By ALAN PERROTT
Children with cerebral palsy who could not swallow after being injected with botox received three times the normal volume of the paralysing drug, a review has found.
The investigation followed the hospitalisation of three children who were among six treated with botox at Starship children's hospital in July.
Botox injections
have been used for about a year to prevent people with cerebral palsy from excessive drooling.
Six-year-old William Sangster received the injections in his salivary glands on July 28. Three days later, he was back in hospital after botox-induced paralysis left him unable to swallow.
Two others, aged around 10 and 17, also among six injected that day, were admitted with the same problem.
William still has to be fed liquids through a tube in his nose, and it could be next year before the botox wears off.
An internal hospital review found no error had been made, but an independent review released yesterday blamed the problem on the amount of fluid each had received.
Botox is diluted with saline solution when it is injected.
The reviewer, Associate Professor R. Theo Gregor, from Waikato Hospital, found that instead of the usual volume of up to 1.5ml, the six children each received up to 5ml of diluted botox. He concluded that the extra volume dispersed and affected the muscles surrounding the salivary gland, causing temporary paralysis in a bigger area than intended.
"In hindsight this is easy to determine, but it was not so in examining the literature, since these factors were not reported and therefore came as a surprise," he wrote.
Starship children's health clinical leader Dr David Knight said the hospital had met the families of the affected children to apologise and talk them through the findings.
William's mother, Lonili Lauaki, was satisfied the hospital had finally admitted it had made a mistake.
All three children have been discharged and are expected to recover fully without long-term effects.
Dr Knight said the botox treatment would continue to be used, with the endorsement of several parents of affected children, although the manner of its application would be reviewed.
