Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado.
Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, Arizona.
Ann Allergy Asthma Immunol. 2018 Nov;121(5):530-536. doi: 10.1016/j.anai.2018.03.010. Epub 2018 Mar 15.
To describe medical negligence and malpractice cases in which a patient with a known penicillin allergy received a β-lactam and experienced an adverse reaction related to the β-lactam.
Lexis-Nexus, Westlaw, and Google Scholar were searched.
Medical negligence and malpractice cases were eligible for inclusion if they met the following criteria: the plaintiff had a known penicillin allergy, received a β-lactam, and experienced an adverse event. All United States federal and state cases were eligible.
Twenty-seven unique cases met the inclusion criteria. Eighteen cases involved the receipt of a penicillin-based antibiotic; of these cases with a known legal outcome, the plaintiff (patient or representative) prevailed or settled in 3 cases and defendants (providers) prevailed in 7 cases. Seven cases involved the receipt of a cephalosporin; of these cases with a known legal outcome, the plaintiff settled with physicians before trial in 1 case and defendants prevailed in 3 cases. Two cases involved the receipt of a carbapenem. Defendants prevailed in one case and the legal outcome of the other case is unknown. In cases in which the defense successfully moved for summary judgment, judges cited a lack of scientific evidence demonstrating a cephalosporin or carbapenem was contraindicated for a patient with a penicillin allergy.
The cases with published legal outcomes found limited professional liability for clinicians who prescribed cephalosporins or carbapenems to a patient with a known penicillin allergy. These results may decrease the litigation fears of practitioners and risk managers within health care systems.
描述已知对青霉素过敏的患者接受β-内酰胺类药物后发生与β-内酰胺类药物相关的不良反应的医疗事故和医疗过失案例。
LexisNexus、Westlaw 和 Google Scholar 进行了检索。
如果符合以下标准，医疗事故和医疗过失案例符合纳入标准：原告有明确的青霉素过敏史，接受了β-内酰胺类药物治疗，并发生了不良事件。所有美国联邦和州的案例均符合条件。
27 个独特的案例符合纳入标准。18 个案例涉及使用青霉素类抗生素；在这些有明确法律结果的案例中，原告（患者或代表）胜诉或和解的有 3 例，被告（提供者）胜诉的有 7 例。7 个案例涉及头孢菌素的使用；在这些有明确法律结果的案例中，原告在审判前与医生和解的有 1 例，被告胜诉的有 3 例。2 个案例涉及碳青霉烯类药物的使用。被告在 1 例中胜诉，另 1 例的法律结果未知。在辩方成功动议简易判决的案件中，法官援引缺乏科学证据表明头孢菌素或碳青霉烯类药物对有青霉素过敏史的患者禁忌使用。
有已公布法律结果的案例发现，对于给已知对青霉素过敏的患者开处方头孢菌素或碳青霉烯类药物的临床医生，专业责任有限。这些结果可能会降低医疗保健系统内从业者和风险管理部门的诉讼恐惧。
