Prescription Administered Despite Documented Drug Allergy

This case involves a female patient who presented to the hospital for a ventral hernia repair. Her doctors opted to use a Kugel mesh. Following her procedure, the patient was prescribed Percocet for pain, despite clear documentation of an allergy to the medication on her preoperative medical clearance note. Before she was anesthetized, the general surgeon on her case specifically asked the patient if she had any allergies and she verbally confirmed that it was on her chart. A few months prior, the patient had a sensitization to Percocet that produced itchiness and dry skin for a three-week duration. During this hospital admission, the patient developed an extremely pruritic dermatological reaction that produced dry scaly skin over her entire body.

Question(s) For Expert Witness

1. Was this a breach in the standard of care?

Expert Witness Response E-001161

If what the patient claims is true, then this is without a doubt a breach in care. For the physician to confirm a drug allergy and then to go ahead and prescribe it for postoperative pain is absurd. A true drug allergy occurs when your immune system reacts abnormally to a medication. A number of drugs can cause a drug allergy, including prescription and over-the-counter medications. The most common signs of a drug allergy are hives, rash, or fever. A patient can have an allergic reaction to a drug anytime they take it, even if it caused no reaction in the past. Most drug-related symptoms are not a true drug allergy and don't involve the immune system. Drug allergies and non-allergic drug reactions are often confused because they can cause similar symptoms.