Adverse Reactions to Intravenous Contrast Injections Can Be Fatal
One often overlooked instance of medical negligence / malpractice occurs when a patient suffers an adverse / allergic reaction to IV contrast prior to undergoing a CT scan, MRI or other radiological procedure. Millions of radiology studies are performed utilizing IV contrast each year. In many instances, this reaction occurs in patients with no known risk factors and thus cannot be reasonably anticipated. Most adverse reactions are minor and pass with nothing more than temporary discomfort to the patient. Although rare (somewhere on the order of 1:250,000 patients), a patient will suffer a severe reaction, called an anaphylactoid or idiosyncratic event, a reaction that can be life life threatening if not properly understood and treated. In such instances, it is often the lack of proper and timely care following the reaction that serves as grounds for a medical negligence lawsuit. In our experience, the following steps and measures should be taken in order to comply with the standard of care: (1) prior to the radiology procedure, the radiologist or physician should obtain a patient's informed consent to proceed with the procedure and, in the course of that discussion, discuss the risk of serious injury or death from a contrast reaction; (2) in patients with known previous reactions to IV contrast, premedication should be prescribed; (3) a physician should be available to lead the response to any reaction; (4) emergency response equipment and medications are readily accessible; (5) radiologists or other imaging personnel are trained to recognize and respond to a reaction; (6) transport to an emergency facility or ICU is available in a timely fashion; and (7) a patient's reaction is clearly documented in his/her chart so that the patient can pre-medicated for future contrast studies.
It is well known that people taking beta blockers have an increased risk of serious allergic reaction to IVP dye. In addition, some researchers have discovered the persons with allergies to shellfish and seafood account for up to 15% of the population that have reactions to IVP dye. Histories of asthma or hay fever may also increase one's risk for a reaction. Recent studies indicate that serious allergic reactions occur in 1.2 to 1.5 percent of the population with life threatening reactions occurring in approximately .1 to .5 percent of people. Even the administration of a small dose of the dye can trigger a fatal reaction. In many cases, if the administration of IVP dye is essential to the diagnostic requirements, these individuals are often prescribed corticosteroids to reduce inflammation before receiving the dye. Perhaps most importantly, health care providers who inject IVP must have life-saving equipment at hand that is in working order and be trained to use it in an emergency. In the event of an adverse reaction, treatment must include airway maintenance with oxygen administration; administration of medications to reduce bronchospams; and intravenous fluids to help maintain blood pressure.
Symptoms of an allergy to the IVP dye include, but are not limited to: facial swelling; itching; hives; nausea; vomiting; difficulty breathing; airway closure; wheezing; low blood pressure; coma; shock; and death. These symptoms typically are experienced within 1-2 hours of the IVP administration. It is estimated that approximately 500 people per year die in the United States as a result of IVP allergic reactions. Many of these reactions could be successfully prevented if careful attention is paid to the patient's medical history and past experiences with IVP dye by health care providers or those administering the dye.
If you or a loved one has been the victim of a reaction to an IV contrast agent prior to or during a radiology study, cal the lawyers at STSW for a free consultation.