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The Toxicology Investigators Consortium Case Registry—the 2016 Experience

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Abstract

The Toxicology Investigators Consortium (ToxIC) Case Registry was established by the American College of Medical Toxicology in 2010. The Registry contains data from participating sites with the agreement that all bedside medical toxicology consultations will be entered. Currently, 83% of accredited medical toxicology fellowship programs in the USA participate. The Registry continues to grow each year, and as of 31 December 2016, a new milestone was reached, with more than 50,000 cases reported since its inception. The objective of this seventh annual report is to summarize the Registry’s 2016 data and activity with its additional 8529 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from 1 January to 31 December 2016. Detailed data was collected from these cases and aggregated to provide information which includes the following: demographics (age, gender, race, ethnicity, HIV status), reason for medical toxicology evaluation (intentional pharmaceutical exposure, envenomation, withdrawal from a substance), agent and agent class, clinical signs and symptoms (vital sign abnormalities, organ system dysfunction), treatments and antidotes administered, fatality and life support withdrawal data. Fifty percent of cases involved females, and adults aged 19–65 were the most commonly reported. There were 86 patients (1.0%) with HIV-positive status known. Non-opioid analgesics were the most commonly reported agent class, with acetaminophen the most common agent reported. There were 126 fatalities reported in 2016 (1.5% of cases). Major trends in demographics and exposure characteristics remained similar overall with past years’ reports. While treatment interventions were commonly required, fatalities were rare.

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Acknowledgments

Toxicology Investigators Consortium (ToxIC) Study Group Collaborators:

Aks SE, Algren DA, Alwasiyah D, Beauchamp G, Bentur Y, Beuhler MC, Boyle KL, Bruccoleri RE, Burns, MM, Cahana A, Cannon RD, Caravati EM, Carey JL, Chhabra N, Chomin J, Christian MR, Conner K, Cook MD, Cumpston KL, Dissanayake V, Dribben WH, Eisenga BH, Engebretsen KM, Falkowitz D, Farkas A, Fenton A, Froberg BA, Furmaga JF, Ganetsky M, Garlich F, Geib AJ, Gorodetsky R, Greene S, Greller HA, Gummin DD, Hart K, Hendrickson RG, Hernandez S, Hoyte CO, Judge BS, Kazzi Z, Kerns W, Kessler BD, King J, Kirschner R, Kleinschmidt KC, Kostic MA, Kusin S, Leikin, JB,LeRoy JM, Levine M, Lo CY, Lowry JA, Lung D, Lurie Y, Maddry J, Majlesi N, Manini AF, Marlin MB, McKay C, McKeever RG, McKeown NJ, Meggs WJ, Miller SN, Minns A, Moore E, Morgan BW, Mullins ME, Nappe TM, Nogar JN, Oakley E, Olmedo R, Othong R, Parker-Cote J,Regina A, Riley BD, Rowden A, Ruha AM, Rusyniak DE, Schult, R, Schwarz ES, Seifert SA, Sessions D, Shulman J, Smolinske SC, Smollin C, Spyres MB, Steck A, Stellpflug SJ, Sullivan R, Toce MS, Troendle MM, Vearrier D, Warrick BJ, Watts DC, Wills BK, Wolk BJ, Zosel AE.

We also wish to thank study coordinators AB Adefeso, Mary Connie Aubin, Anita Kurt, Julie Licata, Misti Marshall, Maureen Morgan, Tammy Phan, Andrea Ramirez, and Melissa VandenBerg.

Author information

Authors and Affiliations

  1. Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA

    Lynn A. Farrugia

  2. Saint Francis Hospital and Medical Center, 114 Woodland St., Hartford, CT, 06105, USA

    Sean H. Rhyee

  3. New Jersey Medical School, Rutgers, the State University of New Jersey, 140 Bergen Street, Suite G1600, Newark, NJ, 07101-1709, USA

    Diane P. Calello

  4. American College of Medical Toxicology, 10645 N. Tatum Blvd., Suite 200-111, Phoenix, AZ, 85028, USA

    Sharan L. Campleman, Anne M. Riederer & Paul M. Wax

  5. University of Arizona College of Medicine, Banner University Medical Center, 1012 E. Willetta Ave, Phoenix, AZ, 85006, USA

