Opioid Safety, Respiratory Compromise

How To Avoid The Possibility Of Catastrophic Injury in Anesthesia

At the recent conference “Medical Malpractice Catastrophic Injury,” medical and legal experts discussed “The Distinct Dangers of Anesthesia: How To Avoid The Possibility of Catastrophic Injury, Notable Cases and Decisions, and Looking Towards the Future with Non-Human Administration.”

Speaking on the dangers of anesthesia were:

  • Victoria L. Vance (Partner, Chair, Health Care Practice, Tucker Ellis LLP)
  • Kenneth P. Rothfield, MD (System Vice President, Chief Medical Officer, Saint Vincent’s Healthcare, Ascension Health)
  • Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Ms. Vance discussed notable cases and decisions, pointing out that anesthesia-related claims are one of the top 10 by severity:

Severity of Claims by Cause of Loss

Severity of Claims by Cause of Loss

One case discussed by Ms.Vance involved a $7 million settlement of a 31 year old woman during tubal ligation that resulted in the patent suffering cardiac arrest, anoxia, and irreversible brain damage.

$7 million settlement of 31 year old woman receiving #anesthesia tubal ligation #ptsafety Click To Tweet

Dr. Rothfield, who is a member of PPAHS’s board of advisors, spoke about four areas of concern in anesthesia delivery – failure-to-rescue, airway injuries, ambulatory and office-based anesthesia, and obstetric anesthesia.

In his discussion of failure-to-rescue, Dr. Rothfield focused on the most vulnerable patients, particularly obstructive sleep apnea patients and postoperative patients. Citing ASA Sleep Apnea Guidelines, he emphasized the need for continuous electronic monitoring with pulse oximetry for oxygenation and with capnography for adequacy of ventilation:

ASA Sleep Apnea Guidelines

ASA Sleep Apnea Guidelines

Dr Ken Roithfield - need for continuous electronic monitoring of #OSA #patients #ptsafety Click To Tweet

Before speaking about how hospitals may save money through improved care, Mr. Wong spoke of the need to never believe that patients’ lives can be adequately compensated by dollars:

Dollars Don't Equal Patient Lives

Dollars Don’t Equal Patient Lives

He then discussed the case of Wesley Medical Center in Wichita, Kansas, which utilized the continuous monitoring discussed by Dr. Rothfield. Wesley Medical Center was able to shift the severity of adverse events related to opioid use for pain management. Per 100 adverse events, such a shift would on average save more than $3.5 million:

Cost Savings Per 100 Adverse Events

Cost Savings Per 100 Adverse Events

Saving $3.5m per 100 adverse events related to #opioid administration #ptsafety Click To Tweet

Copies of the presentations made at the conference may be obtained at by going to the conference resources page by clicking here.

To view the presentation on “The Dangers of Anesthesia” by Ms. Vance, Dr. Rothfield, and Mr. Wong, please click here.

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