Daniel E Brooks

Clinical Professor, Internal Medicine

Contact

(602) 239-6690
COLLEGE OF MEDICINE PHX
broode@arizona.edu

Biography

BIOGRAPHICAL SKETCH

NAME: Daniel E. Brooks, MD

eRA COMMONS USER NAME (credential, e.g., agency login): Daniel.Brooks

POSITION TITLE: Clinical Professor of Medicine and Emergency Medicine; Medical Director, Banner Poison & Drug Information Center.

EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable. Add/delete rows as necessary.)

INSTITUTION AND LOCATION	DEGREE (if applicable)	Completion Date MM/YYYY	FIELD OF STUDY

University of Stony Brook; Stony Brook, NY.	BS	05/1993	Psychology
University of Stony Brook School of Medicine; Stony Brook, NY. University of Pittsburgh Medical Center, Depart. of Emergency Medicine; Pittsburgh, PA. Good Samaritan Medical Center; Phoenix, AZ.	MD with distinction in research Residency Fellowship	05/1997 05/2000 05/2002	Medicine Emergency Medicine Medical Toxicology

Personal Statement

I have dedicated my career to the treatment and prevention of poisoning-related morbidity and mortality. First as a bedside treating physician, working in Emergency Departments and Intensive Care Units, and then as the Medical Director for three Poison & Drug Information Centers (consecutively over the past 16 years). I have been very fortunate to work both clinically (bedside care of thousands of patients with poison, drug, medication or venom-induced illnesses), administratively (poison control centers, toxicology patient clinic and College of Medicine research center) and academically (scholarly work).

Academically, I have focused my research and publication efforts on critical care toxicology and poison control centers’ patient care and epidemiology. I have been fortunately to serve on the national level through various positions within the American Association of Poison Control Centers (AAPCC). My most honored, and rewarding, work has been as a Co-Chair for the AAPCC’s National Poison Data System’s Fatality Review Committee. For the past four years I have helped record, review and analyze all poisoning related deaths reported to US poison centers. These tasks include publishing a yearly review of the work US poison centers perform and included data about call types and volume, clinical effects, provided treatments and patient outcomes including death. Selected deaths are represented with concise abstracts in hopes of educating healthcare providers, policy makers and industry leaders about these risks. In addition, each report focuses on a specific exposure or substance that displayed unique, or worrisome, findings during the last year’s data. For instance, the 2016 report included specific data about opioid-related fatalities collected through the AAPCC and CDC: https://aapcc.s3.amazonaws.com/pdfs/annual_reports/12_21_2017_2016_Annua.pdf

My educational efforts have focused on teaching toxicology and pharmacology to EMS providers, college of medicine and graduate medical students (nurses and pharmacists), physicians-in-training (residents and fellows) and healthcare providers throughout Arizona. I was also given a visiting Professor position at the University of Osaka Medical Center, where I have spent several weeks a year, for the past four years, teaching clinical and didactic aspects of toxicology, including alcohol and opioid toxicity and withdrawal. I have also worked with several Tribal and critical-access (rural) healthcare facilities to develop alcohol withdrawal treatment guidelines.

Administrative work has included being the Director of Poison & Drug Information Centers, an Outpatient Toxicology Clinic and the Center for Toxicology and Pharmacology Education and Research (CTPER). Toxicological work that is currently being done through CTPER include The Arizona Opioid Assistance and Referral Line (which provides 24/7 treatment and resource advise for opioid-related injuries to providers and laypersons), Medical Marijuana safety and monitoring, Zika (and other infectious agents) and Disaster Preparedness.

My diverse experiences have allowed me to develop a holistic view of poisoning-related events while fostering new relationships with (sometimes) not so obvious partners and stake-holders. Throughout all of this work I have endeavored to move forward, simultaneously with three ideals: 1- provide world-class patient care, 2 - further education and research, and 3 - save lives and resources.

Positions and Honors

1997-2000 Emergency Medicine Resident; University of Pittsburgh Medical Center, Pittsburgh, PA.

2000-2002 Medical Toxicology Fellow; Good Samaritan Medical Center, Phoenix, AZ.

2002-2004 Clinical Instructor of Emergency Medicine; University of Pittsburgh Medical Center.

2002-2007 Chief; Division of Medical Toxicology, University of Pittsburgh Medical Center.

2002-2007 Medical Director; West Virginia Poison Control Center, Charleston, WV.

