Administering a medication a patient is documented to be allergic to is one of the most preventable errors in medicine, because the allergy is recorded specifically to stop that from happening. When a patient’s allergy to a medication is known and recorded, the standard of care is straightforward: do not give that medication and use a safe alternative. The warning is supposed to exist at every level, in the chart, in the pharmacy systems, and in the awareness of the treating team.
A patient who receives medication they are allergic to can suffer an immune system overreaction that ranges from mild skin irritation to life-threatening emergencies. The immediate medical steps are to stop the medication, administer the correct treatment, and closely monitor vital signs, and update patient’s chart to prevent future exposure.
In this case, our client was given medication that caused her to have a severe reaction months earlier. When she reacted again, the clinic staff failed to treat her properly and failed to call for emergency help. She never regained consciousness and died about two weeks later.
The Townsley Law Firm represented her family and recovered a settlement of over $275,000.
A Prior Allergic Reaction Is a Warning That Must Be Heeded
Several months before her death, our client suffered an anaphylactic reaction at her primary care clinic after receiving a DuoNeb breathing treatment and intravenous Solu-Medrol. The clinic’s own records showed that reaction. Yet the staff never properly updated her medical record to flag the allergy.
That failure set the stage for what followed. When she returned to the same clinic with persistent shortness of breath and a dry cough, rather than sending her to a higher level of care, staff gave her an albuterol breathing treatment and an injection of Solu-Medrol. She was told she could not leave until she took breathing treatment.
Giving a patient a drug that has already sent her into anaphylaxis is not a subtle clinical judgment. It is a failure of the basic safety checks that are supposed to make this exact outcome impossible.
When a Severe Reaction Happens, Epinephrine and Speed Are the Treatment
Epinephrine is the first-line treatment for a severe allergic reaction, and giving it promptly is the most important step in preventing a reaction from becoming fatal. A severe reaction can progress rapidly to anaphylaxis, in which the airway swells, breathing becomes difficult, and blood pressure drops. The standard of care calls for giving epinephrine without delay, calling for emergency help, and managing the patient’s airway.
When our client began reacting in the exam room, staff did not give her epinephrine and did not call an ambulance. Instead, they moved her to an urgent care clinic two floors down in the same building. The clinic where she reacted did not have the life-saving medication needed to treat anaphylaxis on hand.
Our client did not receive epinephrine until she went into full arrest in the urgent care clinic. By then, the reaction had been allowed to progress unchecked.
The treatment that could have saved her was known. It was not used in time.
How Delay and Poor Airway Management Became Fatal
When a severe allergic reaction compromises breathing, managing the airway and restoring oxygen is critical. If the airway is not properly maintained and effective treatment is delayed, the brain is starved of oxygen, and brain injury begins within minutes. That is what happened here.
The physician failed twice to place a breathing tube before placing a backup airway device, and the records do not show whether that device was ever confirmed to be working. An ambulance was not called until our client had been unresponsive for nearly an hour. She suffered seizure activity before she left the urgent care clinic. At the hospital, she had to be intubated again. She never regained consciousness and died about two weeks later.
Each failure compounded the others. The missing allergy warning allowed the reaction, the absent epinephrine and delayed ambulance let it escalate, and the airway and communication failures turned escalation into a prolonged loss of oxygen.
None of these were isolated. Together they formed a chain in which every safeguard that should have protected her gave way.
