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A Mother's Plea:
The Dangers of Acetaminophen Overdose

 

March 21, 2005

Some of you may remember an article I wrote during the summer of 2003 about a 17-year-old girl from Oklahoma who turned to Tylenol for Migraine pain relief, accidentally took too much, and paid for that accident with her life. Since then, her mother has been working diligently to educate people. She wants people to realize that over-the-counter medications such as Tylenol can be every bit as dangerous as prescription medications. She also wants to encourage people to become organ donors. She recently wrote a letter to me to share with you:

                    

Teri,

I wanted to write explaining to you the dangers of acetaminophen and ask why no one does anything to stop this. You see I HAD a beautiful daughter named Kellie. She, as I do, suffered with Migraines, but she wouldn't take anything stronger than Tylenol.

On the morning of June 26, 2003, Kellie got a Migraine around 3am, so she took some Tylenol. She vomited, so she took more, not realizing it had already been digested. This happened three or four more times. She ended up taking up to 20 in a 16-hour period. Around 4:00 p.m., she started having severe stomach pain. I took her to the hospital then. At the hospital, they took blood, started the "antidote," and gave her some "charcoal stuff," which she threw-up. She said, "Mom, I'm sorry. I tried to keep it down." I told her, "It's OK, don't worry about it."

She said "I thought it was OK, Mom. It was only Tylenol". I said "It's OK, Kel." I had no idea what was to come of it. I figured she'd be OK. WRONG!!! The doctor came in and told me that, at that point, Kellie had an 80% chance of dying. You could have blown me over with a feather. The doctor told me, "You need to call whoever you need to. She might not make it through the night." I was horrified and in shock. I couldn't understand why he was saying that and went into denial mode. I called my husband and told him to get there as fast as possible. He argued with me; he was in shock too.

The next day Kellie started going into convulsions, and they transferred her to a hospital where they could do transplants. The Tylenol had started to shut her liver down. There is no liver machine, transplant was her only chance. They put her on the "list" as #1 , but there wasn't a liver available. They put her into a medically induced coma to, "lessen the stress on the organs," we were told. We had called our son, who lived in Georgia, and he immediately flew out here. Kellie was his only sister. He loved her very much. By the time he got here, she was in the coma. On June 25, Kellie's kidneys shut down. On June 27,The doctors put a screw into Kellie's brain to monitor the fluid, they then found out that she started getting water on the brain. On June 28, the doctors told us she was brain dead. We as a family had to make a decision to keep her alive as a vegetable or let her go. She wouldn't know who she was or who we were. The only part of her brain that was still functioning at that time was the part that was keeping her organs going. We all agreed Kellie would not want live like that, for that is not living. We then made the decision for Kellie to be a donor, in hopes of saving someone else. Her heart was still good and her eyes and other parts, but unfortunately she developed an infection and no parts could be used. I truly believe if Kellie had gotten a liver she would be with us now. That's why I believe strongly in organ donation. Livers do not age. Unless they're damaged, they regenerate themselves, and without a liver machine, a transplant is your only hope of survival.

Now, without even being able to say, "good-bye," or "I love you," we watched her slowly die as the machines slowly shut down. On June 28th, 2003, at 6:00 p.m., Kellie was pronounced dead.

Please get this across to your readers in hope no one else has to live through a hell like this.

Thank you,
Jodie


There is an unfortunate tendency for people to think that over-the-counter medications aren't as strong as prescription medications, that they're safer, and that they won't hurt us. When Kellie died, the Managing Director of the Oklahoma Poison Control Center commented, "People think analgesics are safe, but they don't read the labels and they easily can make dosage errors ... fatal errors."

The American Association of Poison Control Centers shows the following statistics for reported acetaminophen poisonings in 2001:

  • Total reported exposures: 57,516
  • Reported exposures, under the age of 19: 40,774
  • Unintentional overdoses: 35,705
  • Intentional overdoses: 20,002
  • Total treated for the exposure: 24,934
  • Impact on health from the incident:
    • none: 15,029
    • minor: 6,223
    • moderate: 3,138
    • major: 829
    • fatal: 120

While we would hope those numbers would be declining, they aren't. The report of the Toxic Exposure Surveillance System (TESS) reported the the following statistics for reported acetaminophen poisonings in 2003:

  • Total reported exposures: 61,902 (up 7.63% from 2001)
  • Reported exposures, under the age of 19: 44,504 (up 9.15% from 2001)
  • Unintentional overdoses: 40,833 (up 14.36% from 2001)
  • Intentional overdoses: 20,113 (up 0.55% from 2001)
  • Total treated for the exposure: 25,964 (up 4.13% from 2001)
  • Impact on health from the incident:
    • none: 15,985 (up 6.36% from 2001)
    • minor: 6,534 (up 5% from 2001)
    • moderate: 3,372 (up 7.46% from 2001)
    • major: 916 (up 10.49% from 2001)
    • fatal: 147 (up 22.50% from 2001)

In trying to address Jodie's question about, "why no one does anything to stop this," I took a look at the labels on some acetaminophen products. The do say, "Do not take more than recommended," and they do say that exceeding that dosage "may cause liver damage."

Is that enough? In my opinion, with over 20,000 unintentional overdoses and 147 deaths from those overdoses in 2003, the answer is, "No, stronger warning language is needed." I'd like to see those warnings changed to say:

  • "Taking more than recommended can be dangerous or fatal."
  • "may cause fatal liver damage."

Changing those warnings wouldn't result an any significant reduction in sales of acetaminophen products, but it might save lives. Even if there were a reduction in sales, no price can be put on the human lives that are now being lost to accidental overdoses. Educating people to the potential dangers is the key.

Please, remember that over-the-counter medications are just as potentially dangerous as prescription medications. Follow the directions. Never take more than the recommended dosage. Migraineurs tend to vomit during Migraine attacks. Do not take additional doses of any medication because you have vomited unless your doctor tells you to. Even a very short period of time in the stomach allows some medications to reach the bloodstream.

Educate yourself. Be smart about medications. Be safe.

 

"Teenager Accidentally Overdoses On Over-The-Counter Analgesic." The Associated Press. ChannelOklahoma.com. July 2, 2003.

"A Profile of U.S. Poison Centers in 2001: A Survey Conducted by the American Association of Poison Control Centers." American Association of Poison Control Centers.

Watson, William A. et al. "2003 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System." American Association of Poison Control Centers. 2004.

 

 

 

 

 

 

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Remember:

Optimal health care
can be achieved
only when patients
are educated
about their health
and patients and
physicians work together as
treatment partners in an atmosphere of mutual respect.


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