This is so clearly a case of respiratory distress leading to cardiac arrest after surgery. The 62-year-old plaintiff underwent a carotid endarterectomy and an angioplasty.

During the first postoperative day, the plaintiff had what the plaintiffs claimed were the signs and symptoms of an approaching respiratory arrest, including shortness of breath, a hoarse voice, anxiety and agitation, complaints of throat pain and neck swelling and hematoma. The nursing note for the night shift indicated that the plaintiff was very restless and was attempting to get out of bed frequently.

Security was called that night because the patient was agitated and combative. About forty-five minutes later the plaintiff complained of difficulty breathing. Stridor was noted and he became unresponsive. He had a cardiac arrest. He had large amounts of airway compression and could not be intubated. An emergency cricothyroidotomy was done, but he suffered a massive anoxic brain injury.

This case was Anonymous Sixty-Two-Year-Old Man v. Anonymous in an unknown Massachusetts venue.

Comment: I reviewed a few cases like this as a liability expert witness. The signs of compression on the airway are so clear cut. Why were they not clear at the time? The nurse looked at the behavior of the patient instead of the cause of it. She treated the symptoms but not what was closing off the patient’s airway. The patient’s symptoms required critical thinking by the nurse, who sadly, instead, got a security guard to try to control the patient.

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