My non-verbal, developmentally delayed son underwent a routine myringotomy (ear tube placement), a low-risk procedure typically requiring minimal anesthesia. The anesthesiologist administered fentanyl nasal spray, a highly potent opioid, without informing my spouse or me beforehand. We were only vaguely told that a "nasal spray" would be used, with "dosage hard to gauge," providing no opportunity to inquire about the specific drug or its risks. Post-operative nurses disclosed the use of fentanyl after the procedure, at which point we expressed significant distress over the lack of informed consent. The nurses remarked, they "always get that look," indicating they frequently observe parental shock upon learning fentanyl was used. This suggests a systemic failure to ensure informed consent. Post-procedure, my son showed severe, uncharacteristic behaviors: hallucinations, screaming, crying, and aggression for two hours, consistent with fentanyl side effects, especially in disabled children sensitive to opioids. He stabilized after a few hours. Per medical advice, we sent him to school on April 11, 2025, but he was sent home within 2 hours with vomiting, diarrhea, fever, and lethargy. He refused food for four days, with vomiting for two days and diarrhea for six. Seven days later, he barely eats. At 40 pounds, this weight loss is alarming.
Fentanyl nasal spray is rarely used in pediatrics due to its potency, risk of respiratory depression, and potential for severe side effects, especially in non-verbal, disabled children who cannot communicate distress. For a routine ear tube procedure, safer alternatives such as local anesthetics, mild sedatives or non-opioid analgesics are standard and sufficient. The decision to use fentanyl in this context appears unjustified and deviates from typical pediatric anesthesia protocols. The failure to disclose the use of fentanyl nasal spray prior to administration violates informed consent principles, as outlined in FDA regulations and medical ethics standards. Parents must be fully informed of the risks, benefits, and alternatives for any medication, particularly a high-risk opioid like fentanyl.
I have made formal complaints to regulatory bodies regarding the anesthetist's use of fentanyl without clearly informing us and I will not take my child here again for another procedure. Otherwise, our surgeon Dr. Prager was kind pre and post op and responsive to my concerns - but dismissive of his symptoms as a "stomach bug". We are well aware of our child's typical physical responses to "stomach bugs" and this situation looked nothing like what we have witnessed. He was either allergic to the fentanyl or the dosage was too high. Regardless, my child is not up for experimentation and I would warn all parents to steer clear or ask direct and specific questions when choosing this facility for your child. read more
