ANESTHETIC MISHAPS

A review[1] of malpractice claims, excluding dental trauma, originating in the University Hospitals of Paris, France showed that 3-4% were directly-anesthetic related. The successful claims attracted extraordinarily high awards.

Damages due to positioning on the operating-room table were most numerous, but responsibility was shared between surgery and anesthesia. Otherwise, neurological complications of spinal or epidural anesthesia were the commonest, followed by complications of intubation or inhaling of stomach contents.

PRACTICE POINT

The commonest anesthetic suits are for

1. positioning on the operating-table
2. neurological damage from the spine and epidural injection
3. faulty intubation and extubation


In a study[2] of closed US anesthetic malpractice claims, 2% resulted from use of gas delivery equipment. Misuse occurred three times as often as equipment failure, and faulty connection within the breathing circuit
accounted for a third of cases. 

Three-quarters of all the gas delivery cases were potentially preventable, half by routine monitoring of oxygen in the blood and/or carbon dioxide in the exhaled gases. In three-quarters, the outcome was death or permanent brain damage.

PRACTICE POINT

Most gas-delivery medical malpractice suits are high-quantum and viable


A study[3] in different US centre made other recommendations for prevention, involving training, supervision, and regular recertification and medical examination of all anesthetists.

Copyright © 2008 Electronic Handbook of Legal Medicine