Most Anesthesiologists Experience Multiple Patient Tragedies In Their Career

June 4, 2012

At one point, nearly everyone will require surgery involving general anesthesia. Usually, surgery goes as expected and there are no anesthesia complications. However, anesthesia errors can occur and, when they do, the results can be catastrophic. According to the results of a recent survey published in Anesthesia & Analgesia, 84% of anesthesiologists have been involved in a fatal or serious incident to a patient during surgery. Over an entire career, it is estimated that most anesthesiologists experience at least four incidents in which a patient dies or suffers serious injury.

Medical malpractice lawsuits involving anesthesia mistakes are not uncommon. The most common malpractice lawsuit stemming from anesthesia are those involving general anesthesia. With general anesthesia, patients are placed in a medically induced coma using certain medications that eliminates a patient's protective reflexes. In addition to eliminated motor reflexes, general anesthesia has other purposes including eliminating pain though analgesia, eliminating memory though amnesia, and skeletal muscle relaxation.

Over the last few decades, there have been a number of studies that have attempted to estimate the number of anesthesia complications. Anesthesia complications are a controversial subject and the reported incidents vary widely. However, experts generally agree the most common anesthesia related complications are from pulmonary aspiration, asphyxiation, and anaphylaxis. Pulmonary aspiration is where a patient vomits and then inhales the contents into their voice box and lungs. Asphyxiation is where the patient cannot breath. And anaphylaxis is where a patient experiences a severe allergic reaction. Any of these complications can lead to brain damage and/or death. The incidence of death directly caused by anesthesia ranges from 1 in 6,795 to 1 in 200,200. The incidence of brain damage and other serious complications from anesthesia is unknown.

According to the most recent survey published in Anesthesia & Analgesia, anesthesiologist who experience patient catastrophes in surgery experience a range of emotions, including guilt and anxiety. Many anesthesiologists surveyed also had difficulty with periodically reliving the event. Most also said they felt personally responsible for the death or injury, though some also reported the outcome was unpreventable.
As this anesthesiology survey indicates, an anesthesiologist job can be quite stressful. Even under the best of care, bad outcomes can occur. In other cases, the bad outcomes are a result of a medical malpractice. Either way, carefully examining each bad outcome is beneficially for at least two reasons. First, assessing a bad outcome is often the best way doctors learn to improve their profession. Second, as the recent study confirms, a formal debriefing after a bad outcome is psychologically beneficial to the individual doctor.

Sources Used:
Medical News Today, 84% Of Anesthesiologists Involved In Surgical Catastrophes, March 3, 2012.
Wikipedia, General Anesthesia, Last Reviewed May 25, 2012.

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