Dr.Bosnak’s
DRUG DETECTIVES
Breathless Demise
Episode 04
Mr. LB, a 34-year-old male with a history of mild asthma, was found unconscious in his home by a neighbor who promptly called an ambulance. Despite immediate medical attention, Mr. LB could not be revived and was pronounced dead upon arrival at the hospital.
Mr. LB's medical history includes mild, intermittent asthma for which he has been prescribed a metered-dose inhaler (MDI) containing albuterol (salbutamol) as needed. His health records indicate infrequent visits to the hospital or clinic for asthma-related issues.You must begin your work immediately. Good luck to you.
In his home, Mr. LB's medication was found scattered around, including the MDI prescribed to him. It was nearly full, despite the obvious signs of an asthma attack such as overturned furniture and signs of panic. The inhaler's mouthpiece appeared dusty and unused. You, Drug Detective, have been called in to investigate this mysterious death. You must begin your work immediately. Good luck to you.
Environmental factors, including air quality in Mr. LB's neighborhood, were reportedly normal at the time of his death. Absence of evidence implicating poor air quality as a trigger for his asthma exacerbation suggests that other factors within his immediate control may have been more influential in determining the outcome of his respiratory crisis.
Entries in Mr. LB’s personal hospital document indicate a progressive increase in episodes of shortness of breath in the days leading up to his death. This pattern of worsening respiratory symptoms suggests a deterioration in his asthma control, highlighting the importance of timely intervention and effective management strategies.
While Mr. LB had experienced a cold a few weeks prior, there is insufficient evidence to directly link this event to his fatal asthma attack. The temporal proximity of the respiratory infection?
A layer of dust observed on the mouthpiece of the inhaler suggests infrequent use and neglect in maintenance. This detail hints at a potential lack of familiarity or adherence to proper inhaler hygiene, which could impact its efficacy during an asthma exacerbation.
Although Mr. LB had quit smoking five years ago, his past tobacco use is unlikely to be a significant contributing factor to his asthma-related demise.
The cessation of smoking reduces the long-term risks associated with respiratory diseases, making it an improbable determinant in this context.
Insights gleaned from interviews with Mr. LB’s neighbor suggest that he may have struggled with proper inhaler technique in the past.
What is your opinion?
Which of the following can cause the patient's death?
A. A physical obstruction in the patient's airways.
B. Severe psychological stress triggering a fatal asthma attack.
C. Exposure to a toxic chemical in the environment.
D. A sudden drop in blood pressure due to dehydration.
E. Severe allergic reaction to an unknown allergen.
F. An untreated respiratory infection.
G. Complications from an undiagnosed heart condition.
H. Acute lung infection leading to respiratory failure.
I. Failure to properly use an MDI during an asthma attack.
J. Overdosing on asthma medication.
