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What you should know about the risks of physician office-based surgeries

Office practices and ambulatory surgery centers often lack policies, procedures, and training on best practices needed for patient safety

It used to be that if you wanted to have a surgery you had one option, a hospital operating room. These days, though, surgical procedures are done at hospitals, ambulatory surgery centers, and even physician offices.

While most of the time things go well for patients regardless of where the procedure is performed, that’s not always the case. From my experience as a Houston, Texas medical malpractice attorney, when there’s a complication during surgery—whether it’s related to a mistake or not—it’s better to be in a hospital setting, where staff, equipment, and supplies are immediately available to handle the problem.

For example, I’m currently working on a case where a patient went to an ambulatory surgery center for a routine orthopedic procedure. Because of poor care and decisions by a certified registered nurse anesthetist (CRNA) who extubated (removed the breathing tube) prematurely, the man went into a respiratory crisis that led to his death. When the anesthesiologist, who was working on five patients at once, arrived in the recovery room, the resuscitation efforts were inadequate. They eventually called 911 to have the patient transferred to a hospital, but it was too late. If his surgery been performed at the hospital instead, I believe he would still be alive today.

As a former hospital administrator, though, there are other issues that I’ve seen when surgical procedures are performed at an outpatient surgery center or an office-based practice. I believe that many of these are related to the fact that the smaller practice settings lack the administrative and committee staff that are focused on tracking and improving the quality of care.

Recently, The Joint Commission posted about on common things that its surveyors have seen during accreditation visits to office-based surgery sites. The findings include:

• Thermometer readings in medication refrigerators were outside the normal range. This is a problem because the effectiveness of medications can be impacted if they are not stored in a proper temperature.

• Medication storage alarms were silenced or inaccurately set.

• Many practices use multi-use, rather than single-use, vials of medications. Surveyors from the Joint Commission commonly saw opened drug vials and sterile water containers in patient care areas. Some were labeled with an expired “use by” date. These situations present the potential for contamination of medications and sterile water that is used in patient care.

The Joint Commission recommended that office practices that perform in-house surgeries or procedures review and educate their staff on policies and procedures for the safe use, management, and storage of medications.

If you have developed an infection or severe complication related to a surgery or procedure performed in an office setting or ambulatory surgery center, then contact a top-rated, experienced Houston, Texas medical malpractice lawyer for help in evaluating your potential case. I’ve found that many of these facilities lacked proper policies, procedures, and staff training to ensure safe handling and use of medications and equipment.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.

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