case scenario and what were the problems in the scenario that should have been avoided?

Principles Of Pharmacology Med Assist
6th Edition
ISBN:9781337512442
Author:RICE
Publisher:RICE
Chapter9: The Medication Order
Section: Chapter Questions
Problem 19RQ
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A 55-year-old female was transported to the floor after recovering from a surgical procedure. An epidural catheter with morphine was placed for post-operative pain control. Upon arrival, the patient complained of nausea and a headache prompting the on-call physician to prescribe, “Demerol 75mg every three hours for pain.” The preprinted medication orders from anesthesia stated “No narcotics, sedatives, or other respiratory depressants to be given during infusion of epidural medication and for 12 hours after epidural is discontinued except by order of anesthesia.” The nurse had not reviewed this order prior to obtaining and administering the new order for Demerol, a narcotic. Twenty minutes later, the patient was found unresponsive and aggressive resuscitation efforts were implemented, resulting in intubation and mechanical ventilation of the patient. When brain activity was not found, the family made the decision to take the patient off of life support and the patient died shortly thereafter. The patient’s family filed a lawsuit claiming negligence in administering the medication. A verdict was entered against the nurse for nearly $4 million.

 

  1. What lessons did you learn from the case scenario and what were the problems in the scenario that should have been avoided?
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