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Jane Doe
DOB: XX/27/XXXX, Age-5, Gender-Female
Drug: Reglan (Metoclopramide)
Brief Summary: Patient had a complaint of gastric esophageal reflux disease (GERD) for which
she was prescribed Reglan by Mohammed Razaq, M.D. on 05/10/XXXX. She later developed
seizures, developmental delay, restless leg syndrome and tardive dyskinesia secondary to Reglan
intake.
Name of the Pharmacy: Walgreens.
Name of Medication Used
Reglan (Metoclopramide) 1mg/ml
Reglan (Metoclopramide) 5 mg/ml
Dates of Use
06/07/XXXX [00035]
05/10/XXXX [00001-3]
06/12/XXXX [00005-7]
02/03/XXXX [000167]
Name of prescribing Health Care Provider
Mohammed Razaq, M.D. [00001-3]
__
Medical Chronology
DATE
05/10/XXXX
PROVIDE
R
The Clinic
of Montfort
06/12/XXXX
The Clinic
of Montfort
06/22/XXXX
08/09/XXXX
08/28/XXXX
09/05/XXXX
Montfort
Clinic
09/13/XXXX
11/15/XXXX
Montfort
Clinic
The Clinic
of Montfort
OCCURRENCE/TREATMENT
Consultation for Gastroesophageal reflux disease (GERD) and diarrhea:
(Mohammed Razaq, M.D.)
Patient has been spitting up after each feeding with occasional vomiting and loose
stools. She was diagnosed with gastroesophageal reflux; however no upper GI
was done. She was placed on Zantac for one month without improvement.
Assessment: Gastroesophageal reflux, diarrhea possibly related to formula
intolerance Plan: Reglan (1mg/ml) 0.8 ml four times daily ½ hour before meals.
Follow up visit for GERD: (Mohammed Razaq, M.D.)
She is currently on Prevacid (7.5 mg Solutab) once daily and Reglan (0.8 ml) four
times daily. Recommended Reglan (1mg/ml) 0.9 ml ½ hour before feeding four
times daily.
Cumulative medical visit:
Patient a multiple medical visits for earache, fever, cough, teething syndrome, and
diarrhea. Patient followed by GI and currently on Prevacid and Reglan.
Follow up visit for GERD and chronic diarrhea: (Mohammed Razaq, M.D.)
She is currently on Prevacid 15 mg Solutab1/2 tab twice daily and her GERD was
well under control. She is currently on Gentlease infant formula. Reglan has been
discontinued.
Cumulative medical visit:
Patient a multiple medical visits for diarrhea, abdominal pain, diaper rash, right
upper gum contusion, fever, and cough. Mother stopped GERD medicine about a
month or more ago as child seemed to get better no vomiting.
Plan: Abdominal pain: Mother instructed to restart GERD medicine as this
behavior may be an indication of abdominal pain from GERD will do 2 week
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00001-3
00005-7
00037-56
00023-25, 629
00058-73
DATE
PROVIDE
R
04/24/XXXX
Illinois
Neurologic
al Clinic
06/18/XXXX
Illinois
Neurologic
al Clinic
Montfort
Clinic
07/23/XXXX
01/22/XXXX
02/03/XXXX
Montfort
Clinic
02/10/XXXX
Good
Shepherd
Hospital
Montfort
Clinic
02/18/XXXX
02/20/XXXX
03/26/XXXX
04/22/XXXX
Montfort
Clinic
04/30/XXXX
05/08/XXXX
05/11/XXXX
Montfort
Clinic
05/12/XXXX
05/21/XXXX
Montfort
Clinic
05/26/XXXX
OCCURRENCE/TREATMENT
trail.
Neurology Consultation for pain in the left lower extremity: (Ricardo Maya,
M.D.)
Complains of difficulty walking. I have the impression that she may have hemi
hypertrophy by the fact that she has increased blood flow to the particular leg.
Neurology Consultation for paroxysmal pain: (Ricardo Maya, M.D.)
My conclusion at this point is that she has paroxysmal pain which I am not certain
of the way to explain that. Could be pill phenomena?
Cumulative medical visit:
Patient a multiple medical visits for diarrhea, speech therapy, precocious
adrenarche, anisocoria, juvenile osteochondrosis of proximal tibia, nasal
discharge, cough, delayed developmental milestones, bronchitis. Per mother last
neurologist wanted to start seizure medications, but mother has refused. Patient’s
parent complained of possible seizure due to episodes of staring delayed
milestone language speech.
Follow up visit for pneumonia.
Esophageal reflux: Continue Zantac. Medication: Metoclopramide- per oral
5mg/ml solution-Give 1.5ml per oral QID before meals.
Barium swallow esophagram:
Normal exam. No gastroesophageal reflux.
