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Ethicolegal
ethics
adverse events
An 82-year-old male, with a history of severe chronic pain due to widespread osteoarthritis, is admitted to a regional hospital in Manitoba for pain management. During an evening shift, a junior internal medicine resident, overwhelmed by a heavy workload, mistakenly enters an order for a potent long-acting opioid at a dose of 10 mg instead of the intended 1 mg, due to a transcription error from a handwritten note. The night nurse, despite an institutional double-check policy, administers the incorrect dose. Within an hour, the patient is found to be profoundly sedated with respiratory depression (respiratory rate 6 breaths/minute, SpO2 85% on room air). He is immediately administered naloxone, requires intubation, and is transferred to the ICU for ventilatory support. The patient makes a full neurological recovery after 48 hours and is extubated. The incident is reported to the attending physician and the hospital's patient safety office. In this situation, considering medical ethical and legal principles, what is the most appropriate initial action regarding communication with the patient and his family?
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