Title: Reflections on the care of a patient severely poisoned by 'rogue' botulinum toxin and rendered paralysed for a protracted hospital stay

Authors: Steven M. Marcus

Addresses: New Jersey Poison Information and Education System, Department of Preventive Medicine and Community Health, New Jersey Medical School of The University of Medicine and Dentistry of New Jersey, 140 Bergen Street, Suite G1600, P.O. Box 1709, Newark, NJ 07101-1709, USA

Abstract: Just before the Thanksgiving weekend in 2004 an unlicensed physician in Florida administered a raw botulinum toxin type A to himself and three other individuals. Three of the four ended up totally paralysed requiring long term care in intensive care units and rehabilitation services. This report chronicles the daily struggles of one such patient through her stay in acute care hospitals. Five years later this patient still struggles with both physical and mental effects from her ordeal. The story is presented from both the physician|s and patient|s viewpoint. It provides useful insight into the management of an unusual illness and will prove of invaluable background for anyone involved in treating such patients.

Keywords: medical care; intensive care; humanism; botulism clinical syndrome; personal reflections; botulinum toxins; paralysis; rehabilitation; poisoning; patient management.

DOI: 10.1504/TBJ.2009.031683

The Botulinum Journal, 2009 Vol.1 No.3, pp.318 - 339

Published online: 17 Feb 2010 *

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