The Hazards of Anesthesia
If you’ve ever had any type of surgery or certain medical procedures, you have experienced anesthesia. Anesthesia enables us to undergo life-saving operations without experiencing any pain during the process. It has become so commonplace that you might even have been lightly sedated in a dentist’s office for a tooth extraction.
Anesthesiologists and certified registered nurse anesthetists (CRNAs) specialize in pain management, especially during surgery or medical procedures that necessitate sedation. Situations that used to require a doctor of anesthesiology are now often taken care of by nurse-anesthetists, especially in rural or other underserved areas or during relatively minor procedures. While CRNAs are supposed to be supervised, unfortunately, this is not always the case.
In the process of keeping a person sedated and free from pain, anesthesia sometimes stops the breathing process, depending upon the medications required for the procedure or surgery. Minor medical procedures do not usually require forms of anesthesia that stop a person’s breathing. But for major surgery, the doctor or nurse must not only use the right amount of the various medications required—and there are several—they must also keep a patient breathing by intubating them to deliver oxygen. That translates into multiple ways that the process can go wrong.
Botched anesthesia can arise from a number of different medication errors or intubation mistakes, leaving you with any number of complications that include brain damage. It can also kill you: approximately 3 in every 10,000 patients die as a result of anesthesia problems. The rate of anesthesia complications, from minor to major, was 4.8 percent between the years 2010 and 2013. Generally, the older and sicker a patient is, the higher the risk of certain complications. However, anesthesia mistakes mean that even a healthy young person can experience complications or die.
In the United States, medical errors are thought to be the third most common cause of death, following heart disease (#1) and cancer (#2). A study done by Johns Hopkins physicians in which they analyzed death rate information led them to estimate that 251,454 deaths, at a minimum, are due to medical errors in our country every year. It is believed that the real number is actually much larger, because at-home and nursing home deaths were not counted.
Types of Anesthesia
Anesthetics stop pain signals from reaching the brain. Anesthesiologists and anesthetists employ various drugs and procedures to short-circuit pain:
- Local anesthesia. You’ve experienced this if you’ve ever been “numbed” at the dentist for a filling, or had a small wound stitched. You are still conscious after being anesthetized.
- Regional anesthesia. Larger areas of the body are numbed. Such anesthesia is either spinal or epidural. Caesarean sections often use this form of anesthesia. Again, you are generally conscious.
- Conscious sedation. You are relaxed and drowsy, with drugs administered intravenously to block pain, but often you can still answer questions.
- General anesthesia. You are unconscious, and the relevant drug is given intravenously or via a mask. Not every form of general anesthesia requires intubation to take over your breathing process. For example, if you have a colonoscopy done, generally a quick-acting drug is administered intravenously but you are not intubated. More extensive surgery requires different drugs and intubation.
You may also be given muscle relaxers and sedation drugs for general relaxation. Technically, these are not anesthetics.
Reasons for Preventable Anesthesia Errors
A number of anesthesia errors—indeed, a number of surgical errors—occur for two big reasons: failure to communicate properly with others on the medical team, and failure to read medical charts and orders. Communication, or the lack of it, causes many medical errors, but in a surgical situation with numerous team members, proper back-and-forth becomes critical. Recent studies have shown that checklists of necessary tasks can reduce the number of mistakes during surgeries and procedures.
Other errors that can occur during the administration of anesthesia mistakes are as follows:
- Insufficient or improper supervision of CRNAs, when a doctor of anesthesiology is not the primary person administering and monitoring the anesthesia.
- Medication errors, which can take several different forms: using the wrong drug; using expired drugs; using the incorrect concentration of the drug; using the incorrect dosage; administering the drug incorrectly; and not recognizing an adverse medication event when it happens.
- Anesthesia equipment that is defective in some way.
- Failure to maintain a sufficient airway for breathing.
- Improper intubation, resulting in tracheal damage, dental damage, or insufficient oxygenation of the patient.
- Failure to recognize an allergic reaction to a drug.
Common Problems Resulting from Anesthesia Mistakes
Complications from anesthesia errors can include tracheal damage (from intubation), brain damage and blindness (often from insufficient oxygen), spinal cord injury and paralysis (from regional anesthesia), heart attacks, strokes, and death.
Other problems that can result from anesthesia mistakes include:
- Birth injuries. Improperly-given anesthesia during birth can damage the newborn or even cause death, as well as injure the mother.
- Anesthesia awareness. A nightmare scenario for many of us, it means receiving the wrong dosage of medications, or the wrong medications, and being aware during surgery but unable to communicate it. This kind of medical error is extremely traumatic.
- Damage to the airway and insufficient oxygen. Such damage can range from knocked-out teeth to injuries to the trachea, to a lack of oxygen, which can cause brain damage or death.
- Complications from monitored anesthesia care (MAC). Many minor surgeries and medical procedures are done these days in medical offices and ambulatory surgical centers using MAC. Drugs such as propofol combined with opiods or benzodiazepines are often given to keep the patient unaware. However, this variety of anesthesia is not without its risks; in fact, the chances of complications with MAC are higher than with other forms of anesthesia.
Anesthesia is a medical advance that has enabled us to extend our lives. It is truly a miracle that we sometimes take for granted. However, when anesthesia is improperly administered because of medical negligence, it can turn harmful or even deadly. We hope you’ll seek professional legal advice if you or a loved one has suffered from an anesthesia error.