Dr.Bosnak’s
DRUG DETECTIVES
Toxic Dose: A Fatal Mix-Up
Episode 44
A hospital ward, quiet except for the beeping of machines. Dr. Ethan Ricketts examines a 63-year-old patient, James Connors, unconscious with respiratory distress. “We admitted him 18 hours ago,” Dr. Ricketts mutters, flipping through Connors’ chart. “Respiratory failure, but the labs are strange. Medication levels don’t add up.” He looks up at YOU, “Something about how the meds were administered isn’t right. Let’s dig in.”
The sterile autopsy room. Dr. Ricketts prepares the body for examination. “See here?” Dr. Ricketts points to discolored tissue during the internal exam. “The drug didn’t metabolize properly. Could be the route of administration. But why?” He frowns and makes a note. YOU can see the questions hanging in the air.
The forensic lab, filled with the low hum of machines. “It’s odd,” Dr. Torres says, peering at the medication logs. “The patient was prescribed an oral form, but serum levels suggest an IV delivery. Someone switched it up. Why would they do that?” She glances at YOU. “We’re missing something big here.”
A modest living room. Mack sits across from Sarah Connors, who clutches a photo of her father. “He was getting better,” Sarah whispers. “But the nurses said they had to adjust something. They never explained. He hated needles, but suddenly they were giving him IVs. Is that normal?” Detective Mack scribbles a note, his jaw tight. YOU feel the tension in the room.
Hospital staff room. A nurse fidgets under Mack’s questioning. “Orders come from above,” Nurse Julia says defensively. “We don’t question. But I did notice – there was confusion with Mr. Connors’ meds. Someone altered the records late at night.” Mack exchanges a glance with YOU. “Who gave the order?”
The pub is alive with chatter. Liz, Mack, and Dr. Torres sit at a corner table, papers scattered. “Here’s what doesn’t add up,” Mack says, beer untouched. “Oral meds ordered, IV meds administered. Why the switch? And why hide it?” Liz sighs. “Maybe someone botched the preparation. Or was it deliberate?” Dr. Torres nods. “We’re not dealing with a simple error. This smells like negligence.” She looks at YOU. “What do you think?”
Hospital pharmacy storage room. “It’s subtle,” says the pharmacist, pulling out vials. “The labeling on this batch was nearly identical. Oral solution misfiled as IV concentrate. If it wasn’t diluted properly…” He shakes his head. “It would’ve been toxic.” YOU realize the pieces are falling into place.
Liz’s cluttered office, notes pinned across a whiteboard. “Midnight,” Liz mutters, tapping a red mark. “The night shift changed his meds. By 6 AM, Connors was crashing. If they’d caught the error sooner…” Her voice trails off, and she looks at YOU. “This wasn’t an accident. It’s negligence.”
The team gathers in a hospital conference room. “The mix-up killed him,” Dr. Ricketts states plainly. “Improper preparation and route. It was avoidable.” Mack clenches his fists. “We need accountability.” Liz looks at YOU. “What’s your take?”
Dr. Ricketts stands alone in the hospital morgue. “Another life lost to a preventable mistake,” he says quietly. “And no one’s asking the pharmacist. Why does that always come last?” He turns to leave, his shoulders heavy.
The team looks at YOU expectantly in a silent room. “We’ve gathered everything,” Liz says softly. “Now it’s your call—what’s your decision?”
Which of the following can cause the patient's death?
A. The IV administration of undiluted potassium chloride caused acute hyperkalemia, leading to cardiac arrest.
B. Respiratory failure and the rapid clinical decline mimic symptoms of a pulmonary embolism (PE), where a blood clot blocks the pulmonary artery.
C. A beta-blocker overdose could have caused bradycardia and cardiac arrest due to hypotension and suppressed heart rate.
