As a Houston, Texas medical malpractice attorney, patients and their family members call my office every day to ask for help for serious injuries they have sustained from medical errors. This gives me the opportunity to spot trends in healthcare and how they impact patient safety.
In recent years we all know that medicine has been moving toward having doctors see more and more patients in less time. When it comes to surgery, I have noticed two trends that I think are ill-advised and dangerous.
The first trend deals with anesthesiologists. Anesthesiologists are medical doctors who are highly trained on how to sedate patients, put them to sleep, wake them up, and manage life-threatening complications. Certified registered nurse anesthetists (CRNAs) are nurses with additional training in providing anesthesia care. CRNAs have less training than anesthesiologists and are much cheaper for hospitals, surgical centers, and others to hire.
From my experience in handling medical malpractice cases, having a CRNA manage general anesthesia for serious surgical procedures is more dangerous than having an anesthesiologist provide the hands-on patient care. Yet, the recent trend has been that many anesthesiologists only rarely provide direct patient care during surgeries.
Instead, the anesthesiologist may see the patient before the procedure for introductions, informed consent, and to answer any questions, and then turn anesthesia care over to a CRNA. Some anesthesiologists now practice more as supervisors than physicians, supervising or managing four or five CRNAs who have patients under anesthesia at the same time.
The problem with this system of providing anesthesia care is that CRNAs are not as well-trained as anesthesiologists to manage complications, like an airway issue where the patient stops breathing. These are the situations when CRNAs desperately need an anesthesiologist to take over. What happens when the anesthesiologist is not immediately available to step in? Or what happens when there is an emergency at the same time with one of the other four or five patients that he is managing?
The second trend is with surgeons themselves. Many surgeons are now double booking (or more) their surgeries. This means that the surgeon who meets with a patient, proposes a surgical procedure, and obtains informed consent will not be in the operating room with the patient for the entire procedure. In fact, the surgeon may only participate in a short, focused part of the procedure, and then leave the rest for other surgeons—some who may still be in their residency training—to finish the operation.
In the many depositions that I have taken of defendant CRNAs and surgeons, they have claimed that this is a safe practice. This is despite the fact that I am invariably prosecuting a medical malpractice lawsuit against them because something terrible went wrong during surgery. Interestingly, though, multiple anesthesiologists have privately confided in me that there are definitely reasons to be concerned about these practices.
It all comes down to two words: Pay attention. If you are an anesthesiologist involved in a patient’s anesthesia care, give it your undivided attention. If you are a surgeon operating on a patient, give that patient your undivided attention.
A recent surgical mishap that happened in Nairobi illustrates what can happen when healthcare providers are not paying attention. There were two patients who needed treatment related to the brain. One needed neurosurgery for a blood clot on the brain, while the other only needed nursing and non-surgical care for swelling following a head trauma.
A neurosurgeon, anesthesiologist, and two nurses did not notice that they brought the wrong patient to the operating room. They were hours into surgery before they realized that there was no blood clot on this patient’s brain.
What a mistake! A commentator described this as indicative of an “overwhelmed” system and staff. We all have limited abilities to focus—even brain surgeons—and the rushed pace, assembly-line nature of modern healthcare has introduced this type of new danger to patients.
This is not an isolated incident in some foreign country. I am working on a case right now where a patient at a Spring, Texas facility was taken to surgery by mistake. She was supposed to be discharged, but ended up in the operating room and undergoing an unneeded surgery that added many months to her recovery.
Call Painter Law Firm for help
If you or someone you care for has been seriously injured by a medical malpractice, call Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.
Robert Painter is an attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who files medical negligence and wrongful death lawsuits on behalf of patients and family members against hospitals, doctors, surgeons, pharmacists, and other healthcare providers. In 2017, H Texas magazine recognized him as one of Houston’s top lawyers. That same year, the Better Business Bureau recognized Painter Law Firm with its Award of Distinction.