Hong Kong health care and hospitals

29-month-old boy in critical condition after being given six times the prescribed dose of heart medication at Hong Kong public hospital

Toxicologists say however that patient’s condition may not be related to overdose

PUBLISHED : Thursday, 04 October, 2018, 8:52am
UPDATED : Thursday, 04 October, 2018, 8:52am

A 29-month-old boy with heart problems was in a critical condition on Wednesday night after being injected with six times the prescribed amount of a medication at Hong Kong’s Prince of Wales Hospital.

A spokesman for the public hospital in Sha Tin said the overdose of atropine, a drug for treating an abnormally slow heart rate, might not be the cause of the boy’s condition, citing clinical toxicology assessments. An investigation panel would be set up and a report submitted in eight weeks, he added.

The boy had undergone surgery in April 2016 for heart defects detected after he was born. He was also diagnosed with complete heart block. Doctors had suggested a permanent pacemaker, but his parents did not opt for one.

The patient was taken to the hospital’s emergency unit on Sunday for fever and difficulty in breathing.

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Paediatricians on duty prescribed him 0.26mg of atropine while referring to the Broselow tape, a colour-coded length-based tape measure that is used for paediatric emergencies.

The boy’s condition worsened, and he fell into a complete coma. Resuscitation was performed, and his heart rate gradually went back to normal before he was transferred to Queen Mary Hospital the following morning.

The patient was found to have myocarditis – an inflammation of the heart muscle – and a viral infection, and was in a critical condition.

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Nurses from the Prince of Wales Hospital’s emergency unit later reviewed the records and found that he had been injected with 1.56mg of the drug, six times the amount prescribed.

The hospital spokesman said however that this might not be related to the boy’s condition, noting that the atropine had failed to boost his heart rate, and there were no symptoms of overdosing.

Toxicologists from the hospital said they believed there was no obvious causal relation between the dosage and the patient’s condition.

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The spokesman said the error could have arisen from medical staff using a package with a drug concentration of 0.6mg per ml while thinking it was 0.1mg per ml.

A doctor from a public hospital emergency unit said atropine for adults and children was usually bottled in different concentrations. The nurses involved may have picked one for adults, which was more commonly used, and the doctors may not have checked before giving the injection.