Medical Malpractice - Perils of Anesthesia

Posted on January 12, 2009 by Paula Strand

Perils of Anesthesia.

Occasionally we read about medical errors and malpractice cases brought as a result of anesthesia errors. Despite the overall healthcare improvements and technical innovations, anesthesia errors still pervade our medical system.
Anesthesiology is a branch of medicine specializing in the use of drugs or other agents that cause insensibility to pain. While anesthetics are essential to conducting many medical procedures with little to no discomfort, they carry the risk of unwanted post-effects. Anesthesiology is also defined as a continuity of patient care involving preoperative evaluation, intraoperative and postoperative care. Most people think of anesthesia-related malpractice as it relates to surgery; however it can happen during pre-operative preparation, post-operatively in the recovery room, and in any procedure room in a medical facility or doctor’s office. Anesthesia mistakes can take place during childbirth and even before routine dental procedures. Anesthesia mistakes are not limited to anesthesiologists.

According to the American Society of Anesthesiologists , it is estimated that nearly 40 million anesthetics are administered each year in this country. Anesthesiologists provide or participate in more than 90 percent of these anesthetics. In the operating room, they are responsible for the medical management and anesthetic care of the patient throughout the duration of the surgery. The anesthesiologist must carefully match the anesthetic needs of each patient to that patient’s medical condition, responses to anesthesia and the requirements of the surgery. In many surgical settings, anesthesiologists work in the “anesthesia care team” mode, medically supervising the work of non-physician anesthetists such as nurse anesthetists and anesthesiologist assistants, who, although are not physicians, have been trained in the technical administration of anesthetics. Anesthesiologists have important functions outside of operating rooms, such as evaluating patients prior to surgery or conducting postoperative visits. However, the majority of their activities, which are performed inside the operating room, are seen by few people outside of the surgical and nursing team. Usually the patients are unable to remember the anesthesiologist’s involvement because much of the critical work may be done while the patient is anesthetized. The role of the anesthesiologist in the operating room is to: 1) provide continual medical assessment of the patient; 2) monitor and control the patient’s vital life functions; and 3) control the patient’s pain and level of consciousness to make conditions ideal for a safe and successful surgery.
 

Many healthcare professionals administer sedatives and anesthetics to their patients prior to procedures and surgeries. Administration of anesthesia requires specialized training and certification. The seriousness and number of complications increases significantly outside of the setting of the anesthesiologist in the operating room. Severe complications and death can occur in dental offices and cosmetic surgery clinics during procedures where patients are under general anesthesia and trained anesthesia staff are not present. Potential anesthesia medical malpractice defendants include anesthesiologists, nurses, nurse anesthetists, surgeons, dentists, and doctors.

Medical malpractice claims are common in anesthesiology, because problems are common. Anesthesia malpractice is usually devastating, often resulting in permanent injury, brain damage, and even death. As a result, medical indemnity premiums for anesthesiologists are usually higher than other specialties. Anesthesia medical malpractice accounts for a large number of medical malpractice cases across the country. A small error in dosage can have grave and potentially life-threatening consequences. According to the American Society of Anesthesiologists, as of 2007 there were 248 closed malpractice claims for events that occurred in the year 2000 or later. Among these 248 claims, malpractice insurance payment was made on behalf of the anesthesiologist in 108 claims or 44% of the claims, no payment was made in 134 claims or 54%. Payments ranged from $1,250 to $2 million with a median payment of $115,000. 96% of all payments were $1 million or less.

Unfortunately, proving negligence by an anesthesiologist or anesthesia staff is difficult because the plaintiff, at the time of the malpractice, was unconscious or sedated, and medical records are the only source of information in the case. Hospitals and out-patient clinics should always keep detailed anesthesia notes in a patient’s chart including a pre-anesthesia exam; informed consent form; operative record; transfer notes; physician notes and post-anesthesia record. Sometimes, after a tragic malpractice mistake, records get “lost” or altered. Only careful inspection of medical records can reveal post-mistake additions, omissions or alterations. John Sellinger, our medical malpractice lawyer who has been reading and interpreting medical records for thirty years, has gained immeasurable knowledge and skill when combing through medical records.  An altered or destroyed medical record offers the plaintiff’s side opportunities to prove malpractice or an attempt to hide the malpractice. Malpractice insurers and professional medical societies continuously warn medical practitioners to never alter medical records, but in the moments surrounding a potentially fatal mistake, professional and ethical advice can be forgotten.


 

To learn more about medical malpractice issues, please read medical malpractice.  TO learn mopre about our medical malpractice lawyer, John Sellinger, please read John Sellinger, or watch his medical malpractice video.
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