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February 14, 1986

Malignant hyperthermia: nightmare for anesthesiologists—and patients

JAMA. 1986;255(6):709-715. doi:10.1001/jama.1986.03370060015002

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"This his is one of the worst things that has ever happened to me in the operating room and I sincerely hope I never have to experience another thing like it."

The quotation is from a letter written to a colleague by the chair of anesthesiology at a major university medical center. He is discussing the death of a patient during a routine fracture reduction.

The patient, Richard Davidson, appeared to be as good an operative risk as one could find. He was 35 years old, tall, muscular, and robustly healthy. He had slipped on an icy street and had sustained a compound fracture of the ankle, the repair of which necessitated an open reduction.

The operation was successful, but as the tourniquet was removed from Davidson's leg, he had a few premature ventricular contractions. Attempts at suppressing arrhythmia were only temporarily successful, and 60 minutes after the tourniquet's release,