2002-2007 Back-up Medical Director; Pittsburgh Poison Center, Pittsburgh, PA.

2004-2007 Assistant Professor of Emergency Medicine; University of Pittsburgh Medical Center.

2007 Medical Director; Banner Poison and Drug Information Center, Phoenix, AZ.

2007-current Attending, Department of Medical Toxicology; Banner University Medical Center-Phoenix.

2007-current Attending, Division of Medical Toxicology; Phoenix Children’s Hospital, Phoenix, AZ.

2008-current Director; Medical Toxicology Outpatient Clinic, Banner University Medical Center-Phoenix.

2010-current Clinical Professor; Department of Medicine, University of Arizona College of Medicine-Phoenix.

2010-current Clinical Professor; Department of Emergency Medicine, UofA College of Medicine-Phoenix.

2015-current Visit Teaching Professor; Department of Traumatology, University of Osaka, Osaka, Japan.

2015-current Co-Director, Center for Toxicology and Pharmacology Education and Research, University of

Arizona College of Medicine-Phoenix.

2015-current Co-Chair; American Association of Poison Control Centers’ National Poisoning Data System

Fatality Reports.

2015-current Committee member; America Association of Poison Control Centers CSPI Examination.

2018-2020 President, American Association of Poison Control Centers Medical Directors’ Advisor Council.

Contributions to Science

Publications and Invited Lectures on Medical Toxicology Subjects

Focus on the acute care of poisoned patients, management of alcohol and drug (e.g. opioid) withdrawal and poisoning-related fatalities. Selected work include the following:

Enfield B, Brooks DE, Welch S, Roland M, Klemens J, Greenlief K, Olsen R, Gerkin RD. Human plant exposures reported to a regional (southwestern) poison control center over 8 years. Journal of Medical Toxicology 2018;14(1):74-78.

Levine M, Beuhler MC, Pizon AF, Cantrel F, Spyres M, LoVecchio F, Skolnik A, Brooks DE. Assessing bleeding risk in patients with intentional overdoses of novel antiplatelet and anticoagulant medications. Annals of Emergency Medicine 2018;71(3):273-278.

Gummins DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W: 2016 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34nd annual report. Clinical Toxicology 2017;55(10):1072. Doi:10.1080/15563650.2017.1388087.

Kang, MA, Brooks DE: Geographic Analysis of Scorpion Exposures Reported to US Poison Control Centers from 2010 to 2015. American Journal of Public Health 2017;107(12):1958-1963.

Mowry JB, Spyker DA, Brooks DE, Zimmerman A, Schauben JL: 2015 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 33nd annual report. Clinical Toxicology 2016;54(10):924. DOI10.1080/15563650.2016.1245421

Kang, AM, Brooks DE: Nationwide Scorpion Exposures Reported to US Poison Control Centers from 2005-2015. Journal of Medical Toxicology 2016: DOI 10.1007/s13181-016-0594-0.

Kang, AM, Brooks DE: US Poison Control Center Calls for Infants 6 Months of Age and Younger. Pediatrics 2016;137(2): e20151865.

Mowry JB, Spyker DA, Brooks DE, McMillan N, Schauben JL: 2014 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 32nd annual report. Clinical Toxicology 2015;53(10):962-1147.

Bosak A, Brooks DE, Welch S, Padilla-Jones A, Gerkin RD: A retrospective review of 911 calls to a regional poison control center. Journal of Family Medicine and Primary Care 2015;4(4):546-550.

Otaluka O, Corrado R, Brooks DE, Nelson DB: A survey of poison center knowledge and utilization among urban and rural residents in Arizona. Toxicology Reports 2015;2:203-204.

Curry SC, Brooks DE, Skolnik AB, Gerkin RD, Glenn S: Effect of a medical toxicology admitting service on length of stay, cost and mortality among inpatients discharged with poisoning-related diagnoses. Journal of Medical Toxicology; 2014; Doi: 10.1007/s13181-014-0418-z.

Glogan D, Levitan RD, Brooks DE, Gerkin RD: Unintentional use of mistaken insulin products: a retrospective review of poison center data. Journal of Emergency Medicine 2013;45(4):547-553.

Levine M, Ruha AM, Graeme K, Brooks DE, et al: Toxicology in the ICU; part 3: Natural Toxins. Chest, 2011;140(5):1357-1370.

Brooks DE, Levine M, et al: Toxicology in the ICU; part 2: Specific toxins. Chest 2011;140(4):1072-1085.

