May 4th, 2019
During both scheduled and emergency surgeries, patients often count on anesthesiologists to make the surgeon’s job easier and expedite recovery. But too often, things go wrong. In fact, anesthesia errors are one of the leading causes of medical malpractice claims. These claims are different from other kinds of personal injury matters in several different ways.
Anesthesiologists and other doctors have a very high duty of care. That’s because patients are at the mercy of their doctors. Patients count on doctors for both skilled care and solid advice. Lawyers and psychiatrists have a similar duty toward their clients and patients. A commercial driver’s duty is not quite as high. But it is higher than a non-commercial motorist’s duty of reasonable care.
Because of the higher duty of care, jurors are sometimes inclined to award substantial punitive damages in medical malpractice claims. These additional damages are designed to punish the tortfeasor (negligent actor) and deter future misconduct. These damages may be available on top of compensatory damages for economic and noneconomic losses.
But the news is not all good. Over the years, the powerful medical insurance lobby has given millions of dollars to legislative and judicial candidates. As a result, there are a number of pro-doctor statutes and court decisions in place. For example, there is a punitive damages cap in Texas. Usually, this hard limit has nothing to do with the facts of the case.
Emboldened by the lesser risk of a lawsuit, many anesthesiologists and other doctors take shortcuts. Some of these shortcuts, and the consequences thereof, are outlined below.
Inadequate Patient History
In a perfect world, patients have no allergies to any anesthesia drugs, have no pre-existing medical condition, and are not taking any medicine that would affect the anesthesia. Although we do not live in a perfect world, some anesthesiologists act like this is the case. They treat questionnaires like background information as opposed to critical patient safety information. Moreover, many anesthesiologists may skip over red flags and fail to reinforce these safety issues with the patient.
Some other negligent anesthesiologists collect the right information from patients and thoroughly review their medical histories, but they do not follow up. They do not adjust the dose to account for the patient’s medical history. They only consider obvious variables, like the type of operation and the amount of time the surgeon needs. Dosage errors are especially common in emergency surgical procedures, like C-sections and appendectomies. WHen time is limited and the patient is already prepped for surgery, many doctors are not as diligent as they should be.
When surgery is iminent, seconds count. Unless the anesthesiologist promptly administers medicine, it may not be effective. For example, doctors may begin a C-section when the patient is not fully anesthetized. As a result of the doctor’s negligence, the patient must endure excruciating and unnecessary pain. In delayed administration cases, many anesthesiologists overcorrect. They administer a stronger dose so the medicine will work faster. As a result, especially if there are other foreseeable complications, the patient may not be able to wake up.
Refusal to Intubate
Intubation is basically inserting a tube into the patient’s trachea (windpipe). Ths tube allows the patient to breathe comfortably in the event of a complication. It also allows the anesthesiologist to quickly administer additional medicine, or an anesthetic antidote, if required. Some anesthesiologists consider intubation to be an unnecessary precaution. They assume that, since the may no preoperative mistakes, there’s no need for intubation. In some cases, that’s simply not true. A lot of things can go wrong during the anesthesia process. Just one small mistake can lead to tragedy.
Failure to Monitor During Surgery
An “I’ve got this” attitude also prompts many doctors to skip surgical sessions altogether. They assume they have made no mistakes. Even if something does go wrong, they reason, the surgeon will page me and I’ll be there straightaway. So, they conclude, if I closely monitor the patient, I’ll just be watching the person sleep. But “straightaway” may not be soon enough.
Shutting Off Monitoring Equipment
This mistake is closely related to the previous two. Many doctors are in the operating room at the beginning of the procedure. After they loiter for a few minutes, they leave and do not come back. As they leave, the often shut off alarms and other equipment. They reason that these alarms would distract the surgical team. Although their motives may be pure, this action is clearly negligent, especially given the high duty of care in these cases.
Failure to Monitor Post Surgery
This mistake is usually the big one. Once the patient goes into the post anesthesia care unit, some anesthesiologists believe their job is over. However, adverse side effects, allergic reactions and complications may not manifest until the patient is in the post anesthesia care unit. Patients who have been administered a powerful sedative or narcotic may relax so much they stop breathing. If not monitored properly, this can lead to a patient dying in the PACU.
As seen above, anesthesia-related errors can cause serious injury or even death. Be sure you have given a complete history not just to your surgeon but to your anesthesiologist before undergoing surgery under anesthesia. If you experience an injury or loss and suspect it was due to improper anesthesiology care, contact a medical malpractice lawyer who offers free consultations to learn your rights.
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Robert Simmons is a graduate of The University of Houston Law Center, Houston, Texas, 1966. He has been practicing law in Texas since 1996. He is a founding member and managing shareholder of Simmons and Fletcher, P.C. He has been recognized as a Top Lawyer by H Texas Magazine in 2014 and 2015.