Law Med Blog

Supervision Of CRNAs Does Not Create Liability For Surgeons

April 05, 2012 lawmed 8 Comments

By Greg Stocks, The Law Med Blog

While any author certainly prefers that the reader take the time to read his or her work in its entirety, for those who want a quick answer without the evidence and law explained, here it is: Surgeons do not expose themselves to greater liability when they work with Certified Registered Nurse Anesthetists (CRNAs) alone vs physician anesthesiologists alone. Regardless of what anyone might tell you to the contrary, the courts and the case law are unambiguous and very complete on the matter. But don’t just believe me, read on for the irrefutable facts based in law.

It is worth noting from the outset that due to the incredible record of safety which the administration of anesthesia enjoys (so safe that it is the envy of every other medical and nursing specialty in this regard), concerns from surgeons over their liability exposure for anesthesia … (Continued…)

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$2.4 M Verdict: Nurse Failed To Report Patient Change

November 03, 2011 lawmed No comments

On June 27, 1996, 71-year-old Pearl Cominsky entered Holy Redeemer Hospital in Meadowbrook, Pa., for an elective knee replacement. The surgery progressed normally and the patient was placed in a monitored bed on a telemetry floor post-op where she suffered a devastating cardiovascular event and later died. Originally, in a medical malpractice lawsuit filed by her husband, the plaintiff’s theory of the case was that Cominsky’s psychiatric medications, one of which was the potentially dangerous Clozaril, interacted with her anesthetic and/or her post-operative pain medication, causing her cardiovascular collapse. The original claim cited a failure by a psychiatrist, surgeon and anesthesiologist to order close post-operative monitoring due to these potential interactions as a causative factor in the death of Cominsky.

However, as discovery in the case progressed, it became apparent that adequate monitoring had taken place, but the results were not properly reported to the patient’s physicians, despite a … (Continued…)

Hospital & Surgeon Equally Responsible For Retained Surgical Sponge

October 28, 2011 lawmed No comments

In a somewhat odd case out of Louisiana, an appellate court has ruled that a hospital cannot have greater liability for a surgical sponge left in a patient than the surgeon. It is not this ruling which is odd. It is the fact that the plaintiff in the case filed the appeal, asking the court to assign the hospital a greater portion of the $50,000 judgment the trial court awarded. The trial court split the responsibility 50/50 between the surgeon and the hospital. But the plaintiff, for some strange reason, decided that spending thousands of dollars in legal fees appealing who should pay what percentage was worthwhile. The surgeon did not file or join the appeal to have the hospital pay a greater portion…and the hospital did not file an answer in the appeal against it. Unusual.

The plaintiff, Brenna Davis, originally brought this medical malpractice action against Dr. Richard … (Continued…)

Jury Awards $340K For Unecessary Thyroid Removal

August 03, 2011 lawmed No comments

In 2003, Sheraline Austin, 47, underwent evaluation of a lump that occupied her throat. An otolaryngologist, Dr. Aaron Spingarn, aspirated the lump, and performed a sonography which suggested a carcinoma in the left lobe. Spingarn recommended surgical removal of the lump. An intraoperative biopsy revealed that the lump was not cancerous, but Spingarn noted that additional lumps were also present on the right lobe of the thyroid. He did not biopsy these masses and elected to remove the entire thyroid. Austin subsequently developed hypothyroidism.

She sued claiming that Spingarn should not have removed her thyroid. Austin sued Spingarn; his practice, Westchester Medical Group, P.C.; and the pathologist who reviewed the results of the initial aspiration of her lump, Dr. Vincent Gemellaro; and Gemellaro’s employer, Quest Diagnostics Clinical Laboratories Inc. Austin alleged that Gemellaro improperly interpreted the aspiration’s pathology as suggestive of cancer, that Spingarn unnecessarily removed her thyroid, that Quest … (Continued…)

Anesthesia Malpractice In ‘Simple’ Eye Case $2.25 Million Judgment

June 30, 2011 lawmed No comments

It was to be a routine outpatient eye surgery done thousands of times per day across the country. In fact most anesthesia providers would describe it as a boring, bread and butter clinical procedure from their perspective. In Tseng v. Mazzocco Ambulatory Surgery Center, the plaintiff was to have an artificial lens placed in one eye. Depending on the surgeon, this is generally a 10-30 minute procedure done under local anesthesia with varying degrees of sedation. According to court documents filed in Los Angeles Superior Court, the plaintiff claimed both the anesthesiologist and Mazzocco Ambulatory Surgical Center were negligent, resulting in significant brain damage to the plaintiff. And the jury agreed.

The plaintiff contended that the anesthesiologist administered IV sedation in an amount greater than was clinically indicated, resulting in the plaintiff’s breathing being compromised. To make matters worse, the anesthesiologist then left the room and failed to properly monitor … (Continued…)

$260K For Retained Surgical Sponge

May 26, 2011 lawmed 1 Comment

On March 26, 2008, Justin Bartle, 26, underwent a resection of a portion of his bowel. The procedure was performed by a colorectal surgeon, Dr. Fred Boehmke, at Sisters of Charity Hospital, in Buffalo, NY. Boehmke was assisted by another surgeon, Dr. William Heyden. A surgical pad was left in Bartle’s abdomen and caused an infection, and required additional surgery for removal.

