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New Mitochondrial Genetic Disorder with Hypersensitivity to Volatile Anesthetics

All reports to AIRS are maintained as privileged and confidential within AQI's patient safety evaluation system.

(please include any negative outcomes in patients known to have the m.11232t>C genetic variant so that we can compile a more robust list of safe anesthetics.)
⚠ Please only fill out this report if the patient did NOT have a complication related to the anesthetic.


Describe what happened
Please include as much detailed information as possible.
(Please include any outcome information if known from previous anesthetics)

List the type of anesthetic (Select all that Apply)

Other (Please list sedatives used)

Setting
Facility Type
Age
Gender




Reporter Detail (Optional)

If you elect this option and provide your contact information, you will be provided with a reference number for your report.
 This reference number can be used to review and modify your case at a later date by selecting the 'Review Previous Report' button.