The Doctors Company, which is the largest physician-owned medical malpractice insurer, recently published a study of closed medical malpractice claims against anesthesiologists entitled, “Making Further Advancements in Anesthesia Care Safety,” in which it found: “the two most common anesthesia allegations—improper management of patients under anesthesia (32 percent) and improper performance of anesthesia procedures (27 percent)—had not changed from the previous study. However, the order of frequency was reversed. In the 2007 through 2012 study, improper management of patients under anesthesia represented 22 percent of allegations, and improper performance of anesthesia procedures represented 34 percent.”
The top three factors identified in closed medical malpractice claims against anesthesiologists were deficiencies in patient assessments (including histories and physicals), patient monitoring, and communication among providers. The most common factor that contributed to patient injury was technical performance (88 percent) followed by improper performance of anesthesia procedures (27 percent).
The study reported: “A review of cases revealed limited opportunities to conduct pre-op assessments. Older and sicker patients needed closer investigation, but production pressures often limited testing and input from attending or referral physicians. These pressures also limited anesthesia professionals’ opportunities to arrange for the safest location for anesthesia care (hospital operating room versus a remote ambulatory surgery center or GI or cardiac labs) or to prepare for complications that might occur as a result of multiple comorbidities or complicated health histories.”
The study found that the most common reason for alleged mismanagement of patients under anesthesia was selection and management of therapy (55 percent of these cases had respiratory complications, central nervous system complications, adverse effects of anesthesia, or cardiac complications). When the physician reviewers identified inadequate histories and physicals, 67 percent of patients had at least one comorbidity (patients averaged 2.2 comorbidities) that affected the outcome of care. The most common comorbidities were obesity (50 percent), OSA (25 percent), chronic pulmonary disease (17 percent) hypertension (17 percent), cardiovascular disease (8 percent), and renal disease (8 percent).
The study found: “The improper performance of anesthesia procedures arose from intubation of the respiratory tract, injection of anesthesia into a peripheral nerve, and injection of anesthesia into the spinal canal. Intubation cases resulted from injuries during intubation or from improperly located endotracheal tubes, causing hypoxia. Injection of anesthesia into the spinal canal cases occurred when the injection was incorrectly placed as spinal (not epidural) anesthesia. Injection of anesthesia into a peripheral nerve or peripheral nerve blocks sometimes resulted in nerve damage or inadvertent injection into or near blood vessels. The frequency of these cases has been decreasing in recent years due to the use of ultrasound-guided needle placement. As with all cases, lack of documentation or inadequate documentation (18 percent) may impact the quality of care and the anesthesiologist’s ability to defend the care provided.”
If you or a loved one suffered harm as a result of the medical negligence by an anesthesiologist in the United States, you should promptly find a medical malpractice lawyer in your state who may investigate your anesthesiologist medical malpractice claim for you and represent you or your loved one in an anesthesiologist medical malpractice case, if appropriate.
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