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Boy Dies from Overdose of Epilepsy Medication, Doctors Charged with Negligence
[Wang Yinfang / Kaohsiung Report]
Two years ago, a boy named Dai Zhangjie was admitted to the pediatric department of Kaohsiung Chang Gung Memorial Hospital due to an epileptic seizure. However, the attending physician, Huang Litong, and the resident physician, Luo Maohong, failed to pay attention to the dosage when prescribing the epilepsy medication "Depakine." They prescribed a dose nearly a hundred times higher than the reasonable amount, leading to Dai's death from acute Depakine poisoning on the third day of medication. Yesterday, the prosecutors charged both doctors with professional negligence resulting in death.
During the investigation by the Kaohsiung District Prosecutors Office, the two doctors argued, "We knew the dosage was excessive when prescribing, but at the time, we judged there were no other treatment options. If we didn't try, there would be no chance." However, based on the report from the Department of Health's medical review committee, which concluded that the doctors were negligent, the prosecutors found that the doctors had not compensated the victim's family. Although they repeatedly expressed willingness to settle in court, they later retracted, claiming the amount was too high, showing no remorse. Therefore, the prosecutors recommended the court to impose a heavy sentence. Pediatric specialist Huang Litong could not be reached yesterday, and Luo Maohong was also unreachable. Both doctors, through Chang Gung Memorial Hospital, stated that they await the judicial investigation.
On the morning of October 17 two years ago, Dai Zhangjie, a first-grade student at Zhaoxiang Elementary School in Gangshan, was rushed to the hospital after suddenly convulsing and fainting. The emergency department at Kaohsiung Chang Gung Memorial Hospital diagnosed it as an epileptic seizure. After treatment by Huang Litong and Luo Maohong, Dai's condition improved. However, after a week of hospitalization, due to multiple seizures, the two doctors decided to treat him with Depakine.
The prosecutors found that the doctors neglected to pay attention to the medication dosage, which should have been maintained at 1mg (milligram) per kilogram of body weight per hour. Given Dai's weight of 30 kilograms, the reasonable dosage should have been 30-150mg/hr. However, under circumstances where it was not impossible to pay attention, the doctors prescribed doses of 166.7mg/hr, 3200mg/hr, 3000mg/hr, 3000mg/hr, and 1800mg/hr, leading to Dai's death from acute Depakine poisoning on October 28 due to excessively high blood levels of the drug.
Dai's mother, holding back her grief, said yesterday, "Even if I can't win the lawsuit, Chang Gung should at least tell me how my child died!" She mentioned that her son called for her during the early days of his hospitalization but later fell into a deep sleep. "On the 27th, I had to go home for a worship ceremony and asked the nurse to call me if my son woke up. The nurse replied, 'He won't wake up, he's knocked out by the medication!'" Suspecting that the hospital had caused her son's death through an overdose, she reported the case to the police the next day.
Regarding this case, Guan Shangyong, a neurologist at Taipei Veterans General Hospital and secretary-general of the Pediatric Epilepsy Society, commented that if the dosage was as stated in the indictment, "it was indeed significantly excessive! Even when not overdosed, this medication can cause liver inflammation and pancreatitis, let alone when overdosed."Chronicle of the Overdose Incident That Led to a Child's Death
2006/10/17 First-grade boy Dai Zhangjie fainted and convulsed at school, was sent to the hospital
2006/10/18 Dai was transferred to Kaohsiung Chang Gung Memorial Hospital, diagnosed with continuous epileptic seizures, and admitted to the ICU
2006/10/25 Dai's condition improved, he was conscious and able to eat
2006/10/26 Dai experienced multiple seizures again, doctors Huang Litong and Luo Maohong treated him with a dose of "Depakine" nearly a hundred times the normal amount
2006/10/28 Dai died from poisoning due to excessively high levels of Depakine in his blood
2006/10/29 Dai's parents reported the incident to the police, and an investigation was initiated
2008/06/02 Prosecutors charged doctors Huang Litong and Luo Maohong with professional negligence resulting in death
Source: Indictment
Abnormal Brain Cell Discharge Causes Illness
Dr. Guan Shangyong from the Neurology Department of Taipei Veterans General Hospital explained that epilepsy is caused by abnormal discharges of brain cells, leading to various sensory, autonomic nervous system, or motor system disorders, resulting in different forms of seizures such as convulsions or fainting, either generalized or localized. Epilepsy is not a shameful or unexplained genetic disease. Statistics show that 70% of epilepsy patients in the country are triggered by other brain diseases, such as stroke or neonatal brain injuries. Clinically, some cases are even caused by head injuries from not wearing a helmet while riding a bike.
Source: http:/ / 1- apple. com. tw/ index. ……30614472& NewsType=1& SubSec=6
Depakine, known in Chinese as 帝拔癲, contains Sodium valproate + Valproic acid.
Indications: Grand mal epilepsy, petit mal epilepsy, mixed types, and temporal lobe epilepsy; manic episodes.
Precautions:
Side effects: Gastrointestinal discomfort, nausea, dyspepsia, drowsiness, weight gain, hair loss, hand tremors.
Pregnancy category D
Source: http:/ / www. liverx. net/ 2007/ 0……% E5% B8% 9D% E6% 8B% 94% E7% 99% B2/
Double Dose of Strong Medicine Saves Child but Ends in Tragedy
[Wang Yinfang / Kaohsiung Report]
Two years ago, a boy named Dai Zhangjie was admitted to the pediatric department of Kaohsiung Chang Gung Memorial Hospital due to an epileptic seizure. However, the attending physician, Huang Litong, and the resident physician, Luo Maohong, failed to pay attention to the dosage when prescribing the epilepsy medication "Depakine." They prescribed a dose nearly a hundred times higher than the reasonable amount, leading to Dai's death from acute Depakine poisoning on the third day of medication. Yesterday, the prosecutors charged both doctors with professional negligence resulting in death.
