She called an ambulance when the situation seemed to quickly worsen and was transported to a local hospital. She awoke in the early morning hours with shortness of breath and redness on the skin of her chest and torso. K used the rinse that night after brushing her teeth and took the first of the antibiotic pills before going to sleep. The pharmacist said that he had it figured out, in part based upon the condition being treated: he filled the prescription for Dicloxacillin, which he reasoned must be for 500 mg (rather than what looked to be 100 mg). B’s office, where only the receptionist remained at that time of the evening the receptionist was able to tell from the chart that K had a periodontal infection, so she passed that information on to the pharmacist but nothing more in terms of the name of the antibiotic. The pharmacist was fairly easily able to discern the rinse and its dose, but the antibiotic was a different story: neither the name of the drug, save for the letters “D” and “x”, nor the dose was readable. On her way to dinner with a friend, K dropped the prescription forms at a busy chain pharmacy near the restaurant, planning to pick up the medications before traveling home. B found to be effective in such situations, Doxycycline, dosed at 100 mg twice daily. B handed K both handwritten prescriptions, one for the rinse and the other for an antibiotic which Dr. B saw no problem with this approach, so he would prescribe an oral antimicrobial rinse and an antibiotic.Īs she left the office, Dr. With travel plans coming up imminently, K wanted to try to “baby it along” until she returned home, at which time she would have the extraction performed. B advised his patient that extraction looked to be the best solution, at least for #14 currently. At her most recent office presentation, #14 had several probe points nearing 8mm, with noticeable mobility and pressure tenderness, and slight sinus opacification radiographically. Tooth #14 was becoming symptomatic, beginning to show signs of an endo-perio lesion. Over her last few dental examinations, K had shown a worsening overall periodontal condition, most prevalent in her 2 upper left molars, which had apices in very close proximity to the low-lying maxillary sinus. B was asked (socially) what his biggest weaknesses were, he responded without missing a beat – – awful handwriting and an aversion to technology (the latter of which led to his hanging on to handwritten records and handwritten prescriptions, for as long as the upcoming mandates for electronic prescribing would allow). B viewed himself as being in his last few years of practice, so he no longer accepted new patients but maintained his existing patients who had been loyal to him for so long. B was well aware of the allergy, with K’s patient chart being clearly marked to reflect it.ĭr. K had an essentially benign medical history, with one important exception: a history of having had a severe, life-threatening allergic reaction to Penicillin as a child. K, now in her late 50s, has been a dental patient of Dr.
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