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Avatar universal

Over medication after surgery to remove cancer from liver

My father just had surgery to remove a golf-ball sized cancer from his liver (he has cirrhosis and hep c).  The surgeon said the procedure went well and that he didn't need to go to ICU so he was placed into IMU after the surgery.  He was put on a PCA for his pain medication and was prescribed a dosage to be given when pressed after every eight minutes. As he lost mental clarity (with the increased ammonia in his blood) and and lost coordination, his family noticed him in pain but he was unable to push the PCA button so when we thought he would have pushed it, we pushed his PCA for him.  To make a long story short, his doctors and nurses say his "family overmedicated him" which caused him to became "too sleepy to breathe" and he apparently "aspirated" so they had to put him on a ventilator and into ICU where he's been for a week now. He developed pnemonia, his ammonia levels remained high (his liver wasn't clearing the medication out of his system),  and he didn't have any bowel movements in 5 days.  My question is, should it even have been possible to push his PCA button "too many times" if the dosage on the PCA was correct/safe?  Is it common to prescribe a dosage on a PCA relying on the fact that the patient won't push the button enough times to "overmedicate"? Is it okay for the medical staff to blame the family for over medicating a patient?

Thank you for taking the time to read my question.  

Amber
4 Responses
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Avatar universal
Thank you so much!

Helpful - 0
517301 tn?1229797785
MEDICAL PROFESSIONAL
patients cannot be overmedicated with the PCA.  This could happen if additional medications were also administered.
Helpful - 0
Avatar universal
Thank you for your response, your time is much appreciated.  I know your comment noted that the whole concept of the PCA is that people cannot overmedicate themselves, but I was also hoping you might speak to the possibility of overmedication by third parties (nurses, families, etc...) as well as the appropriateness of laying blame on the family.

Again, thank you for your time.

Amber
Helpful - 0
517301 tn?1229797785
MEDICAL PROFESSIONAL
the whole concept of the PCA is that people cannot overmedicate themselves as the machine will not allow an OD of the medicine.  encephalopathy could occur after a liver resection.  I am dubious that overuse of the PCA contributed signifcantly to this.
Helpful - 0

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