Dialogue Volume 12 Issue 1 2016 | Page 28

practice partner If the printout on methotrexate had been reviewed, it is possible that healthcare providers would have recognized the symptoms of methotrexate toxicity. monitoring blood work was ordered at the same time. On November 17, 2010, the longterm care nursing note indicated that both the patient and her daughter had questions about the methotrexate that the nurse answered to the best of her abilities. There was no comment about whether the faxed information about methotrexate was reviewed and used to answer those questions. [Note: Both nurses who administered the methotrexate said they had never administered it before.] By November 27, 2010, it was noted that the patient’s skin was worse, her voice was hoarse, she was complaining of a sore mouth and throat, and generally feeling unwell. All of these symptoms were consistent with methotrexate toxicity as noted in the printout obtained by the attending physician. On November 30, 20