Levine M, Brooks DE, et al: Toxicology in the ICU; part 1: A general overview and approach to treatment. Chest 2011;140(3):795-806.

Lecture; “Opioid Toxicity; Pediatric / PCC Perspective.” Arizona Pediatric Symposium: 03/13/2018

Lecture; “Toxidromes.” Grand Rounds, Fort Defiance Medical Center, Navajo Nation: 03/2017.

Japan Lecture Series; Peripheral Neuropathy, Acute Psychosis in the ED, Opiates and Reversal Agents, Carbon Monoxide, Toxidromes, Cyanide and Hydrogen Sulfide, Corrosive Injuries, Lead Poisoning. Osaka University, Police, Tane and Osaka City General Hospitals; Osaka, Japan: 03/2016.

Lecture; “Toxicological Drug Testing.” CTPER Continuing Education Conference, Phoenix, Arizona, 4/25/15.

Lecture; “Introduction to US Poison Centers.” Japan Poison Information Center; Osaka, Japan: 2/23/15.

Japan Lecture Series; Introduction to US Poison Centers, Poisoned Patients, Toxicological Syndromes, Carbon Monoxide, Cyanide, Hydrogen Sulfide, Food-related Illnesses, Agitated Delirium, Corrosive Injuries, Serotonin Syndrome and Organophosphates. Osaka University Hospitals; Osaka, Japan: 02/2015.

Lecture; “Effect of a Medical Toxicology Admitting Service on Length of Stay, Cost and Mortality
Among Inpatients Discharged with Poisoning-related Diagnoses.” NACCT, New Orleans, LA: 10/2014.

Lecture; “Envenomations of the Desert Southwest.” 2011 Arizona Infectious Disease Training & Exercise; Arizona State University, 07/2011.

Lecture; “Chemical Restraint of the Agitated Patient.” The 2nd EurAsian Congress on Emergency Medicine, Antalya, Turkey, 10/2010.

Lecture; “Salicylate Toxicity.” The 2nd EurAsian Congress on Emergency Medicine, Antalya, Turkey, 10/2010.

Local and National Patient Care Event Planning

2008-current Resource member; Maricopa County Department of Health Services.

2009-current Member; Banner Health Clinical Consensus work groups.

2013-2017 Participating Center; Flu on Call® - CDC Pandemic influenza response.

2014-current Member; Arizona Department of Health Services Disaster Preparedness.

2015-2016 Member; Phoenix EMS Preparedness Committee (NCAA football championship).

2016-current Member; American College of Medical Toxicology Quality Task Force

Peer-review Journal Editor and Reviewer

2004-current Reviewer; Journal of Emergency Medicine.

2005-current Reviewer; Internal and Emergency Medicine.

2007-current Reviewer; Journal of Medical Toxicology.

2011-current Editorial Board, Journal of Medical Toxicology.

2014-current Reviewer; Case Reports in Medicine.

Additional Information: Scholastic Performance

1989 Presidential Scholarship; University of Stony Brook, Stony Brook, NY.

1997 MD with Distinction in Research Award; University of Stony Brook Medical School, Stony Brook, NY.

2000 Clinical Excellence Award; Emergency Medicine Residency, University of Pittsburgh Medical Center.

2006 Faculty Excellence Award; Department of Emergency Medicine, University of Pittsburgh Medical Center

2012 Teaching Award; Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ.

Degrees

M.D. Medical Toxicology

Good Samaritan Medical Center, Phoenix, Arizona, United States
Fellowship in Medical Toxicology

M.D. Emergency Medicine

University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
Residency in Emergency Medicine

M.D. Emergency Medicine, Medical Toxicology

Stony Brook University, Stony Brook, New York, United States

Work Experience

Osaka University (2015 - Ongoing)
Department of Emergency Medicine (2007 - Ongoing)
Department of Medical Toxicology (2007 - Ongoing)

Awards

Pharmacy Appreciation Award

Arizona Pharmacy Association, Summer 2018

Licensure & Certification

MD, Arizona Medical Board (2007)
MD, West Virginia Medical Board (2001)

Interests

Research

Poison Center Management

Teaching

Acute care, environmental exposures, industrial/occupational toxicology, opioid abuse treatment, training emergency medicine and toxicology in other countries.

Courses

No activities entered.

