Subnanogram Assay for Pilocarpine in Biological Fluids

Bayne, W.F.; Chu, L.‐C.; Tao, F.T.

doi:10.1002/jps.2600651208

Cited by 21 publications

(2 citation statements)

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“…(2) Poisoning with amanitas mushrooms: the symptoms usually include vomiting, and no mushrooms were present in the soup or main course. (3) Other causes of pulmonary oedema, such as acute ischaemic left ventricular failure, myocardial infarction, and inhalation of gastric contents, were unlikely given the history.…”

Section: Possible Differential Diagnosesmentioning

confidence: 99%

Deaths of two hospital inpatients poisoned by pilocarpine.

Cordner¹,

Fysh

Gordon³

et al. 1986

BMJ

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Two inpatients of one hospital ward died. Pilocarpine poisoning was suspected and subsequently confirmed by analysis of urine. The circumstantial evidence strongly suggested that the food given to the patients in the ward had been adulterated. Police inquiries failed to elict any further information, and open verdicts were returned at the inquest. Precautions taken subsequently to prevent a similar event-sealing food containers and trolleysentailed a capital cost of £43 000. In addition, food stores were kept locked and tighter control kept on drugs stored in ward pharmacies.

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Section: Possible Differential Diagnosesmentioning

confidence: 99%

Deaths of two hospital inpatients poisoned by pilocarpine.

Cordner¹,

Fysh

Gordon³

et al. 1986

BMJ

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“…Preliminary observations on the effect of dietary brussels sprouts on thyroid function. Hwnan Toxicolo 1986;5:15-9 3. Sones K, Heaney RK, Fenwick GR.…”

mentioning

confidence: 99%

Dangerous misuse of sulphonylureas.

Ludman¹,

Mason²,

Joplin³

1986

BMJ

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pneumonia after pilocarpine toxicity but declaring that there was no evidence as to where, when, or how the drug had been administered. The Department of Health and Social Security has highlighted the ease of access to most hospitals5 and in 1982 asked health authorities to review their procedures for keeping equipment, stock, and premises secure and to develop a security strategy. There are no reports of hospital security in the United Kingdom, but the topic is occasionally aired in the United States. For example, Coiling outlined incidents of rape, robbery, kidnapping, assault, and even homicide, which were occurring with increasing frequency on hospital campuses.6 He emphasised that a well organised security programme was essential for the provision of excellent patient care. As food containers travel up to a third of a mile from the kitchen area to wards in West Park Hospital it was clear that tighter security was necessary. All the food containers are now sealed either with a plastic heat sealed bond or within a polythene bag sealed with a ratchet tag. The trolleys are also sealed around the body and doors. Food stores and ward larders are locked. Unauthorised access to any kitchen area, including those in the wards themselves, is prohibited; patients are not allowed in these areas. The capital cost of providing equipment to ensure the security of food was £43 000, with an annual cost of £3 500. The practice of sometimes using one minim of eye drops to treat both eyes was curtailed, thus improving the accuracy of ward pharmacy records. As a coincidental safeguard food prepared in the hospital kitchen is sampled. These samples are frozen and retained for five days. This action was a consequence of the outbreak of food poisoning at the Stanley Royd Hospital near Wakefield.' We acknowledge the cooperation of the environmental health officers of Epsom and Ewell Borough Council. We thank Colonel G M McEwan, HM Coroner for Surrey, and Dr G H Robb, consultant physician, for permission to report on these three patients.

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