title: Quality problems that result in adverse outcomes provide opportunities for quality improvement.
abstract: Patient suffers central nervous system damage after prolonged use of metoclopramide and ranitidine hydrochloride to control gastroesophageal reflux. Treatment is complicated by poor communication among providers and omissions in history-taking.
mesh_terms: D000328:Adult; D000897:Anti-Ulcer Agents / Q000009:adverse effects*; D000932:Antiemetics / Q000009:adverse effects*; D003266:Continuity of Patient Care; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000209:etiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy; D006801:Humans; D008787:Metoclopramide / Q000009:adverse effects*; D011899:Ranitidine / Q000009:adverse effects*; D012308:Risk Management; D017749:Total Quality Management
chemical_list: D000897:Anti-Ulcer Agents; D000932:Antiemetics; D011899:Ranitidine; D008787:Metoclopramide