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Transparency in Health Care: CASE REPORT |

Iatrogenic Delirium and Coma*: A “Near Miss”

William F. Dunn, MD, FCCP; Shirley C. Adams; Robert W. Adams
Author and Funding Information

*From the Mayo Foundation, Rochester, MN.

Correspondence to: William F. Dunn, MD, FCCP, 200 First St SW, Mayo Foundation, Rochester, MN 55905; e-mail: dunn.william@mayo.edu



Chest. 2008;133(5):1217-1220. doi:10.1378/chest.08-0471
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A 66-year-old woman was cared for at two referral institutions following a witnessed cardiac arrest in a local emergency department. Despite aggressive initial care, she failed to regain consciousness during a 28-day course. Based on an erroneous neurologic diagnosis of anoxic encephalopathy, pessimism regarding likelihood of improvement existed, prompting clinical consideration of withdrawal of care. The correct diagnosis of iatrogenic drug-induced coma alternating with drug-induced delirium only became apparent after the IV administration of repeated doses of a benzodiazepine antagonist. The patient and husband (co-authors) provide insights often unheard within care circles.

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