I’m a firm believer in giving credit where it is due. Credit should go the anesthesia profession for leading the way in the effort to reduce medication errors. During the 1980s, the American Society of Anesthesiologists (ASA) conducted a comprehensive analysis of the cause of anesthesia errors, and as a result, drafted standards of care that became a model for medical error prevention. The ASA standards addressed subjects of concern such as patient monitoring during anesthesia, continuing education for anesthesiologists, anesthesia in office (i.e., non-hospital) settings, pre-anesthesia care, documentation of anesthesia, and others. As a result, the incidence of anesthesia errors fell dramatically.

One of the key elements in the ASA standards of care, is its recognition that anesthesiology is administered by an anesthesia team. The concept of doctors treating a patient, especially patients undergoing surgery, being on the same medical team, is a critical understanding in the reduction of medical errors. While the analogy is not perfect, and sports analogies are often overdone, think of what members of a sports team must do before a big game. First, team members need to know each other and their abilities, limits, and styles. They need to understand as well, the opponent they are facing. Next, there must be a game plan – no competently managed team simply goes out on the field with no pre-determined approach. And most important and fundamental, team members must communicate with one another, clearly and consistently. If you grafted the concepts of knoweldge, understanding, planning, and communication onto the practice of anesthesiology, you would have a good idea of what the ASA standards require.

Unfortunately, anesthesia errors continue to occur. When anesthesia mistakes do happen, the results are often catastrophic. A serious anesthesia error frequently causes deprivation of oxygen to the patient, resulting in death or permanent brain damage. When a deadly anesthesia mistake does occur, it is often because the excellent standards of care of the ASA are not followed. In other words, deadly anesthesia errors are often a result of medical negligence. Causes of the negligence may include failure of communication between surgeon and anesthesiologist or between anesthesiologist and nurse practitioner, inadequate monitoring of the patient during anesthesia – an error that is never excusable – failure to protect the patient’s airway, failure to empty the stomach of food prior to administration of general anesthesia (which can cause the patient to vomit into the lungs, with often fatal result), and administration of the wrong anesthetic drug, to name a few.

Any time a patient dies unexpectedly or suffers permanent brain damage during surgery, a call to an attorney with experience in medical malpractice cases, is warranted. Anesthesia records, if properly kept, contain minute-to-minute data on drugs administered, the patient’s blood oxygen saturation, and other vital patient signs. If there has been a patient catastrophe during surgery, and the anesthesia records are missing or incomplete, suspicions of malpractice and coverup are warranted. If anesthesia records have been properly maintained and not tampered with, an expert review of the records should reveal whether there was any negligent error causing the patient’s death or disabling injury.