Scholarly Contributions

Chapters

Brooks, D. E. (2016). Gyromitra Mushrooms Chapter.. In In Critical Care Toxicology. Brent J et al Eds. Elsevier Mosby, 2016.

Journals/Publications

Enfield, B., Brooks, D. E., Welch, S., Roland, M., Klemens, J., Greenlief, K., Olson, R., & Gerkin, R. D. (2018). Human Plant Exposures Reported to a Regional (Southwestern) Poison Control Center Over 8 Years. Journal of medical toxicology : official journal of the American College of Medical Toxicology.
More info
There is little published data about human plant exposures reported to US poison control centers (PCCs).
Levine, M., Pizon, A., Beuhler, M., Cantrell, F. L., LoVecchio, F., Spyres, M., Skolnik, A. B., & Brooks, D. E. (2018). Exploratory Ingestions of Novel Anticoagulants and Antiplatelets: What Is the Risk?. Pediatric emergency care.
More info
Historically, anticoagulants and antiplatelet agents included warfarin and aspirin, respectively. In recent years, numerous novel anticoagulants (eg, direct thrombin inhibitors and factor Xa inhibitors) as well as the adenosine diphosphate receptor antagonists have increased significantly. Little information on the bleeding risk after exploratory ingestion of these agents is available. The primary purpose of this study is to evaluate the bleeding risk of these agents after an exploratory ingestion in children 6 years or younger.
Bosak, A., Brooks, D. E., Welch, S., Padilla-Jones, A., & Gerkin, R. D. (2017). A retrospective review of 911 calls to a regional poison control center. Journal of family medicine and primary care, 4(4), 546-50.
More info
There is little data as to what extent national Emergency Medical Services (EMS; 911) utilize poison control centers (PCCs). A review of data from our PCC was done to better understand this relationship and to identify potential improvements in patient care and health care savings.
Brooks, D. (2017). 2016 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th annual report.. Clinical Toxicology.
Brooks, D. (2017). Geographic Distribution of Scorpion Exposures in the United States, 2010-2015.. Am J Public Health.
Gummin, D. D., Mowry, J. B., Spyker, D. A., Brooks, D. E., Fraser, M. O., & Banner, W. (2017). 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Clinical toxicology (Philadelphia, Pa.), 55(10), 1072-1252.
More info
This is the 34th Annual Report of the American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS). As of 1 January 2016, 55 of the nation's poison centers (PCs) uploaded case data automatically to NPDS. The upload interval was 9.50 [7.33, 14.6] (median [25%, 75%]) min, facilitating a near real-time national exposure and information database and surveillance system.
Heise, C. W., Malashock, H., & Brooks, D. E. (2017). A review of vilazodone exposures with focus on serotonin syndrome effects. Clinical toxicology (Philadelphia, Pa.), 55(9), 1004-1007.
More info
Vilazodone is an antidepressant with selective serotonin reuptake inhibition and partial 5HT1A agonism. Serotonin syndrome is believed to be due to excessive stimulation of 5-HT2A and 5-HT1A receptors, resulting in the clinical triad of altered mentation, autonomic instability and neuromuscular abnormalities. The goal of this study is to define serotonergic effects after vilazodone exposure.
Kang, A. M., & Brooks, D. (2017). Geographic Analysis of Scorpion Exposures Reported to US Poison Control Centers from 2010 to 2015.. American Journal of Public Health, 107(12), 1958-1963.
Kang, A. M., & Brooks, D. E. (2017). Geographic Distribution of Scorpion Exposures in the United States, 2010-2015. American journal of public health, 107(12), 1958-1963.
More info
To determine the geographic distribution of scorpion envenomations in the United States by zip code, with particular attention to the neurotoxic Centruroides sculpturatus (Arizona bark scorpion), for which an antivenom is available.
Levine, M., Beuhler, M. C., Pizon, A., Cantrel, F. L., Spyres, M. B., LoVecchio, F., Skolnik, A. B., & Brooks, D. E. (2017). Assessing Bleeding Risk in Patients With Intentional Overdoses of Novel Antiplatelet and Anticoagulant Medications. Annals of emergency medicine.
More info
In recent years, the use of novel anticoagulants and antiplatelet agents has become widespread. Little is known about the toxicity and bleeding risk of these agents after acute overdose. The primary objective of this study is to evaluate the relative risk of all bleeding and major bleeding in patients with acute overdose of novel antiplatelet and anticoagulant medications.
Heise, C. W., & Brooks, D. E. (2016). Ayahuasca Exposure: Descriptive Analysis of Calls to US Poison Control Centers from 2005 to 2015. Journal of medical toxicology : official journal of the American College of Medical Toxicology.
More info
