One was a teenager who died after receiving too much Dilaudid (hydromorphone). He was given the PCA device after surgery. His mother pushed the button for him several times while he was sleeping. She believed she was making her son more comfortable. The rest of the story: With PCA, the patient himself provides a measure of safety. If the patient is too sleepy, he will not push the button to give more medication. This built-in safety feature helps prevent patients from receiving too much. But if other people push the button for him, the device may deliver unneeded medication that can cause a tragic overdose.
Lessons learned: PCA gives you access to your pain medication when you need it, an important step forward in pain control. However, make sure that family and friends know not to push the button for you or anyone who is receiving PCA.