emrythelion t1_iuphkzu wrote
Reply to comment by Poopsandboops in Jury awards $21m to family of patient after simple leg surgery left him in a vegetative state by TheFullerTron
While it’s likely in this case that the issue occurred due to the fact that he didn’t seem to be getting the correct supervision from an anesthesiologist…
it’s not a guarantee this wouldn’t have happened anyways. Surgery is always dangerous. Even the simplest of surgeries could mean you never wake up again.
The absolute best of the best anesthesiologists will still likely face a death where anesthesia was the cause (or a factor) at some point in their career. Not to mention other issues, like what happened in the OP, or heart attacks, strokes, etc.
Elderly or those with pre existing conditions will always be the highest risk, but just being 27 doesn’t mean there are no risk factors. At that age, pre existing conditions may still be unknown; especially if the person in question has never been put under anesthesia before. Some people are more (or less) susceptible to the affects of anesthesia, which can make a huge difference. Some people are born with heart defects that only become known when specific situations occur. There’s a million and one different factors involved with anesthesia and while the anesthesiologists best judgement will be correct in the vast majority of cases, there’s always a possibility it’s wrong or something goes wrong during the process.
The family was awarded money correctly, and it’s very likely that this situation would never have occurred if it wasn’t a distracted doctor supervising CRNAs who were also busy. That, or it would have been caught earlier, meaning no or little longterm impairment. The fact that private companies are trying to cheap out by pushing overworked CRNAs instead of fully trained anesthesiologists is absolutely disgusting and shouldn’t be allowed.
But I think it’s still important to point out that what they said is not necessarily false. He may very well have gotten the best care possible, and this could have happened regardless of who was supervising him. It’s just not the most likely situation.
DylanHate t1_iupoma5 wrote
I think the issue here was electronic medical records were “lost” and there is the appearance of a coverup by the hospital.
emrythelion t1_iuzv3ag wrote
Yeah, that’s definitely fair.
dinner_is_not_ready t1_iur0hxa wrote
So how does one avoid this? Should we just avoid private hospitals or should we avoid treatment where anesthesia is done by CRNA?
rchart1010 t1_iuuwnul wrote
I have specifically asked. I used to date a CRNA and he seemed good at his job. But, I'd like an anesthesiologist. So I've asked specifically if the anesthesiologist is an MD or CRNA. It's always been an MD.
dinner_is_not_ready t1_iuvo9tx wrote
Oh so in your case it was MD. I don’t know if I can make hospital get an MD to do anesthesia just for me but I can avoid places if they only offer CRNA. On that, what other things you avoid? Any other tips?
[deleted] t1_iuvyobv wrote
[deleted]
emrythelion t1_iuzv2me wrote
Avoiding a CRNA is ideal, yes. It’s unfortunate, because there are absolutely CRNAs who are incredibly experienced and as knowledgeable as actual Anesthesiologists. But the reality is, it’s mostly shitty private hospitals and clinics that use CRNAs because they’re too cheap to pay for someone with actual experience. Capable CRNAs are the exception, not the rule (or even common) in this situation.
It’s just greedy fucks being greedy.
rchart1010 t1_iuuwbr9 wrote
Are you an anesthesiologist?
Prior to my most recent surgery my anesthesiologist said that nearly all anesthesia complications/deaths are in unplanned anesthesia situations such as when someone has an accident and needs immediate/emergency surgery.
Is there a specific reason you have that leads you to a different conclusion?
emrythelion t1_iuzurx5 wrote
Nearly all. That’s the caveat.
Not every anesthesiologist will see a death due to anesthesia, but most will. Based on current numbers at least (and even a decade ago it was much worse.). Most deaths they face will be due to people with extreme risk factors or unplanned situations, but that doesn’t change the fact that most anesthesiologists will face at least one death they absolutely didn’t expect.
I’d also bring up that unplanned anesthesia really doesn’t matter; because the people that die unexpectedly in those situations are those with no risk factors at all. You never expect a young person, in good shape, with no known health issues to suddenly go into cardiac arrest, because it turns out they have a faulty valve in their heart. It doesn’t really matter whether it was a planned surgery or not. The majority of people who die in unplanned anesthesia situations have known or very obvious risk factors.
It is improving. Better imaging makes a HUGE difference. Issues that wouldn’t have even been caught 10 years ago, let alone longer, are being seen far in advance and can be planned around.
I’m not an anesthesiologist. But I’ve been put under almost 20 times, the majority of which have been in the last 10 years. I’m 29, just to clarify. I also carpooled with a child of an anesthesiologist the majority of highschool. I‘ve had this discussion with every single anesthesiologist besides the first, since it was my tonsils when I was 2 years old.
I’m not a doctor, but what I’m saying is what every single experienced anesthesiologists have told me. Every time before I’ve been put under. It’s always a risk. And I was probably in a better position, because i was generally healthy and had “good“ experiences with anesthesia.
rchart1010 t1_iv0pumz wrote
Okay, so, it sounds like you're basing your statement on the fact that you've been told there is a risk of death and maybe some CYA statements from your anesthesiologists. Oh, and carpooling with the child of an anesthesiologist? Which seems like a pretty big reach.
However, even 20 years ago it appears there were only 315 anesthesia related deaths a year in the US so I'm not sure how that led you to a conclusion that most anesthesiologists experiencing an unplanned anesthesia death.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/
>First, our results indicate that the numbers of anesthesia-related deaths in the United States averaged about 315 deaths per year from 1999 to 2005.
Also, unless you have another data source I'm not sure how you'd know that emergency situations aren't the setting in which most complications occur, serine as how there is no time to get a history, perhaps limited access to different drugs and a person who may have wildly fluctuating vital signs due to being in distress.
You've been talking like an authority and I just don't think you are one, even if you carpooled with someone whose parent was an anestheologist and have been under anesthesia multiple times.
Anymore than I'm an authority in the field of endocrinology because I've seen an endocrinologist hundreds of times or an expert in eye injections even though my doctor tells me there is a risk of blindness or complication. Or an expert in gastroenterology even though I went out on a date with a gastroenterologist.
Unless of course there is an outside data source that backs your claims that most doctors have experienced x, y or z and the causes, I don't think your experience or even your conversations make you any better situated to speak authoritively in this area.
ETA: there is some evidence to suggest increased anesthesia risk in emergency situations which is also counter to your post.
>Difficult intubation is far more likely to occur in suboptimal environments outside of the OR such as in the emergency department, the intensive care unit (ICU), patient wards and even outside of the hospital.
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