Death of 18-Year Old Amanda Abbiehl and Opioid-Induced Respiratory Depression: Physician-Patient Alliance for Health & Safety Releases Podcast on Fifth Death Anniversary

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In honor of July 17, the day that 18-year old Amanda Abbiehl died five years ago after being connected to a patient-controlled analgesia (PCA), the Physician-Patient Alliance for Health & Safety (PPAHS) has released the podcast, “Opioid-Induced Respiratory Compromise Can Be Prevented.”

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PCA pumps increased the risks of patient harm by 3.5 times

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In honor of July 17, the day that 18-year old Amanda Abbiehl died five years ago after being connected to a patient-controlled analgesia (PCA), the Physician-Patient Alliance for Health & Safety (PPAHS) has released the podcast, “Opioid-Induced Respiratory Compromise Can Be Prevented.”

The podcast is now available on:

The podcast is hosted by Pat Iyer, MSN, RN, LNCC, a legal nurse consultant. Approximately 14 million patients use PCA each year and an estimated 600,000 to 2 million adverse events and deaths per year could involve PCA. In the podcast, Ms. Iyer describes the extent of the problem with PCA:

"… there was a study that was done by the U.S. Pharmacopeia and MEDMARX which showed the PCA pumps increased the risks of patient harm by 3.5 times.

The podcast features interviews of the parents of Amanda - Brian and Cindy Abbiehl - who discuss Amanda and how her death is irrevocably changed their lives:

"Amanda was a very outgoing and loving child she was very diverse. She had a lot of friends. She has a lot of different types of friends. She had friends who were very wealthy. She had friends who were very poor. She would drop anything for anybody.

"She went into the hospital mainly with a virus and dehydration and by the time we got into the hospital she had a fever, so they knew that there was something going on more than just rehydrating her. We went in on a Thursday. Friday evening she was put on the pain pump and by Saturday morning she had passed away. She was our only daughter.

"From a personal standpoint Brian and I will never be able to see who she marries. I'll never be able to pick a wedding dress out with her. We'll never be able to have her father/daughter dance."

Joining the Abbiehls on the podcast was Michael Wong, JD (Executive Director, PPAHS), who discusses standard of care and the lack of continuous electronic monitoring in Amanda’s care:

"… in Amanda's case she was not monitored with a capnography machine and I believe had she been monitored the nursing staff at the hospital where she was staying would have been alerted and might have been able to know that she was suffering from respiratory depression and could have been able to do something."

To help address adverse events and death associated with the use of PCA, PPAHS brought together a group of renowned health experts to develop the PCA Safety Checklist, including intensive care specialist and a leader in medical checklist development Peter J. Pronovost, MD, PhD, FCCM, Professor, Departments of Anesthesiology/Critical Care Medicine and Surgery, The Johns Hopkins University School of Medicine and Medical Director, Center for Innovation in Quality Patient; and Atul Gawande, MD, Professor in the Department of Health Policy and Management at the Harvard School of Public Health, who is a surgeon at Brigham and Women’s Hospital Professor of Surgery at Harvard Medical School and author of “The Checklist Manifesto.”

The PCA Safety Checklist is a concise checklist that reminds caregivers of the essential steps needed to be taken to initiate PCA with a patient and to continue to assess that patient’s use of PCA.

The checklist:

  •     Summarizes information about the characteristics of patients at higher risk for over sedation and respiratory depression
  •     Helps to ensure that patients have been appropriately educated about their pain management before using a PCA pump
  •     Reminds healthcare providers of potential red flags
  •     Makes sure the patient is electronically monitored with both pulse oximetry and capnography, and
  •     Provides guidance on assessment and pump settings verification at shift change.

The PCA Safety Checklist is a free resource on the PPAHS site at: http://www.ppahs.org/pca-safety-checklist-download/

About Physician-Patient Alliance for Health & Safety

Physician-Patient Alliance for Health & Safety is a non-profit 501(c)(3) whose mission is to promote safer clinical practices and standards for patients through collaboration among healthcare experts, professionals, scientific researchers, and others, in order to improve health care delivery. For more information, please go to http://www.ppahs.org

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