Ayahuasca is a hallucinogenic plant preparation which usually contains the vine Banisteriopsis caapi and the shrub Psychotria viridis. This tea originates from the Amazon Basin where it is used in religious ceremonies. Because interest in these religious groups spreading as well as awareness of use of ayahuasca for therapeutic and recreational purposes, its use is increasing. Banisteriopsis caapi is rich in β-carbolines, especially harmine, tetrahydroharmine and harmaline, which have monoamine oxidase inhibiting (MAOI) activity. Psychotria viridis contains the 5HT2A/2C/1A receptor agonist hallucinogen N,N-dimethyltryptamine (DMT). Usual desired effects include hallucination, dissociation, mood alteration and perception change. Undesired findings previously reported are nausea, vomiting, hypertension, and tachycardia.
Kang, A. M., & Brooks, D. E. (2016). Nationwide Scorpion Exposures Reported to US Poison Control Centers from 2005 to 2015. Journal of medical toxicology : official journal of the American College of Medical Toxicology.
More info
Previous studies of scorpion envenomation in the United States (US) have focused on Arizona and the bark scorpion, Centruroides sculpturatus. Although many other scorpion species live in the US, information about envenomations in other states is lacking.
Kang, A. M., & Brooks, D. E. (2016). US Poison Control Center Calls for Infants 6 Months of Age and Younger. Pediatrics, 137(2), e20151865.
More info
Anticipatory guidance and prevention efforts to decrease poisonings in young children have historically focused on restricting access to minimize exploratory ingestions. Because infants through 6 months of age have limited mobility, such exposures are expected to be less frequent and therapeutic (or dosing) errors should be more frequent. Although recent prevention efforts target some types of therapeutic errors, the epidemiology of these exposures is not well characterized in this age group. This could have important implications for the effectiveness of current prevention efforts.
Mowry, J. B., Spyker, D. A., Brooks, D. E., Zimmerman, A., & Schauben, J. L. (2016). 2015 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 33rd Annual Report. Clinical toxicology (Philadelphia, Pa.), 54(10), 924-1109.
More info
This is the 33rd Annual Report of the American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS). As of 1 January 2015, 55 of the nation's poison centers (PCs) uploaded case data automatically to NPDS. The upload interval was 9.52 [7.40, 13.6] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system.
Curry, S. C., Brooks, D. E., Skolnik, A. B., Gerkin, R. D., & Glenn, S. (2015). Effect of a medical toxicology admitting service on length of stay, cost, and mortality among inpatients discharged with poisoning-related diagnoses. Journal of medical toxicology : official journal of the American College of Medical Toxicology, 11(1), 65-72.
More info
There are no published studies that have compared quality outcomes of hospitalized poisoned patients primarily under the care of physician medical toxicologists to patients treated by non-toxicologists. We hypothesized that inpatients primarily cared for by medical toxicologists would exhibit shorter lengths of stay (LOS), lower costs, and decreased mortality. Patients discharged in 2010 and 2011 from seven hospitals within the same health care system and greater metropolitan area with Medicare severity diagnosis-related groups for "poisoning and toxic effects of drugs" with and without major comorbidities or complications (917 & 918, respectively) were identified from a Premier® database. The database contained severity-weighted comparisons between expected and observed outcomes for each patient. Outcome parameters were differences between expected and observed LOS, cost, and percent mortality. These were then compared among groups of patients primarily admitted and cared for by (1) medical toxicologists at one hospital (Banner Good Samaritan Medical Center, BGS), (2) non-toxicologists at BGS, and (3) non-toxicologists at six other hospitals. Records of 3,581 patients contained complete data for assessment of at least one outcome measure. Patients cared for by medical toxicologists experienced favorable differences in LOS, costs, and mortality compared with other patient groups (p
Mowry, J. B., Spyker, D. A., Brooks, D. E., McMillan, N., & Schauben, J. L. (2015). 2014 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 32nd Annual Report. Clinical toxicology (Philadelphia, Pa.), 53(10), 962-1147.
More info
This is the 32nd Annual Report of the American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS). As of 1 January 2014, 56 of the nation's poison centers (PCs) uploaded case data automatically to NPDS. The upload interval was 7.82 [7.02, 11.17] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system.

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