Description of Event or Problem · 1
THE PATIENT WITH A DIAGNOSIS OF IDIOPATHIC THROMBOCYTOPENIC PURPURA (ITP) WAS TREATED WITH HIS FIRST PROSORBA COLUMN TREATMENT ON 05/05/97. APPROXIMATELY 250CC OF TREATED PLASMA HAD BEEN RETURNED TO THE PATIENT WHEN THE PATIENT COMPLAINED OF TINGLING THEN BURNING IN HIS HANDS AND DIFFICULTY BREATHING. THE REINFUSION RATE WAS 12-15 ML/MIN.THE TREATMENT WAS PAUSED AND THE SYMPTOMS ABATED. THE TREATMENT WAS RESUMED BUT THE BURNING SENSATION IN THE PATIENT'S HANDS RETURNED. THE PATIENT COMPLAINED OF NAUSEA, EXPERIENCED FACIAL FLUSHING AND HYPOTENSION. THE TREATMENT WAS DISCONTINUED. THE NURSE LEARNED UPON QUESTIONING THE PATIENT THAT THE PATIENT HAD BEEN TAKING AN ANGIOTENSION CONVERTING ENZYME (ACE) INHIBITOR MEDICATION, ACCUPRIL. USE OF THE PROSORBA COLUMN IS CONTRAINDICATED IN PATIENTS RECEIVING ACE INHIBITOR MEDICATIONS. THE NURSE STATED THAT THE PATIENT WAS NEW TO HER AND THE SHE FORGOT TO CHECK THE MEDICATIONS THE PATIENT WAS TAKING.