My mom has had cirrhosis of the liver for 3 years. She was given tramadol once before and had 3 grand-mal seizures. Her DR said it was an allergic reaction. The nursing home she is in now has been giving her tramadol around the clock for 6 days even though her medical records state she is allergic. The nursing home had to call 911 because they thought my mother was having a stroke because of sudden slurred speech and loss of coordination. A CT was done and her liver is now in complete failure and enlarged as well as her spleen. Her ammonia level was 61 when first tested at the ER and now is at 127. She has had episodes of encephalopathy when her ammonia level is high and seems like she is going through it again. Until yesterday, medically, she was pretty stable for a person in her condition. Is it possible tramadol could have caused all these news problems and medical decline? Also, what can I do about the nurse and staff DR at the nursing home giving my mother a medication that it clearly says in her records she is allergic to?
15 Jul 2012
Hi, check out this link on DC about Tramadol and liver disease...
I would suggest you contact your local Citizens Advice center or similar to discuss the details around your mums treatment, or alternatively contact a solicitor. They will be able to advise you on your/your mothers rights.
Considering the warnings of Tramadol usage in liver failure it is worrying that your mum was still prescribed it. Also take note of the dosage instructions on the link - 50mg in 12 hours suggested. What was her prescribed dosage?
15 Jul 2012
If it is clearly marked in her records, the doctor and the nursing home have got a big problem. I'd love to get into her chart and see what went on there. Someone dropped the ball somewhere. The doc when he ordered it, the nurse who admitted her if it wasn't in her admission work, the nurses who gave the medication, and the nursing home. Did they tell you without you asking that they had given it to her? Does she wear a bracelet from the nursing home that says she's allergic to it? I would call a good lawyer if I were you. They will check into everything and let you know what is to be done. From what you're saying I'd say you have a pretty good lawsuit. I worked in nursing homes for years, and part of my job was to check into these things, and I know that a good shake up from a legal inspection helps everyone.
I'ts possible that the nursing home was expecting their staff to work short all the time and the nurses were responsible for the meds of more people then its humanly possible to give them to and really pay attention to what they're giving. I'm going to friend you so we talk if you want. I have a few things I don't want to say in public. I'll look up tramadol in depth and see what I can find for you too.
15 Jul 2012
Here is what I found in the prescribing info: Hepatic
Metabolism of tramadol and M1 is reduced in patients with advanced cirrhosis of the liver, resulting in both a larger area under the concentration time curve for tramadol and longer tramadol and M1 elimination half-lives (13 hrs. for tramadol and 19 hrs. for M1). In cirrhotic patients, adjustment of the dosing regimen is recommended (see DOSAGE AND ADMINISTRATION).
Healthy elderly subjects aged 65 to 75 years have plasma tramadol concentrations and elimination half-lives comparable to those observed in healthy subjects less than 65 years of age. In subjects over 75 years, maximum serum concentrations are elevated (208 vs. 162 ng/mL) and the elimination half-life is prolonged (7 vs. 6 hours) compared to subjects 65 to 75 years of age. Adjustment of the daily dose is recommended for patients older than 75 years (see DOSAGE AND
It is metabolized in the liver, and any drug that is can be a risk to the liver.
15 Jul 2012
Also be sure to report immediately to the state licensing for nursing homes. You may find they have other complaints as well. There are huge fines and loss of Medicare and Medicaid benefits if too many reports. Also contact Medicare and any other insurance she may be on. A lot to do? Yes. But since you are in a wait state with her health at least there are things to do.
Also be sure to be in direct contact with her regular physician, not the home physician. Make sure she has a medical directive signed so you can deal with her records and power of attorney if not done yet.
I had an episode when I was in recovery In a nursing home with nurse error on meds. I ended up meeting with the head of the facility. Lots of excuses until I told her that I was reporting to the government. Boy, did they fly into action and fired the incompetent nurse. Lots of apologies. I did have to point out that I was aware of the error and many people would not know that we're in their care. I was reporting for the others. They were investigated and ended up on a watch list with many penalties. I wasn't the only one to complain. But I sure was loud.
If you are not in the US be sure you report to whatever agencies you have.
So sorry she has needlessly suffered and now her life is threatened. People make mistakes. They can also be pretty dumb once they stop caring.
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