Seen by the neurologist Dr. Benita for possible seizures. Mom said the
neurologist was not impressed and asked that the child comes back if more
symptoms develop. Mom said the baby had been having symptoms since she was
8 months old- the child cries of pain at least twice a day and will produce
twitching motions on her extremities for about 30 minutes as if she is trying to
relieve the pain.
Follow up medical visit:
Patient had a multiple medical visit for cough, fever, and decrease in appetite.
Active medication: Metoclopramide Hcl, 5mg/ml, syrup, oral.
Neuro consultation: (Danny Tarzon, M.D.)
 Seizure disorder: This sounds like tonic seizures. These may be representative
or complex partial epilepsy
 Visual impairment right eye
 Developmental language disorder
Cumulative medical visit:
Patient had medical visits for cough and seizure disorder.
Active medication: Metoclopramide HCl, 5mg/ml, syrup, oral.
Visit for leg spasm: (Danny Tarzon, M.D.)
 Restless leg syndrome. Other alternative is whether this is a motor tic rather
than an epileptic event
 Developmental delay
Follow up visits:
Patient had a follow up visit for GERD, possible seizures, delayed milestones
language speech, juvenile osteochondrosis of proximal tibia and precocious
puberty. Active medication: Metoclopramide Hcl, 5mg/ml, syrup, oral.
Electroencephalogram: (Danny Tarzon, M.D.)
No lateralized, focal or epileptiform abnormalities were recorded.
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00001-5
00009-12
000109-163
000164-167
000338
000170-174
000175-197
00002-4
000198-210
00008
000211-218
00016
DATE
06/05/XXXX
06/17/XXXX
06/22/XXXX
06/23/XXXX
07/02/XXXX
07/16/XXXX
PROVIDE
R
Montfort
Clinic
Montfort
Clinic
Montfort
Clinic
07/20/XXXX
07/23/XXXX
11/05/XXXX
11/18/XXXX
Montfort
Clinic
11/19/XXXX
03/02/XXXX
Montfort
Clinic
03/22/XXXX
05/13/XXXX
07/13/XXXX
07/26/XXXX
08/11/XXXX
08/11/XXXX
Montfort
Clinic
01/17/XXXX
Illinois
Neurologic
al Clinic
OCCURRENCE/TREATMENT
Follow up visits:
Patient had a follow up visit for juvenile osteochondrosis of proximal tibia,
cough, nasal discharge and unequal leg length.
Neuro consultation: (Danny Tarzon, M.D.)
Developmental language disorder. This combined with stereotyped movements
raise the possibility of Rett’s syndrome. After prolonged observation, the
movements that she has do not appear to be epileptic origin.
Follow up visits and telephone consults
Active medication: Metoclopramide Hcl, 5mg/ml, syrup, oral.
Visit for autism screen:
 Delayed milestones language speech
 Patient to be evaluated for tardive dyskinesia by Dr. Stanford this week, since
she has tics and abnormal movements and leg ‘pain’/bouncing, since was on
Reglan since infancy.
Neuro consultation: (Danny Tarzon, M.D.)
Drug-induced dyskinesia. It is likely this is a long-term side effect of Reglan
and sometimes it can be a long-term side effect to the H2 blocker.
Follow up visits and telephone consults:
Patient had a follow up visit for dystonia musculorum deformans, delayed
developmental milestones, swelling between eyes, diarrhea, rash and fever.
Neuroconsultation for tardive dyskinesia: (Danny Tarzon, M.D.)
Drug-induced dyskinesia. It is likely this is a long-term side effect of Reglan and
sometimes it can be a long-term side effect to the H2 blocker.
Follow up visits and telephone consults:
Patient had a visit for diarrhea, abdominal pain and congestion, asthma, otitis
media, gastroenteritis, cough, rhinitis, rash, pneumonia, sinusitis and strabismus
non-paralytic exotropia.
Follow up neurology visit: (Danny Tarzon, M.D.)
Tardive dyskinesia. This is a side effect Reglan.
Follow up visits and telephone consults:
Patient had a visit for cellulitis of the left first toe, cough, abdominal pain, vomit,
fever, viral syndrome, noninfectious gastroenteritis, urinary tract infection.
Follow up neurology visit: (Danny Tarzon, M.D.)
Tardive dyskinesia. This is a side effect Reglan. There is still a question of
whether this is a former frontal lobe epilepsy.
Electroencephalogram: (Danny Tarzon, M.D.)
Impression: This study is normal. No lateralized, focal or epileptiform
abnormalities were recorded.
Neuro consultation: (Ricardo Maya, M.D.)
Abnormal involuntary movements: I am not sure what exactly to call the
condition but certainly could have been related to Reglan.
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000221-229
00017-18
000230-242,
248
000243-247
00019
000249-271
00021-22
000272-310
00023
000311-332
00024-26
00027
00013-16