Staten Island hospital gives fatal overdose of fentanyl to man being treated for a broken arm.
The hospital's medical staff reassured Latimer that her son's injuries were not life-threatening. Later that day, however, Latimer was stopped by a member of the hospital's medical team and told that he had slipped into a coma. He died nearly three weeks later.
"Fentanyl is a very potent narcotic," said Michael Cohen, R.Ph., president of the Institute for Safe Medication Practices in Huntingdon Valley, Pa. "With the injectible, the dose is measured by microgram and it often gets confused with milligram. "
The lethal dose
Cruz was wheeled into the emergency room of Staten Island University Hospital (SIUH) after crashing his SUV into a brick wall and steel guardrail on the morning of Jan. 19. He was given 40 mcg/min of propofol (Diprivan, AstraZeneca) and transferred to the hospital's surgical intensive care unit, according to the state investigation. Later that afternoon, a surgical resident ordered that Cruz be given 4 mcg/hr of fentanyl. The resident also prescribed Cruz a one-time dose of 50 mcg of fentanyl, to be given through an IV pump, the state investigation concluded.
A nurse discontinued the propofol, and early that evening, the surgical resident wrote an order to discontinue the fentanyl, state health documents show. At 6:40 P.M., nurses reported that Cruz was alert and responding to commands, but less than an hour later, he was unresponsive, his heart rate had slowed to less than 60 beats per minute, and the oxygen levels in his blood were dangerously low. A nurse restarted Cruz's dose of fentanyl at 6:54 P.M. without an order, and mistakenly gave him 20 mcg/hr for 18 minutes.
After Cruz died, the hospital offered to help pay for his funeral. The gesture, however, hasn't deterred Cruz's family from moving ahead with plans to file a wrongful-death lawsuit against SIUH. John G. O'Leary, a Staten Island attorney representing Cruz's family, did not return repeated phone calls for comment on the status of the lawsuit. John Demoleas, a spokesman for SIUH, declined to comment on the pending lawsuit or circumstances surrounding the overdose, saying, "It's a tragedy and our heartfelt feelings go out to the family, but we are not discussing the case whatsoever."