68-year-old Male Dies of IV-Administered Haldol
Type of Injury: Wrongful Death
Type of Case: Settlement
Settlement Amount: $500,000
Jurisdiction: District Court for Cerro Gordo County, Iowa
On December 2, 2018, M-68 was admitted to hospital for monitoring and care with a chief complaint of intermittent fever/confusion, shortness of breath, and failed antibiotic therapy for a previously diagnosed infection. Due to some agitation, an order was placed on December 4, 2018 for the drug haldol decanoate to be given via intramuscular injection (IM). On December 6, 2018, M-68 was erroneously given the haldol decanoate via intravenous (IV) injection, rather than IM, which increases the risk of clots and neuroleptic malignant syndrome (NMS) like symptoms. Later in the evening on December 6, 2018, M-68 began showing stroke like symptoms, slumping over to one side, unable to follow commands, and becoming suddenly weak.
Following the IV haldol decanoate injection, M-68 continued to have an altered mental state and was ultimately transferred to intensive care and intubated. A brain MRI was performed showing an acute/subacute right parietal lobe infarct and EEG x2 showed signs of hypoxia or hypoperfusion injury. After transfer to the ICU, M-68 did not show any significant neurologic improvement, prompting his family to make the difficult decision, after consultation with providers at Mercy North, to pursue hospice care.
On December 19, 2018, M-68 passed away.M-68 was survived by his wife and parents and four adult children.
Haloperidol decanoate is synthesized by esterification of the active drug to a long chain fatty acid (decanoic acid) and then dissolved in a vegetable oil. After intramuscular administration it is absorbed via the lymphatic system and then hydrolysed to haloperidol. As a result, the haloperidol plasma concentration rises gradually, usually peaking within the first week after injection and falling thereafter with an apparent half-life of about 3 weeks.
In 1996, a German publication discussed complications from giving haldol decanoate via intravenous (IV) injection. See Heinz P., Accidental intravenous administration of haloperidol decanoate [Article in German], Psychiatrische Praxis 23(1): 42 (1996).
M-68 was represented in this highly-contested case by Craig Sandberg with his Des Moines-based co-counsel, Brian B. Galligan from the law firm of Galligan Law P.C.
The above summary is specific to a particular case and is not intended as a projected outcome on any other matter.