Mistaken substitution of medication leads to child's death

October 09, 1994|By Jim Stratton | Jim Stratton,Newport News Daily Press

HAMPTON, Va. -- Megan McClave didn't want to take her medicine.

It tasted "yucky" she said, and the 8-year-old spit it out. On the second try, she managed to take about half.

Megan kissed her father good night and slipped off to sleep.

By morning, July 18, she was dead.

Her mother, Johnda McClave Thompson, who lives in Westminster, said Megan was born in West Virginia but the family moved to Randallstownwhen she was less than a year old.

"I just want people to know what happened to her, to know these things can happen and watch out," said Mrs. Thompson. "This should never happen again."

"This," say authorities in Virginia, was mistaken substitution of medications that led to the child's death.

A few days before her death, Megan's tonsils had been removed.

Megan, still a little woozy, was home resting with her mother, who had arrived from Maryland to be with her after the operation.

Her father, Michael a foreman for the CSX railroad, drove to the Rite Aid drugstore in Oyster Point, Va. to fill the prescription for Megan's painkiller.

Demerol liquid, it said. Take "2-3 tsp." every four hours as needed for pain. Mr. McClave waited as the pharmacistfilled the prescription.

'Generic substitute'

A few minutes later, the pharmacist returned to the counter. They didn't have Demerol, he said; what he'd provided was a generic substitute.

Like Megan's prescription, the label stuck on the bottle read: "Take 2 to 3 teaspoonfuls by mouth every 4 hours as needed for pain."

The label also said "Roxanol" and in smaller letters "morphine sulfate."

According to the toxicology reports, Megan Colleen McClave died July 18 from "morphine toxicity due to ingestion of Roxanol."

Instead of dispensing Demerol -- the drug written on Megan's prescription -- authorities say Kent Lee Schafer doled out Roxanol, a powerful morphine-based mixture typically used to relieve the chronic and often crippling pain of cancer patients.

In a two-teaspoon dose Megan got about 200 milligrams of morphine, some six to 20 times the typical adult dosage, said William Cooke, chairman of the pharmacology department at Eastern Virginia Medical School in Norfolk.

Medical experts say the drug shut down her respiratory system. But the primary problem, said the Tidewater District's deputy chief medical examiner, Faruk Presswalla, was morphine poisoning.

"I've never heard of anything like this," said Irwin Reich of the Philadelphia College of Pharmacy and Science. "To think Roxanol is the same as Demerol is inexcusable. They're completely different."

Roxanol is morphine. Demerol is a brand name for a drug called meperidine. Both drugs are painkillers, but they are not interchangeable.

Mr. Schafer's license has been suspended by the Virginia Board of Pharmacy.

Medicine for a sore throat

Friday evening, six or eight hours after her surgery, Megan complained that her throat hurt. Her father measured out a dose of the painkiller and spooned some into her mouth.

Megan spit it onto the floor. "It tastes yucky, daddy," she said.

Saturday, Megan spent the day with her mother. Megan and her 13-year-old sister, Bethany, lived with their father, and Megan looked forward to seeing her mother.

The next afternoon, the pain returned, stronger this time. Mr. McClave decided to try the prescription painkiller again.

He put a couple of teaspoons in a glass of 7-Up and stirred. Megan drank about half.

A little while later, she threw up. Her stomach hurt too, and she seemed quiet and drowsy.

'She seemed better'

Around 7 p.m., Megan nestled into her father's bed to watch TV with him. "It was the first time we'd really spent any time together since the surgery," says Mr. McClave. "She seemed to be doing a little better."

After Megan fell asleep, he read for about an hour and then slept. He woke at 4 a.m. and went to work.

He felt a little uneasy about leaving Megan, but he expected this day to go like most others during the summer. The girls would get up and go to the Winers, the neighbors who watched them during the day.

At 8:30 a.m., Mr. McClave called his daughters. He let the phone ring, but no one answered. He hung up and called his neighbors to see if Bethany and Megan were already there. Not yet, said Geretta Winer.

He said he guessed the girls were in bed and he planned to call later.

At 9:17, his pager began screeching: "It had my phone number, and then '911' after it."

He ran to a phone. At his house, Geretta's husband, Richard, snatched up the receiver.

"You need to get back here right away," Mr. Winer told him.

Bethany had found Megan just after 9 a.m. She lay motionless in her father's bed. Her face was blue and looked a little bloated.

Bethany couldn't wake her. Terrified, she called the Winers, who sprinted over to the house. They called 911 and tried CPR.

It was useless. Megan was dead and may have been for hours.

Mr. McClave turned onto his street to find the neighborhood lit up by the flashing lights of police and emergency vehicles.

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