6533b830fe1ef96bd1297a6e

RESEARCH PRODUCT

An unusual fatal case of overdose of Vinblastine and review of literature

Elvira Ventura SpagnoloCristina MondelloFrancesca IndoratoLuigi CardiaCataldo RaffinoGiulio CardiaGiovanni Bartoloni

subject

medicine.medical_specialtydeath; intoxication; medical malpractice; overdose; Vinblastine; 2734Therapeutic treatment2734Poison controlmedical malpracticeVinblastinePathology and Forensic MedicinePharmacological treatment03 medical and health sciences0302 clinical medicineBolus (medicine)intoxicationdeathmedicine030216 legal & forensic medicineIntensive care medicineChronic toxicitybusiness.industrymedicine.diseaseLymphomaVinblastineSurgery030220 oncology & carcinogenesisAccidentaloverdosebusinessmedicine.drug

description

The pharmacological treatment of neoplasia is based on the use of chemotherapeutic substances. Chemotherapeutic agents can cause acute and chronic toxicity even at therapeutic doses. For this reason their overdose puts a patient’s life at severe risk. This work presents an unusual fatal case of overdose subsequent to an accidental massive administration of Vinblastine (90 mg instead of 9 mg), slow bolus (five minutes), to a 33-year-old woman who suffered from Hodgkin’s Lymphoma. The administration of the massive dose was due to a transcription error of the therapeutic treatment plan and miscommunication between the health professionals which caused the use of the wrong dose. The forensic investigation showed the systemic macroscopic and histological changes due to the toxic effect of Vinblastine on the body, by offering a realistic example of the microscopic tissue changes caused by the antineoplastic agent to different organs. Such evidence shows the importance of being very accurate when writing the therapeutic treatment plans and of counting on adequately-trained health care staff.

10.1080/00450618.2016.1195874http://hdl.handle.net/10447/279716