Page 18 - Dallas Vol 5 No 3

KAY VAN WEY | Medical Malpractice
Out-Patient and Of ce-Based Surgery
Center Safety
I’ll have to tell a little story on myself. I recently took my 18-year-old son in to
have his wisdom teeth extracted. Being a med mal lawyer, I researched until I found one of the best oral surgeons in Dallas. I knew he would pro- vide the best care possible for my son and I wasn’t really concerned, a er all it was a quick and simple procedure. However, I couldn’t help myself. As we showed up on the
day of the procedure, I asked the following questions: What drugs will you be using for sedation? Propofol. Oh, will you be using qualitative end tidal Co2 monitor- ing? Yes. Good, because you know what I do for a living and I am sure you also know that all throughout Texas and elsewhere doctors are sedating patients without the neces- sary safety monitoring. Yes, I know and I have pushed for reform in this area because patients do run into complica- tions and we can’t predict which ones will and which ones won’t, so we prepare for the worst. Yes, I know too because I have several cases I am working on right now for families of patients who went in for super minor procedures and either came out brain damaged or dead. I can only imag- ine and I guess you heard that there was a kid who died during wisdom teeth removal here in Dallas recently. NO,
I hadn’t heard. OMG!
So as to not leave you hanging, my 6’3” child was just
ne and will now be going o to college with four less teeth, but completely unscathed from the procedure!
In the “good old days” surgeries were performed in hos- pitals and patients were kept for several days for observa- tion. Now, all but the most major and complex of surgi- cal procedures seem to be performed as “day surgeries” at out- patient surgery centers. O en, patients are released within hours of major surgery.
SAFETY CONCERNS CENTER AROUND FOUR MAIN ISSUES
No. 1: e underlying health of the patient. Doctors will tell you that you could line up 100 people of all ages, sizes, health conditions and be unable to predict which patient would actually su er a complication. Having said that, there are certain patients who are at high risk and should not be operated on in a facility which cannot promptly and completely respond to a life-threatening complication.
No. 2: e complexity of the surgical procedure. Gen- erally speaking, very long and very complex procedures should be performed in a hospital that specializes in per- forming those procedures
No. 3: e depth of anesthesia. O en, even simple pro- cedures are performed under general anesthesia, which carries its own set of risks. For example, have you ever had to sign an anesthesia risk disclosure form? You will see that whenever you are” put under”, you have to liter- ally sign your life away, yet every day in the U.S. patients are being put “under” without the properly trained sta or equipment to rescue them if necessary.
No. 4: e training and equipment of the surgery team to respond to emergencies. If you or a loved one have had surgery at an “out-patient” center, would you be surprised to know that in some cases, the rescue plan for medical emergencies is to call 911? Yes, it happens and in the time it takes an ambulance to get to the surgery center, get the patient and take them to a hospital can result in severe brain damage and death.
No. 5: e premature discharge of patients. I am sure that all of you can relate to the feeling of being rushed out of an out-patient surgery center with a half conscious per- son in your charge! It’s scary! Usually, everything works out, but in some instances, the patient may have sustained an intra-operative or post-operative complication that could not possibly be recognized by family members who are lay persons and only if the patient was kept and moni- tored would the complication be caught in time to save the patient.
We must rely on physicians to always place patient safety rst! In our everyday lives we feel comforted by the words “it is only a minor procedure” or “it is only day sur- gery,” but this must be balanced with a healthy respect for the potential catastrophes that can and do occur. Regula- tion and accreditation continue to be important aspects to ensuring patient safety, but there may also need to be a greater push for monitoring compliance and enforcing violations.
KAY VAN WEY IS A PLAINTIFF’S MEDICAL MALPRACTICE AT- TORNEY. AFTER MORE THAN 30 YEARS IN THE TRENCHES, HER GOAL IS TO MAKE HERSELF EXTINCT BY HELPING TO ERADICATE PREVENTABLE MEDICAL ERRORS AND MAKE HEALTH CARE SAFER. SELECTED TEXAS SUPER LAWYER FOR 15 CONSECUTIVE YEARS, SHE’S ALSO BEEN NAMED D BEST IN TORT, PRODUCT AND MEDICAL LIABILITY LITIGATION. KAY IS BOARD CERTIFIED IN PERSONAL INJURY TRIAL LAW BY THE TEXAS BOARD OF LEGAL SPECIALIZATION. KAY IS ADJUNCT PROFESSOR OF LAW AT SMU, TEACHING THE COURSE ON LAW AND MEDICINE. YOU MAY REACH KAY BY EMAILING [email protected].
ATTORNEY AT LAW MAGAZINE · DALLAS· VOL. 5 NO. 3 18