基于死后全血舍曲林水平的致命性血清素综合征假阳性诊断》(A False-positive Diagnosis of a Letthal Serotonin Syndrome Based on Postmortem Whole-blood Levels of Sertraline):法医侦探工作如何利用医学知识和临床药理学破案。
{"title":"基于死后全血舍曲林水平的致命性血清素综合征假阳性诊断》(A False-positive Diagnosis of a Letthal Serotonin Syndrome Based on Postmortem Whole-blood Levels of Sertraline):法医侦探工作如何利用医学知识和临床药理学破案。","authors":"Sheldon H Preskorn, David D Masolak","doi":"10.1097/PRA.0000000000000801","DOIUrl":null,"url":null,"abstract":"<p><p>This column is the third in a 3-part series describing cases in which general medical knowledge, including psychiatric and clinical pharmacology, was instrumental in determining whether dereliction was the direct cause of damages in a malpractice suit. This case illustrates how not taking into account the following variables can result in a false-positive diagnosis of a lethal serotonin syndrome: (a) the time course of treatment, (b) the time course of symptoms, (c) the difference between antemortem plasma and postmortem whole-blood levels of highly protein bound and highly lipophilic drugs. The case also illustrates how taking those 3 variables into account led to the conclusion that there was no dereliction in the care of the patient that was the direct cause of his death, and hence, there was no medical malpractice.</p>","PeriodicalId":16909,"journal":{"name":"Journal of Psychiatric Practice","volume":"30 5","pages":"349-356"},"PeriodicalIF":1.3000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A False-positive Diagnosis of a Lethal Serotonin Syndrome Based on Postmortem Whole-blood Levels of Sertraline: How Forensic Detective Work Uses Medical Knowledge and Clinical Pharmacology to Solve Cases.\",\"authors\":\"Sheldon H Preskorn, David D Masolak\",\"doi\":\"10.1097/PRA.0000000000000801\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>This column is the third in a 3-part series describing cases in which general medical knowledge, including psychiatric and clinical pharmacology, was instrumental in determining whether dereliction was the direct cause of damages in a malpractice suit. This case illustrates how not taking into account the following variables can result in a false-positive diagnosis of a lethal serotonin syndrome: (a) the time course of treatment, (b) the time course of symptoms, (c) the difference between antemortem plasma and postmortem whole-blood levels of highly protein bound and highly lipophilic drugs. The case also illustrates how taking those 3 variables into account led to the conclusion that there was no dereliction in the care of the patient that was the direct cause of his death, and hence, there was no medical malpractice.</p>\",\"PeriodicalId\":16909,\"journal\":{\"name\":\"Journal of Psychiatric Practice\",\"volume\":\"30 5\",\"pages\":\"349-356\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Psychiatric Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PRA.0000000000000801\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Psychiatric Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PRA.0000000000000801","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PSYCHIATRY","Score":null,"Total":0}
A False-positive Diagnosis of a Lethal Serotonin Syndrome Based on Postmortem Whole-blood Levels of Sertraline: How Forensic Detective Work Uses Medical Knowledge and Clinical Pharmacology to Solve Cases.
This column is the third in a 3-part series describing cases in which general medical knowledge, including psychiatric and clinical pharmacology, was instrumental in determining whether dereliction was the direct cause of damages in a malpractice suit. This case illustrates how not taking into account the following variables can result in a false-positive diagnosis of a lethal serotonin syndrome: (a) the time course of treatment, (b) the time course of symptoms, (c) the difference between antemortem plasma and postmortem whole-blood levels of highly protein bound and highly lipophilic drugs. The case also illustrates how taking those 3 variables into account led to the conclusion that there was no dereliction in the care of the patient that was the direct cause of his death, and hence, there was no medical malpractice.
期刊介绍:
Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field.
Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.