Surgery & operating room malpractice: Are the doctors in the room?
It's risky business when surgeons & anesthesiologists handle multiple procedures in different operating rooms at the same time
Do you ever feel like a number rather than a person when you go to a doctor’s office or hospital? If so, you are not alone. Many people feel that medicine has lost its focus on healing, in exchange for a rush to push as many patients through the revolving door as possible every day.
As a Texas medical malpractice lawyer, one of the ways that I have seen this issue pop up in recent years is in the operating room. Many patients and their families would be shocked to find out that their surgeons and anesthesiologists may be responsible for two or more surgeries that are under way at the exact same time.
When it comes to surgical anesthesia, it is usually the anesthesiologist, a highly trained medical doctor, who meets with the patient and family to obtain informed consent. This is the time when the doctor explains the risks and benefits of the anesthesia part of the surgery and then obtains permission to provide that care.
These types of informed consent conversations may leave patients and their loved ones with the impression that the anesthesiologist will be in the operating room to handle the anesthesia and manage life and death complications that may occur.
Yet, in many hospitals around the country—including major academic medical centers like Memorial Hermann Hospital and Houston Methodist Hospital—it is nurses, not physician anesthesiologists, who provide the hands-on anesthesia care to operating room patients. The reason is simply one of money.
Certified registered nurse anesthetists (CRNAs) are registered nurses with an additional two years of training, who have passed a certification exam. They are not doctors. They do not have the same or equivalent training as anesthesiologists. Yet, health care systems have figured out that it is cheaper and more profitable to hire CRNAs, rather than anesthesiologists, to handle most of the hands-on work in the operating room.
According to Medicare and insurance industry standards, one anesthesiologist can medically supervise five or more surgical procedures at the same time. That means that less-trained CRNAs are handling the anesthesia care in five or more operating rooms, with just one anesthesiologist doctor trying to juggle supervision among all of those patients.
As a Houston medical malpractice lawyer, I have handled a number of cases where patients died in the operating room from anesthesia complications that CRNAs were unable to handle. In one recent Houston case, a patient in her 40s died during a routine elective endoscopy. In another case that I handled, a teacher in his 30s died during an exploratory surgery to see if his abdominal wound had healed enough for him to be discharged.
In both of these cases, experts that we hired to look at the records determined that the patients stopped breathing because of propofol overdoses and the CRNAs were not able to resuscitate them. The delay in finding anesthesiologists and getting them into the rooms caused the patients to die.
The next time you or someone you care about is about to go to surgery, ask questions to make sure that you understand who will be in the operating room providing anesthesia care—an anesthesiologist doctor or a nurse CRNA. You can request that the anesthesiologist be present in the operating room and medically direct the procedure.
One Surgeon in Multiple Operating Rooms
It is always an unsettling and scary experience to have to go to the operating room for surgery.
Whether it is for an orthopedic surgery, gynecological procedure like a hysterectomy, a bariatric procedure like a lap band, neurosurgery, or any other type of procedure, patients understand that there is a risk to every surgery.
Before the surgery, there should be an opportunity to meet the surgeon and ask questions. Patients certainly want to know the surgeon who is going to take them into the operating room.
You will probably be surprised to find out that at many major teaching hospitals, your surgeon might be participating in two, three, or more surgeries all going on in different operating rooms, at the very same time that he or she is working on you. Teaching hospitals in the Houston area include places like Baylor College of Medicine, Memorial Hermann, Houston Methodist Hospital, CHI St. Luke’s Hospital, and others in the medical center.
Concurrent and overlapping surgeries have become such a common practice that the U.S. Senate Finance Committee issued a report on it in December 2016, which recommended more transparency and patient safety procedures.
One of the ways that you can protect yourself or your loved one who is facing a surgery is to ask the surgeon if he or she will be present throughout the whole surgery. If the surgeon is unwilling to commit, you may wish to select a different surgeon or even a different hospital.
Operating Room Malpractice
Painter Law Firm’s medical malpractice lawyers have handled anesthesia and surgical malpractice cases and are available to assist you. Call us at 281-580-8800 for a complimentary consultation.
Image credit: Andrew Nilsen, The Houston Press.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes [...]read more
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine [...]read more
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine
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