Patient Suffers Life Threatening Reaction During Prick Test

This case involves a middle aged female who suffered from asthma. On the date of the incident in question, she presented for a prick test at an allergists office to determine possible triggers for her asthma. During the test, the patient developed a severe reaction. The patient went into full anaphylactic shock, during which her breathing tubes swelled dramatically and deprived her of air for an extended period of time. As a result of this oxygen deprivation, the patient suffered permanent brain damage and is now permanently disabled. It was alleged that the doctor administering the prick test failed to take proper precautions to prevent this outcome, and that the patient experienced a delay in receiving appropriate care.

Question(s) For Expert Witness

Expert Witness Response E-011960

Allergy prick skin testing is a proven, safe, effective method for allergy assessment. The risk of anaphylaxis or systemic reactions to testing is less than 1:1000 patients tested. I routinely test adults with asthma with skin tests. The physician supervising the testing should be able to recognize the symptoms of systemic reactions and treat appropriately. Appropriate equipment is specified in the The Diagnosis and Management of Anaphylaxis Practice Parameter. Neither I nor my group of allergists and immunologists have had this experience but we have treated patients for systemic reactions and anaphylaxis. I have also published the textbook on Allergen and Allergen Immunotherapy and World Allergy Organization Guidelines in 2012.

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