    Hannah R. Malashock

  6. University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA, 15213, USA

    Anthony Pizon

  7. University of Rochester Medical Center, Strong Memorial Hospital, 601 Elmwood Avenue, Rochester, NY, 14642, USA

    Timothy Wiegand

  8. UT Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA

    Paul M. Wax

  9. University of Colorado School of Medicine, 13001 E 17th Pl., Aurora, CO, 80045, USA

    Jeffrey Brent

Authors
  1. Lynn A. Farrugia
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  2. Sean H. Rhyee
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  3. Diane P. Calello
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  4. Sharan L. Campleman
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  5. Anne M. Riederer
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  6. Hannah R. Malashock
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  7. Anthony Pizon
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  8. Timothy Wiegand
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  9. Paul M. Wax
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  10. Jeffrey Brent
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Consortia

On behalf of the Toxicology Investigators Consortium Study Group

  • S. E. Aks
  • , D. A. Algren
  • , D. Alwasiyah
  • , G. Beauchamp
  • , Y. Bentur
  • , M. C. Beuhler
  • , K. L. Boyle
  • , R. E. Bruccoleri
  • , M. M. Burns
  • , A. Cahana
  • , R. D. Cannon
  • , E. M. Caravati
  • , J. L. Carey
  • , N. Chhabra
  • , J. Chomin
  • , M. R. Christian
  • , K. Conner
  • , M. D. Cook
  • , K. L. Cumpston
  • , V. Dissanayake
  • , W. H. Dribben
  • , B. H. Eisenga
  • , K. M. Engebretsen
  • , D. Falkowitz
  • , A. Farkas
  • , A. Fenton
  • , B. A. Froberg
  • , J. F. Furmaga
  • , M. Ganetsky
  • , F. Garlich
  • , A. J. Geib
  • , R. Gorodetsky
  • , S. Greene
  • , H. A. Greller
  • , D. D. Gummin
  • , K. Hart
  • , R. G. Hendrickson
  • , S. Hernandez
  • , C. O. Hoyte
  • , B. S. Judge
  • , Z. Kazzi
  • , W. Kerns
  • , B. D. Kessler
  • , J. King
  • , R. Kirschner
  • , K. C. Kleinschmidt
  • , M. A. Kostic
  • , S. Kusin
  • , J. B. Leikin
  • , J. M. LeRoy
  • , M. Levine
  • , C. Y. Lo
  • , J. A. Lowry
  • , D. Lung
  • , Y. Lurie
  • , J. Maddry
  • , N. Majlesi
  • , A. F. Manini
  • , M. B. Marlin
  • , C. McKay
  • , R. G. McKeever
  • , N. J. McKeown
  • , W. J. Meggs
  • , S. N. Miller
  • , A. Minns
  • , E. Moore
  • , B. W. Morgan
  • , M. E. Mullins
  • , T. M. Nappe
  • , J. N. Nogar
  • , E. Oakley
  • , R. Olmedo
  • , R. Othong
  • , J. Parker-Cote
  • , A. Regina
  • , B. D. Riley
  • , A. Rowden
  • , A. M. Ruha
  • , D. E. Rusyniak
  • , R. Schult
  • , E. S. Schwarz
  • , S. A. Seifert
  • , D. Sessions
  • , J. Shulman
  • , S. C. Smolinske
  • , C. Smollin
  • , M. B. Spyres
  • , A. Steck
  • , S. J. Stellpflug
  • , R. Sullivan
  • , M. S. Toce
  • , M. M. Troendle
  • , D. Vearrier
  • , B. J. Warrick
  • , D. C. Watts
  • , B. K. Wills
  • , B. J. Wolk
  •  & A. E. Zosel

Corresponding author

Correspondence to Lynn A. Farrugia.

Ethics declarations

Funding

ToxIC was supported by a continuation of a grant from the US National Institutes of Health on cardiovascular drug toxicity, a new contract with the US Food and Drug Administration, and the continuation of unrestricted grant support from BTG International, which was used to support the North American Snakebite Registry.

Conflicts of Interest

None

Previous Presentation of Data

None

Funding Sources

This study received funding from the NIH National Institute on Drug Abuse 1R56DA38366, and 1R01DA037317-01, a data sharing contract with the U.S. Food and Drug Administration, and BTG International Inc.

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Farrugia, L.A., Rhyee, S.H., Calello, D.P. et al. The Toxicology Investigators Consortium Case Registry—the 2016 Experience. J. Med. Toxicol. 13, 203–226 (2017). https://doi.org/10.1007/s13181-017-0627-3

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  • DOI: https://doi.org/10.1007/s13181-017-0627-3

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