NORTH RICHLAND HILLS -- A substitute in a Birdville elementary school nurse's office gave a kindergartner 20 times his normal dose of heart medicine this week, his parents said.
Christopher Mei, 7, is resting at home after four days in the hospital.
"He experienced no heart issues, but it could have gone sour very quickly with the amount of drug he was given," said Louise Mei, his mother. "I'm sure it probably was an accident, but maybe we need to look at policies to see if they can be changed or strengthened to make sure this doesn't happen."
Mei said her son went to the nurse's office at Mullendore Elementary School for a dose of Flecainide, a liquid medicine that he takes three times a day to help keep his heart rhythm normal. He was diagnosed as an infant with an atrioventricular canal defect and has had three surgeries, his mother said.
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But the substitute gave Christopher 12 milliliters of the medicine instead of 0.6 milliliter, Mei said.
The medicine is supposed to be administered with an oral syringe, but the substitute poured it into a small cup.
The syringe was attached to the bottle with a rubber band, said Bill Curtis, the family's attorney.
The substitute, who is not a licensed nurse, realized that she had given the wrong dosage and summoned the head nurse. The child's vital signs were good, district spokesman Mark Thomas said.
At Cook Children's Medical Center, Christopher was given a charcoal solution to help neutralize the drug and was monitored by cardiologists. He was released Thursday and plans to return to school Monday, his mother said.
District officials are investigating, Thomas said.
"We will make a determination on any changes that need to happen," he said. "We're thankful that he is going to be all right, and we will take measures to see that it doesn't happen again."
The district's health services coordinator, Amy Howard, did not respond to a request for comment.
In Birdville, potential nurse's office substitutes must be trained in CPR and first aid. Substitute nurses have one day of training with the district's health services coordinator and a half-day working under the supervision of a nurse at a school, Thomas said.
A permission form filled out by parents notes that students can be administered medicine by a "school nurse or a non-health professional."
School nurses face increasingly complex responsibilities, including caring for children who have diabetes, who are tube-fed and who have life-threatening allergies, said Kathy Powell, president of the Texas School Nurses Organization.
"Professional nurses are trained for these situations," she said, "and can change their plan of action as the situation changes. Teachers and teacher subs are not trained for this role yet are often asked to take this on."
All Birdville schools have at least one staff nurse, but some share responsibilities. A registered nurse works at Mullendore on Mondays, Tuesdays and Wednesday mornings and at nearby Snow Heights Elementary for the rest of the week. A licensed vocational nurse is on duty at one of the schools when the registered nurse is at the other.
Jessamy Brown, 817-390-7326