The Reality of Medical Error - Revised Entry

I mentioned in yesterday's blog entry that Colin had elevated therapeutic levels of one of his antibiotics, gentamicin. Well, while glancing at his medical record (we have access to his medical record anytime we want, but this time it just happened to be laying out in the open on the bed-side desk) I read that one of Colin's nurses had mistakenly given an extra dose of gentamicin before the gentamicin trough level was checked (this is a measurement of how much medicine - the concentration - is in the system). What normally happens is the nurse will draw a little blood and send it to the lab to determine what the therapeutic level is. If it's too high, the nurse is not supposed to administer the next dose and they are to monitor the antibiotic levels until the concentration comes down to an acceptible range at which point they can continue administering the medicine. Well, the trough was sent off to the lab, but prior to the results returning, Colin was given another dose of gentamicin before getting the trough level back. Sure enough, the trough level was too high and she should have held the dose. As a result, Colin got more gentamicin than he needed and it required more than 24 hours for his body to excrete the excess. Just this morning we learned that the level had dropped to an appropriate level and they then resumed treatments.
We inquired with one of Colin's other primary nurses and the neonatologist working last night, and the thinking is that the momentary increase in the therapeutic level shouldn't have caused any increase risk of hearing loss. We hope it doesn't result in any complications as Colin grows and develops, and he'll get a hearing screening before he's discharged from the hospital. Time will tell.
Let me say that Colin's care has been incredibly good, and we've been very happy. Yes, a mistake was made, but our little man is resilient, and he'll probably be just fine. He really couldn't be in better hands.