In a medical malpractice action Bartle sued Boehmke; Boehmke’s practice, Amherst Colon & Rectal Surgery; Heyden; and the hospital. Bartle alleged that Boehmke and Heyden failed to properly perform the surgery, that nurses failed to properly assist the surgeons, that the failures constituted malpractice, that the hospital was vicariously liable for the actions of Heyden and its nurses, and that Amherst Colon & Rectal Surgery was vicariously liable for Boehmke’s actions.

Bartle’s later dropped the claim against Heyden. The matter proceeded to a trial against the remaining defendants, … (Continued…)

Malpractice Lawsuits Against Hospitals Increasing

October 22, 2010 lawmed No comments

From the Wall Street Journal Health Blog

The pace of malpractice claims against hospitals is picking up, according to a recent report from Aon Risk Solutions and the American Society for Healthcare Risk Management.

Earlier in the decade, growth in the frequency of claims declined for several years in a row, down to a 1.81% increase for incidents occurring in 2006. The pace has now ticked up for the past three years, to 1.95% for incidents occurring last year, the report says.

It estimates the cost of the 44,000-odd claims arising from incidents occurring last year will top $8.6 billion (that covers hospitals only, not physicians or long-term care facilities.) Obstetrics-related claims alone will run an estimated $1.4 billion.

Erik Johnson, health care practice leader for Aon Risk Solutions’ Actuarial and Analytics Practice, tells the Health Blog it’s not clear why the frequency of claims against hospitals is edging … (Continued…)

Two Employees Sue Iroquois Memorial Hosp. Charging Violation Of Federal Wiretap Act

September 22, 2010 lawmed No comments

In a strange story out of Illinois, hospital employees Valerie McCann and Dr. Leslie Lindberg claim their conversation expressing dissatisfaction with hospital CEO Stephen Leurck and the reorganization of the radiology department was recorded by a dictation machine in Lindberg’s office without their knowledge or permission.

The tale begins with McCann, former director of physician services, being terminated from the hospital in 2006 after she and several other employees were given one week to resign. They were told that if they resigned within the week they could then apply for other positions at the hospital. McCann believed that this reorganization was a ploy by then new CEO Stephen Leurck to simply get rid of people he did not like, and she was right. McCann attempted to meet with Leurck, but he refused until the week had passed. McCann did not resign and was terminated and told that no new position … (Continued…)

Sponge Count Erroneously ‘Correct’ And Sponge In Abdomen? Surgeon Cannot Claim Nurses To Blame In TN.

August 28, 2010 lawmed No comments

We recently talked about res ipsa loquitur in an offbeat and roundabout way. Now let’s take a real case from current court proceedings which relate to the fact pattern of another case we also previously discussed.

Dr. Richard Geer (no kidding) operated on the late Clyde Deuel on August 22, 2006 to remove a pancreatic mass. As is common in an open abdominal procedure, surgical lap pads (special cotton mesh towels with a strip of fiber that shows up on x-ray) were utilized. In addition to surgical instruments, suture needles and other devices, lap pads are part of the surgical count. At the end of the procedure, before the abdomen is closed up, all items that are part of the surgical count must be accounted for. Prior to beginning the operation all items are counted and the count is recorded. During the procedure if items are added to the … (Continued…)

Going Rate For Leaving Surgical Towel In Abdomen 6 Years: $564k

August 06, 2010 lawmed 1 Comment

Since undergoing an abdominal hysterectomy in 1999 at Lutheran Hospital of Indiana in Fort Wayne, Sylvia Mata continued to have abdominal pain for 6 years. And it’s no wonder. A surgical towel, not a type of towel know as a “lap pad” which has a stripe of thread running through it that will show up on an x-ray, but a towel similar to one of your cheap dishtowels, which is not meant to be placed into the abdomen, because if left there it may not show up on x-ray, was. And for six years, no xray detected it.

Her bowel eventually encapsulated the towel (likely forming some adhesions, tissue growth and nasty scar tissue that wasn’t much fun to cut away so that the towel could be removed without perforating the bowel. Doctors thought she had a cancerous tumor until they opened her up and, viola’!….a towel.

Mata sued her … (Continued…)

RN’s Sciatica Blamed on IM Post Delivery $1.69 Million Awarded: Hospital Found Vicariously Liable.

July 31, 2010 lawmed No comments

On October 2007, plaintiff Tina Holstein, 31, a nurse who provides residential care, underwent the delivery of her third child. The delivery was performed at Community General Hospital, in Syracuse. During the delivery’s aftermath, Holstein began vomiting. The vomiting was addressed via the administration of an intramuscular injection. Holstein claimed that the injection caused a permanent injury of her sciatic nerve.

Holstein sued the hospital and the nurse who administered the injection, Jacinta Colombo. Holstein alleged that Colombo failed to properly administer the injection, that Colombo’s failure constituted malpractice and that the hospital was vicariously liable for Colombo’s actions.

Holstein’s counsel ultimately discontinued the claim against Colombo. The matter proceeded to a trial against the hospital. Holstein’s expert nurse opined that the injection was administered to the wrong area of Holstein’s buttocks. She contended that Colombo should have targeted a higher area of the buttocks.

Defense counsel contended that Holstein’s … (Continued…)

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