Description of Event or Problem · 1
PT IS AN 80-YEAR-OLD FEMALE WHO HAS VALGUS ARTHRITIS OF PREDOMINANTLY THE RIGHT KNEE. SHE UNDERWENT HYALGAN INJECTIONS AFTER CORTISONE INJECTIONS HAD FAILED. AFTER EACH INJECTION, SHE WOULD HAVE SWELLING IN HER LOWER LEGS. INITIALLY, THE REPORTER THOUGHT THIS WAS RELATED TO MILD CONGESTIVE HEART FAILURE AND FLUID RETENTION PROBLEMS OF HER HEALTH STATUS. HOWEVER, AFTER THE FIFTH INJECTION, SHE HAD TOTAL BODY EDEMA, IN HER HANDS, ARMS, SHOULDERS, LEGS, EVEN SOME PULMONARY EDEMA. IT WAS FELT THAT THIS WAS A MILD ANAPHYLACTOID REACTION TO THE HYALGAN. SHE WAS PLACED ON STEROIDS AND, OF COURSE, THE HYALGAN WAS DISCONTINUED AFTER THE FIFTH DOSE, AND THIS RESOLVED. SHE SEEMS TO HAVE FULLY RECOVERED FROM THIS, BUT IT APPEARS TO BE A SIGNIFICANT ALLERGIC REACTION TO HYALGAN. FOLLOW-UP LETTER REC'D FROM THE REPORTER ON 22 JAN 1999: "FLARE-UP OF RIGHT KNEE PAIN AFTER EACH OF THE 5 WEEKLY INJECTIONS OF HYALGAN. AFTER 5TH INJECTION, SWELLING [OF] ENTIRE BODY, PULMONARY EDEMA; [PT] HAD TO RECEIVE DIURETICS AND STEROIDS." EDITORIAL COMMENT: THE REPORTER CONSIDERED THE EVENT SERIOUS (REQUIRED INTERVENTION TO PREVENT PERMANENT IMPAIRMENT/DAMAGE). ACCORDINGLY, CASE IS CONSIDERED SERIOUS FROM 22 JAN 1999. CORRECTIVE TREATMENT: DIURETICS AND STEROIDS.