Page 50 - 2022 Risk Basics - Anesthesiology

SVMIC Risk Basics: Anesthesiology

anesthesiologist arrived in the OR and determined a need

for an emergency airway and proceeded with a
cricothyrotomy for oxygenation. The patients O2 saturation

came up to around 93 percent with the insertion of the jet

ventilator needle. However, secondary to the jet ventilation,
there was massive subcutaneous emphysema. The

anesthesiologist then made an incision for an emergency
tracheostomy. The surgeon arrived and completed the

procedure. There were still problems with ventilation, so

the surgeon placed bilateral chest tubes. The patient
began to stabilize and the oxygen saturation increased to

100 percent. The patient was then transferred to a tertiary
hospital where she was treated for ARDS (Adult

Respiratory Distress Syndrome) bilateral pneumonia, and

a laryngeal fracture. She improved and was discharged
three and a half weeks later to home with a tracheostomy

and was on oxygen. She had permanent injury to her vocal
cords.

The plaintiff’s expert asserted that the anesthesiologist had

a duty to explain the potential problems and complications
to the patient and advise of potential alternatives to the

anesthesia plan that addressed the likelihood of a difficult
intubation. In fact, it was argued that the standard of care

would have required the anesthesiologist to personally

participate in the anesthesia plan and make advanced
preparations so that an adequate airway could be

maintained.

Page | 50