Our friends at Mishkind Kulwicki Law Co., L.P.A. discuss how catastrophic anesthesia errors were commonplace in the 1990s and early 2000s. In part, these errors were caused by a lack of standards in the industry and the introduction of increasingly powerful drugs. As a result, premiums for professional liability insurance for anesthesiologists skyrocketed. In response, the American Society of Anesthesiologists (ASA) set out to establish standards to improve patient safety. During the ensuing decades, we rarely received calls from potential clients regarding complications of anesthesia. Now, these claims appear to be on the rise. An experienced catastrophic personal injury lawyer can help victims and their families pursue accountability and compensation when anesthesia-related errors occur.
In our experience, several factors seem to be involved in anesthesia errors: (1) the increased use of Certified Nurse Anesthetists (CRNAs) who are only marginally supervised by anesthesiologists; (2) the increased risk of anesthesia on an aging and/or obese population; and (3) overworked and understaffed nursing staffs.
Three recent cases, handled by our office, illustrate how anesthesia errors continue to occur as a result of medical negligence. We use the name “John Doe” to protect the anonymity of our clients.
Case Study #1
John Doe #1 was hospitalized due to excruciating pain from kidney stones. While awaiting surgery, John was dosed with Dilaudid, an extremely potent synthetic opioid. Dilaudid is considered to be up to 10x stronger than Morphine. John had sleep apnea, a common problem in adults especially in obese patients. John had not been formally diagnosed with sleep apnea, but he had a history of snoring, so sleep apnea should have been presumed. Snoring is a cardinal sign of sleep apnea. In 2012, the Joint Commission published a Sentinel Alert warning hospitals about the dangers of using potent opioids in patients with sleep apnea. The Joint Commission is a hospital accrediting agency.
The Sentinel Alert recognized that both sleep apnea and opioid medications depress an individual’s respiratory drive. When strong opioids are given to patients with sleep apnea, patients can experience a respiratory arrest. Respiratory arrest is a silent event. The patient literally stops breathing. The Sentinel Alert warned that apneic patients treated with high potency opioids should be monitored with a specific monitoring device, capnography, to alert caregivers to any cessation of breathing. If respiratory failure is detected, the patient can be roused and opioids can be immediately reversed. In this case, John was not properly monitored. As a result, he died in his sleep due to the combined effects of Dilaudid and sleep apnea. These drugs can be very dangerous resulting in over-sedation and overdose. Our investigation revealed that the hospital had received the Sentinel Alert but failed to train its nurses in proper monitoring techniques. This case was settled during trial.
Case Study #2
John Doe #2 underwent a simple ear drum repair. During the operation, high potency opioids were used by an unsupervised CRNA, unnecessarily, during the operation. John never awoke from the surgery. This medical malpractice case settled before trial.
Hospitals prefer using CRNAs because they are cheaper than MDs and frequently employed directly by the hospital unlike MDs who are often employed by independent private medical practices. In this way, CRNAs provide a source of income to the hospital system.
Case Study #3
John Doe #3 was sedated for a surgical procedure. Once induced, the CRNA could not establish an airway with the endotracheal tube. Panic ensued resulting in a negligent failure to use proper techniques for intubation. John died on the OR table, leaving behind a wife and two children. This case was settled pre-suit (i.e, before filing a lawsuit).
TAGS: medical malpractice, medical negligence, anesthesia error, overdose, over-sedation, medication error