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Lethal Acetaminophen Poisoning Related to Error Prescription: Medico Legal Implications - About a Case Report
Mesrati MA1*, Mahjoub Y1, Boussaid M1, Saadoui H2, Moussa A3, Douki W2, Chadly A1, HajSalem N1 and Aissaoui A11Department of Forensic Medicine, University of Monastir, Taher Sfar Hospital, Tunisia
2Department of Toxicology, University of Monastir, Fattouma Bourguiba Hospital, Tunisia
3Department of Cytology, University of Monastir, Fattouma Bourguiba Hospital, Tunisia
- *Corresponding Author:
- Mesrati MA
Department of Forensic Medicine
University of Monastir
Taher Sfar hospital, Tunisia
Tel: 21673109000
E-mail: mesrati.amin@gmail.com
Received date: July 01, 2017; Accepted date: July 17, 2017; Published date: July 26, 2017
Citation: Mesrati MA, Mahjoub Y, Boussaid M, Saadoui H, Moussa A, et al. (2017) Lethal Acetaminophen Poisoning Related to Error Prescription: Medico Legal Implications - About a Case Report. Neonat Pediatr Med 3: 129. doi: 10.4172/2572-4983.1000129
Copyright: © 2017 Mesrati MA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Acetaminophen poisoning, leading to death, is a serious and dramatic accident for even the family and pediatricians. Prescribing error can engage the physician's responsibility. In this context, we report a case of lethal acetaminophen poisoning related to error prescription, occurred in an infant with underlying liver disease and we discuss its medico-legal implications. He was an 11 month-old boy, without medical history, who was presented to his pediatrician for a nasopharyngitis with gastroenteritis of three days duration. The prescription involved two drug forms of Acetaminophen. The total prescribed dose was 270 mg/kg/day. The death occurred after two days. A blood analysis tested before his death showed a major hepatic cytolysis with toxic level of acetaminophen. Forensic autopsy has been ordered. At dissection, the liver was palish and hemorrhagic. Toxicological screening showed a high level of acetaminophen (79 mg/l). Histological examination concluded to diffuse microvacuolar steatosis. This case report highlights the risk of hepatotoxicity of acetaminophen. This complication is even more serious if the child already has a congenital, unknown liver disease. The physician and the pharmacist's liability, in this case, would be incurred even with partial causal link.
