In Anesthesiology Litigation: Note What Is Documented Then Look for What Isn’t

𝗛𝗼𝘄 𝗜 𝗱𝗶𝘀𝗽𝗲𝗹 𝘄𝗲𝗮𝗸 𝗮𝗻𝗲𝘀𝘁𝗵𝗲𝘀𝗶𝗮 𝗺𝗮𝗹𝗽𝗿𝗮𝗰𝘁𝗶𝗰𝗲 𝗱𝗲𝗳𝗲𝗻𝘀𝗲𝘀:

I note what is documented ... 𝙩𝙝𝙚𝙣 𝙡𝙤𝙤𝙠 𝙛𝙤𝙧 𝙬𝙝𝙖𝙩 𝙞𝙨𝙣'𝙩


A common theme exists after bad outcomes

The positive actions are embellished

And the negative are skimmed over

𝘽𝙪𝙩 𝙤𝙣𝙡𝙮 𝙩𝙤 𝙩𝙝𝙚 𝙪𝙣𝙩𝙧𝙖𝙞𝙣𝙚𝙙 𝙚𝙮𝙚


What's documented:

✅Surgery was uneventful and patient was extubated
𝙩𝙝𝙚𝙣
✅✅ACLS was performed and ROSC was achieved


What 𝙄𝙎𝙉'𝙏 documented:

❌Patient obstructed post extubation
𝙩𝙝𝙚𝙣
❌❌This wasn't relieved and the patient coded.


Why do I look for what ISN'T documented❓

Because omission of pertinent documentation is used to obstruct eventual inquiries


What I look for:

• Pulse oximetry
• Surgical operative note
• Respiration minute-by-minute
• Tidal volume minute-by-minute
• Time from documented extubation
• End-tidal CO2 capnography readings
• Surgical end time per circulator nurse
• Deposition comment: patient was "dusky"


𝙐𝙡𝙩𝙞𝙢𝙖𝙩𝙚𝙡𝙮:

If given the minute by minute vitals

And the minute by minute vent settings

I can virtually always forensically reconstruct

What really transpired during the adverse event

And when necessary ... I call out the Bullsh*t



𝙃𝙖𝙫𝙚 𝙮𝙤𝙪 𝙣𝙤𝙩𝙞𝙘𝙚𝙙 𝙩𝙝𝙚 𝙩𝙧𝙚𝙣𝙙 𝙤𝙛 𝙤𝙢𝙞𝙩𝙩𝙞𝙣𝙜 𝙧𝙚𝙡𝙚𝙫𝙖𝙣𝙩 𝙞𝙣𝙛𝙤𝙧𝙢𝙖𝙩𝙞𝙤𝙣 𝙖𝙧𝙤𝙪𝙣𝙙 𝙗𝙖𝙙 𝙤𝙪𝙩𝙘𝙤𝙢𝙚𝙨?