anesthesiologist caught in a lie.

Anesthesiologist Caught in a Lie

In 20 years of working as a medical legal investigator, my toughest case involved an anesthesiologist who negligently intubated a patient for a relatively simple procedure requiring using a machine to breathe for the patient.

After the anesthesiologist inserted a breathing tube, he never confirmed it was in the right place.

The patient was obviously not being oxygenated and the anesthesiologist was totally unaware of her deteriorating condition because he had turned off the audible alarms on the anesthesia machine. He was “asleep at the wheel”.

The problem was not detected until an OR nurse walked by the monitor and alerted the anesthesiologist to the patient’s condition. Too much time had passed, and a healthy 65-year-old woman had loss of oxygen to her brain and associated brain injury.

Her injury was devastating.

The patient had been a financial secretary for a large school district and after months in a coma and more months in rehabilitation, she was reduced to the intelligence of a 6-year-old. She has constant jerking movements, is unable to use the toilet unassisted, needs maximum assist with ambulation and has to use a sippy cup because of the jerking she is unable to control.

Tragically, after her injury, this woman was unable to answer simple questions about her own history, such as how many children she had and if her parents were living or deceased.

The biggest roadblock of the medical malpractice case was that the medical records were altered to the point that one of my experts said that they were “incompatible with human biology”. If you looked at the patient’s postoperative condition and then looked at the anesthesia record, things just did not add up.

The anesthesia record showed that the patient was maintaining an adequate level of oxygen during surgery. Her lowest oxygen saturation level was 93% (normal is 95-100%.) Because the medical records were so unreliable, the legal team represented her had enormous difficulty lining up an expert willing to testify to a reasonable degree of medical certainty of what we think happened.

Many pages of the chart were missing, and information was withheld. It was not documented until 3 months after surgery that the patient had sustained a broken tooth during the procedure. No complications were noted on the anesthesia records and the record stated that the intubation went without incident.

In the discovery phase of the lawsuit, I requested pertinent policies and procedures from the hospital and found multiple problems and discrepancies.

I noticed that there was no Code Blue (resuscitation record filled out when a patient needs emergency care) Sheet in the patient’s chart, even though the policies and procedures spelled out specific procedures regarding documentation of codes. The hospital was unable to produce a code sheet for our patient. The hospital staff said, “It must have gotten lost”, so I requested a blank one. They were unable to provide that because they didn’t even use one.

The nurses were questioned under oath in front of a court reporter during a deposition. The nurses knew nothing about code sheets and testified that they had never seen one used at that hospital. The written procedures stated that all codes were to be reviewed by a Code Blue Committee and undergo a thorough review. The hospital did not even have a Code Blue Committee.

In my investigation, I found that the hospital’s own website was full of lies. For example, they said that all of their anesthesiologists were board certified when in truth, less than half held certification. The defendant anesthesiologist said he was board certified when, in fact, he was not.

Read part 2 on December 6.

Med League provides medical expert witnesses to trial lawyers. Please call us at (908)788-8227 or contact us today to discuss your next case.

This article originally appeared in Avoid Medical Errors Magazine.