[2522421]
A treatment of iontophoresis was used for this patients left middle "trigger finger". The dispersive pad was placed vertically and following the palm along the path of the flexor tendons, from the a1 pulley, proximally. A 2. 0 cc pad was chosen and dexamethasone was dispersed on the pad. This was then placed on the patients palm and a ground pad placed on the forearm. The machine was turned on and the current placed at 1. 2 ma. The patient was asked about her tolerance to the current. She reported she "felt it all the way through the pad", but it was fine. This was not an unusual comment, as the treatment is usually somewhat uncomfortable. Following 3 to 4 minutes, she was left unattended for approximately 7 minutes. I then returned to check on her. At that time she said she felt it more intensely. I stopped the current to inspect under the pad. The volar aspect of her hand appeared normal. I turned the palm down and moved her gold wedding ring to inspect. The ring was on the adjacent ring finger. There was a pinhead size black spot on her skin under the ring. She stated it hurt. The treatment was stopped, she removed her ring. Triple antibiotic was placed on the wound with a sterile qtip, and sterile gauze was placed over this. A cold pack was then placed on her hand for 10 minutes. She left the clinic at that time to see an md. "the patient states that part of the patch was touching her finger. The patient also stated that that some of "goop" extended over onto the ring finger causing conduction to occur between the electrical probe that they were using and the metal wedding band. This did cause a burn to the proximal phalange #4 left upper extremity, and a discoloration to the wedding ring itself. "======================manufacturer response for dupel iontophoresis system, (brand not provided) (per site reporter). ======================please return the unit for internal evaluation. Company to replace this equipment.
Patient Sequence No: 1, Text Type: D, B5