During the investigation by the Kaohsiung District Prosecutors Office, the two doctors argued, "We knew the dosage was excessive when prescribing, but at the time, we judged there were no other treatment options. If we didn't try, there would be no chance." However, based on the report from the Department of Health's medical review committee, which concluded that the doctors were negligent, the prosecutors found that the doctors had not compensated the victim's family. Although they repeatedly expressed willingness to settle in court, they later retracted, claiming the amount was too high, showing no remorse. Therefore, the prosecutors recommended the court to impose a heavy sentence. Pediatric specialist Huang Litong could not be reached yesterday, and Luo Maohong was also unreachable. Both doctors, through Chang Gung Memorial Hospital, stated that they await the judicial investigation.
On the morning of October 17 two years ago, Dai Zhangjie, a first-grade student at Zhaoxiang Elementary School in Gangshan, was rushed to the hospital after suddenly convulsing and fainting. The emergency department at Kaohsiung Chang Gung Memorial Hospital diagnosed it as an epileptic seizure. After treatment by Huang Litong and Luo Maohong, Dai's condition improved. However, after a week of hospitalization, due to multiple seizures, the two doctors decided to treat him with Depakine.
The prosecutors found that the doctors neglected to pay attention to the medication dosage, which should have been maintained at 1mg (milligram) per kilogram of body weight per hour. Given Dai's weight of 30 kilograms, the reasonable dosage should have been 30-150mg/hr. However, under circumstances where it was not impossible to pay attention, the doctors prescribed doses of 166.7mg/hr, 3200mg/hr, 3000mg/hr, 3000mg/hr, and 1800mg/hr, leading to Dai's death from acute Depakine poisoning on October 28 due to excessively high blood levels of the drug.
Dai's mother, holding back her grief, said yesterday, "Even if I can't win the lawsuit, Chang Gung should at least tell me how my child died!" She mentioned that her son called for her during the early days of his hospitalization but later fell into a deep sleep. "On the 27th, I had to go home for a worship ceremony and asked the nurse to call me if my son woke up. The nurse replied, 'He won't wake up, he's knocked out by the medication!'" Suspecting that the hospital had caused her son's death through an overdose, she reported the case to the police the next day.
Regarding this case, Guan Shangyong, a neurologist at Taipei Veterans General Hospital and secretary-general of the Pediatric Epilepsy Society, commented that if the dosage was as stated in the indictment, "it was indeed significantly excessive! Even when not overdosed, this medication can cause liver inflammation and pancreatitis, let alone when overdosed."Chronicle of the Overdose Incident That Led to a Child's Death
2006/10/17 First-grade boy Dai Zhangjie fainted and convulsed at school, was sent to the hospital
2006/10/18 Dai was transferred to Kaohsiung Chang Gung Memorial Hospital, diagnosed with continuous epileptic seizures, and admitted to the ICU
2006/10/25 Dai's condition improved, he was conscious and able to eat
2006/10/26 Dai experienced multiple seizures again, doctors Huang Litong and Luo Maohong treated him with a dose of "Depakine" nearly a hundred times the normal amount
2006/10/28 Dai died from poisoning due to excessively high levels of Depakine in his blood
2006/10/29 Dai's parents reported the incident to the police, and an investigation was initiated
2008/06/02 Prosecutors charged doctors Huang Litong and Luo Maohong with professional negligence resulting in death
Source: Indictment
Abnormal Brain Cell Discharge Causes Illness
Dr. Guan Shangyong from the Neurology Department of Taipei Veterans General Hospital explained that epilepsy is caused by abnormal discharges of brain cells, leading to various sensory, autonomic nervous system, or motor system disorders, resulting in different forms of seizures such as convulsions or fainting, either generalized or localized. Epilepsy is not a shameful or unexplained genetic disease. Statistics show that 70% of epilepsy patients in the country are triggered by other brain diseases, such as stroke or neonatal brain injuries. Clinically, some cases are even caused by head injuries from not wearing a helmet while riding a bike.
Source: http:/ / 1- apple. com. tw/ index. ……30614472& NewsType=1& SubSec=6
Depakine (Valproate) in Psychiatric Medication Series
Indications: Grand mal epilepsy, petit mal epilepsy, mixed types, and temporal lobe epilepsy; manic episodes.
Precautions:
- Patients with acute or chronic hepatitis.
- Patients with a family history of severe hepatitis, especially drug-induced hepatitis.
- Valproic acid may cause fatal hepatotoxicity; monitor blood drug concentration within the first six months of treatment.
- Valproic acid has been reported to cause fatal pancreatitis. If patients show symptoms of pancreatitis, such as abdominal pain, nausea, vomiting, etc., seek medical attention immediately. Discontinue medication immediately if pancreatitis is confirmed.
- Valproic acid may cause thrombocytopenia and inhibit platelet aggregation. Monitor platelet count, bleeding time, and coagulation tests before and during treatment or before surgery.
- Reduce dosage in patients with renal insufficiency.
- Enteric-coated tablets are hygroscopic and should not be split or crushed.
- Concomitant use with mefloquine is prohibited.
Side effects: Gastrointestinal discomfort, nausea, dyspepsia, drowsiness, weight gain, hair loss, hand tremors.
Pregnancy category D
Source: http:/ / www. liverx. net/ 2007/ 0……% E5% B8% 9D% E6% 8B% 94% E7% 99% B2/
