Details of fatality that occurred from MH
The report by the Palm Beach County Medical Examiner's Office regarding Florida teen Stephanie Kuleba, who died earlier this year of malignant hyperthermia (MH), doesn't answer all of the questions surrounding her death.
Kuleba was having surgery to correct an inverted nipple and asymmetrical breasts when she developed MH, according to a media report.1 The autopsy report doesn't say whether the plastic surgeon and anesthesiologist provided Kuleba with a sufficient amount of dantrolene or whether it was administered quickly enough. The Kulebas' family attorney has said she should have received seven vials as an initial dose, the media report says. On medical records, one doctor noted she received one vial of the antidote, and the other doctor wrote that she received two. It's not known at what time the drug was administered or whether there was enough dantrolene available at the facility. According to the attorney, the surgery began at 8:05 a.m. Paramedics were called at 9:45 a.m., and they eventually administered an epinephrine shot, records show. That shot should have been given by her doctors as soon as Kuleba's heart stopped beating, the attorney maintains.
The family's lawyer said in a media report that several other factors could have contributed to the death.2 The anesthesia wasn't stopped until 10 minutes after Kuleba began to show signs of MH, he said. When her temperature rose to dangerous levels, doctors should have pumped cold saline into her bladder, stomach, and other organs to lower her body temperature, he said. Instead, they placed ice on her body, he said. When her heart stopped beating, doctors should have given her a shot of epinephrine, which clinics are required to keep on hand, he said.
Both doctors have defended their actions and said the situation was handled appropriately.1 They say Kuleba received the dantrolene dose needed once they consulted with the hotline for the Malignant Hyperthermia Association of the United States.
References
- Sarmiento G. Autopsy confirms Boca Raton cheerleader died of rare genetic ailment. The Palm Beach Post; May 30, 2008. Accessed at www.palmbeachpost.com/localnews.
- DeNardo C. West Boca High cheerleader got fraction of drug needed, lawyer charges. The Palm Beach Post; April 1, 2008. Accessed at www.palmbeachpost.com.
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