Anesthesia Errors in the 21st Century

Since its introduction in the mid-19th century to the present day, anesthesia has become notably safer. The first anesthetic compounds were explosive, dosages were not established, and unexpected negative effects included fatal aspiration of stomach contents.

Today, anesthesia is administered by anesthesiologists (MDs) and certified nurse anesthetists (CRNAs) with extensive specialized training in the field. The operating room (OR) is equipped with devices that monitor blood pressure, blood oxygen levels, and actions of the heart and lungs during surgery. The anesthesiologist can choose from a range of drugs proven to be safe and reliable.

Why do patients still die from anesthesia?

Despite the abundance of knowledge about anesthesia drugs and their effects on humans, about allergic reactions and antidotes and about techniques and devices to keep airways clear during surgery, deaths and serious injuries still result from anesthesia. Some are unpredictable and inexplicable. Others, resulting from human error, are medical malpractice. And still others are the result of defective drugs or medical devices.

It is critical that the patient’s airway remain open to receive oxygen. During general anesthesia (when the patient is unconscious, paralyzed and can’t breath normally), the anesthesiologist protects the airway by inserting an endotracheal tube into the trachea (windpipe). If the doctor carelessly inserts the tube into the esophagus instead of the trachea, the patient’s oxygen level will drop and the patient will suffer cardiac arrest and, if the airway is not cleared within four to six minutes, brain damage. A well-equipped OR will have a device to verify correct placement of the endotracheal tube. When a procedure is done in an office, the risk of error rises.

Anesthesia is an entire branch of medical science, not just a class of (potentially toxic) drugs. The anesthesiologist, nurse anesthetist, and anesthesia assistants are responsible for observing the patient, noting any unanticipated changes after administration of a drug and responding accordingly. Fatigue, stress, inattention, or poor training may result in operating room staff’s failure to identify an emergency and take appropriate measures.

One of the earliest noted causes of anesthesia-relate death was aspiration of stomach contents; it continues to threaten patients today, especially those who are pregnant, obese, or have bowel obstructions. Special techniques will protect those patients. Another human error is overuse of a sedative during a minor procedure, causing a patient to stop breathing and die. Strong sedatives are often administered by poorly trained staff in a doctor’s or dentist’s office. After the anesthetic is stopped, the anesthesiologist’s or anesthetist’s failure to administer drugs to reverse the paralyzing effect may result in the patient’s failure to resume breathing.

Mechanical devices used during administration of anesthesia are very reliable, but the doctor/nurse anesthetist is responsible for going through a checklist to ensure the device is working properly and avoid death or injury from failure of the anesthesia machine, ventilator, or monitor.

A family that has lost a loved one, or a patient who suffered brain injury or another serious injury as a result of an anesthesia error, may be entitled to compensation from the hospital, anesthesiologist, anesthetist, or manufacturer of defective medical equipment. If a survivor is considering a personal injury claim, it is important to work with a law firm with the resources to pursue a complex, expensive case, and a successful record in personal injury law.

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