Alleged breach in SOC: 𝙁𝙖𝙞𝙡𝙪𝙧𝙚 𝙩𝙤 𝙩𝙞𝙢𝙚𝙡𝙮 𝙞𝙣𝙩𝙚𝙧𝙫𝙚𝙣𝙚 But was it really a breach?

Alleged breach in SOC: 𝙁𝙖𝙞𝙡𝙪𝙧𝙚 𝙩𝙤 𝙩𝙞𝙢𝙚𝙡𝙮 𝙞𝙣𝙩𝙚𝙧𝙫𝙚𝙣𝙚

But was it really a breach?

2 months ago, I reviewed an anesthesia case for merit

• Colonoscopy
• 78 year old male
• Moderate sedation
• Long bradycardic event
• Cardiac arrest and code activation

So why is an anesthesiologist reviewing this❓


The patient ultimately suffered a severe stroke

And an allegation was made by plaintiff's counsel

That the responding anesthesiologist was negligent


But I disagreed and my retaining counsel was unhappy

"𝙏𝙝𝙚𝙮 𝙛𝙖𝙞𝙡𝙚𝙙 𝙩𝙤 𝙖𝙙𝙢𝙞𝙣𝙞𝙨𝙩𝙚𝙧 𝙀𝙥𝙞𝙣𝙚𝙥𝙝𝙧𝙞𝙣𝙚 𝙞𝙢𝙢𝙚𝙙𝙞𝙖𝙩𝙚𝙡𝙮 𝙪𝙥𝙤𝙣 𝙖𝙧𝙧𝙞𝙫𝙞𝙣𝙜 𝙖𝙩 𝙩𝙝𝙚 𝙘𝙤𝙙𝙚," he argued


But I corrected him.

The epinephrine was not ✴️documented✴️ as being given immediately upon anesthesia arrival

𝙒𝙝𝙞𝙘𝙝 𝙞𝙨 𝙙𝙞𝙛𝙛𝙚𝙧𝙚𝙣𝙩 𝙩𝙝𝙖𝙣 𝙞𝙩 𝙣𝙤𝙩 𝙗𝙚𝙞𝙣𝙜 𝙙𝙤𝙣𝙚 ...


Then I pointed out that upon arrival, the anesthesiologist:

1. Ran to the OR
2. Directed the code
3. Intubated the patient
4. Replaced his infiltrated IV
5. Placed a radial arterial line
6. Secured central venous access
7. Successfully managed to obtain ROSC

And only then sat down and documented

𝙊𝙣𝙚 𝙝𝙤𝙪𝙧 𝙤𝙛 𝙧𝙚𝙨𝙪𝙨𝙘𝙞𝙩𝙖𝙩𝙞𝙤𝙣 𝙡𝙖𝙩𝙚𝙧 ...


In conclusion I stated:

After 1 hour of (𝙨𝙪𝙘𝙘𝙚𝙨𝙨𝙛𝙪𝙡𝙡𝙮) running a code

The anesthesiologist documented his interventions

Thus, there was no anesthesia breach in the standards


... But they can have a word with the GI doc

Who didn't de-insufflate despite several minutes of progressively worsening bradycardia

... 𝙗𝙪𝙩 𝙩𝙝𝙖𝙩 𝙘𝙖𝙡𝙡𝙨 𝙛𝙤𝙧 𝙖 𝙙𝙞𝙛𝙛𝙚𝙧𝙚𝙣𝙩 𝙚𝙭𝙥𝙚𝙧𝙩



𝘿𝙤 𝙮𝙤𝙪 𝙛𝙖𝙘𝙩𝙤𝙧 𝙞𝙣 𝙚𝙢𝙚𝙧𝙜𝙚𝙣𝙘𝙮 𝙘𝙞𝙧𝙘𝙪𝙢𝙨𝙩𝙖𝙣𝙘𝙚𝙨 𝙬𝙝𝙚𝙣 𝙚𝙫𝙖𝙡𝙪𝙖𝙩𝙞𝙣𝙜 𝙢𝙚𝙧𝙞𝙩?