“Clinical Basics and Current Liability Issues” Published by DRI

“Anesthesia Litigation – Clinical Basics and Current Liability Issues”

By: Walter Price and Jennifer “JD” Segers
For the Defense, a DRI publication
May 2017

It is notable that Oliver Wendell Holmes was the first, in 1846, to use the term “anesthesia” to describe the state of amnesia, analgesia, and narcosis, which made painless surgery possible. Morgan & Mikhail’s Clinical Anesthesiology 1 (5th ed. 2013).

This description, by the father of the American jurist Oliver Wendell Holmes, Jr., describes the combination of conditions created by various medications and agents. The description by the father of a United States Supreme Court justice is significant because commentators have noted that all anesthesia practitioners will have patients who experience unexpected and adverse outcomes, and those providers, in some fashion, will likely be involved in medical malpractice litigation in one way or another. Id. at 1,200. And anesthesia-related claims are quite costly. Kris Ferguson, et al., Anesthesia Related Closed Claims and Litigations at the Detroit Medical Center: Analysis, Lessons Learned, and Conclusions, Open Journal of Anesthesiology, Vol. 4, 95 (2014). Most involve certified registered nurse anesthetist (CRNA)
care. Id. at 91. Recently, these claims have involved allegations surrounding anesthetic care of the obese, residual neuromuscular blockade, and post-anesthesia care.

Historically, the first general anesthesia agents were inhalation agents or medicines in the form of gas or vapor that were inhaled. Morgan & Mikhail’s Clinical Anesthesiology 2 (5th ed. 2013). After centuries of development, today sevoflurane is the most widely used inhalation agent in the United States. Id. at 3. Ultimately, as anesthesia medications continued to develop, intravenous anesthesia evolved, after the invention of the hypodermic syringe and needle. Id. at 4. Developed in 1962, ketamine is still used today. However, propofol, with its short duration of action, is the most used anesthetic agent for intravenous induction. Id.

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