Page 24 - Part 1 Anesthesiology Common Risk Issues

SVMIC Anesthesiology: Common Risk Issues

Intra-Operative

In addition to documentation problems with the pre-anesthesia
record, our claims review reveals a number of inadequate

documentation issues within the anesthesia record. What was
often missing in cases evaluated include:

• Details about emergency response and interventions

• Maneuvers utilized for managing a difficult airway,
positioning, and padding details

• Presence of eye protection

• Time-out

• Presence of anesthesiologist during induction and
emergence

• Interventions taken

In a number of the claims, the anesthesia record lacked detailed
notes regarding cardiac activity ceasing during a crisis, and

there were major inconsistencies within the operative record.
The plaintiff was able to allege carelessness and an improper

emergency response. There were also questions as to whether
monitor alarms had been turned off. In cases where there was

an airway emergency leading to a serious outcome such as
hypoxic encephalopathy, the defense was hampered by a lack

of documentation of events that unfolded or the maneuvers
utilized for managing the difficult airway. Negligent lack of

attention to detail was alleged, and this lack of documentation
during an emergency was often accompanied by an inadequate

pre-anesthesia evaluation and/or a boilerplate consent form
such that essential details of the risk of anesthesia appeared not

to have been explored or discussed.

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