Patient Receives Fatally Toxic Treatment For Complex Regional Pain Syndrome

This case involves a 40-year-old male patient with a history of Crohn’s disease who developed meningitis and was given a spinal tap. The patient subsequently suffered a cerebrospinal fluid leak and developed complex regional pain syndrome as a result. He received ketamine infusions for treatment of his complex regional pain syndrome. While receiving treatment, the patient experienced persistent nausea and vomiting. He was treated with an antihistamine but developed altered mental status and began to deteriorate. The patient passed away a few weeks later. An autopsy revealed the patient had a perforated duodenal ulcer and toxic antihistamine levels.

Questions to the Pain expert and their responses

What are risk factors for the development of a duodenal ulcer?

The risk factors for duodenal ulcer include helicobacter pylori infection, poor sanitation, aspirin, NSAIDS, steroids, and other rare causes.

What are symptoms of a duodenal ulcer?

The symptoms of a duodenal ulcer include abdominal and epigastric pain, nausea, vomiting, peritonitis, and shock (late). The differential diagnosis for continued nausea, vomiting, and abdominal pain include benign infectious causes, toxins, and more serious pathologies with a myriad of etiologic causes, including neoplasms, vascular accidents, pancreatitis, ulcers, and traumatic injuries.

What tests can be ordered to diagnose a duodenal ulcer?

Appropriate tests for duodenal ulcer include chest radiographs, endoscopy, CT scans, and laboratory tests such as CBC, helicobacter pylori titers, and chemistries / blood gases.

About the expert

I am a board-certified surgical intensivist and surgeon with specific training and expertise in chronic pain and pain management.

E-006988

Specialties:

Pain

Victoria Negron has extensive experience in journalism and thought leadership in the legal space, with a background crafting content, whitepapers, webinars, and current event articles pertaining to the role of expert witnesses in complex litigation matters. She is a skilled professional specializing in B2B product marketing and content marketing. Currently, she serves as an Enterprise Product Marketing Manager at Postman, and previously held the position of Technical Product Marketing Manager at Palantir Technologies, where she developed her skills in launch strategies, go-to-market strategy, and competitive analysis.

Her expertise in content marketing was further refined during her tenure at the Expert Institute, where she progressed from a Marketing Writer to Senior Content Marketing Manager, and eventually to Associate Director of Content & Product Marketing. In these roles, she honed her abilities in digital marketing, SEO, content strategy, and thought leadership.

Educationally, Victoria holds a Master of Business Administration from the University of Florida - Warrington College of Business and a Bachelor of Arts in Literature, Art, and Hispanic Studies from Hamilton College. Her diverse educational background and professional experience have equipped her with a robust skill set in product marketing, content development, and strategic marketing initiatives.