ASC Septoplasty Lawsuit

[nimbus]

Defense verdict reached in $5M med mal suit | Virginia Lawyers Weekly

This lawsuit was brought by a patient who had a septoplasty procedure performed at a local surgery center to address sleep apnea and migraine headaches.

valawyersweekly.com

Laryngospasm and NPPE.

“Date resolved: 9/26/2023

Demand: $5,000,000

Verdict or settlement: Verdict

Amount: $0 (defense)

Dillman
Attorneys for defendant: Rodney S. Dillman and Brett M. Saunders, Virginia Beach

Description of case: This lawsuit was brought by a patient who had a septoplasty procedure performed at a local surgery center to address sleep apnea and migraine headaches. The procedure itself was without complications, however following extubation, the patient suffered a laryngospasm (vocal cords shutting abruptly), which prevented her from being ventilated, and she eventually suffered negative pressure pulmonary edema (lungs filling with fluid). This resulted in the patient having large amounts of pink froth coming from her throat requiring reintubation. The patient was subsequently put into a medically induced coma for nearly two weeks.

After the patient was brought out of her coma, she spent a total of 34 days in the hospital before receiving many additional months of rehabilitation treatment. The patient had no memory of her life prior to her surgery and continued to have frequent seizures following her hospitalization. The patient eventually moved back in to live with her parents for support and continued to have issues with memory, concentration, problem-solving and almost daily seizures. The patient’s friends and family members described her as a completely different person than before the surgery.

The plaintiff-patient alleged that the CRNA defendant extubated her too soon from surgery and her ventilatory data showed that she was not appropriate for extubation at the time. During litigation, it was discovered that the CRNA defendant had altered numerous values of the ventilatory data both before and after the extubation making the patient appear more stable and her condition less severe. No note was made indicating that these changes were made, and they were only discovered after the patient’s audit trial for the procedure was produced in response to a subpoena duces tecum from plaintiff’s counsel. Plaintiff argued that the changing of these numbers showed that the CRNA knew that the patient should not have been extubated at the time because all the changes were made to make the patient’s condition look better than it actually was at the time. At the videotaped deposition of the CRNA defendant, the CRNA initially did not recall making any changes but later explained that he updated the ventilatory data because the patient was coughing on the endotracheal tube and moving her arms, both before and after extubation, creating inaccurate readings in the medical chart.

The plaintiff-patient alleged that the anesthesiologist defendant should have been present for the extubation and stopped the extubation from occurring.

The plaintiff’s standard of care experts testified that there was no doubt that the patient was not ready for extubation based on both the ventilatory data that was recorded and the values that were changed by the CRNA. They further testified that extubating her too soon directly caused her laryngospasm and negative pressure pulmonary edema. Each expert also testified that the patient’s ventilatory data was updated to make her appear appropriate for extubation when she was not and that they had not ever seen a medical provider alter medical data in this way in their entire careers. Plaintiff’s audit trial expert testified regarding how unusual the CRNA’s changes to the records were as well.

Plaintiff’s standard of care experts testified that the defendant anesthesiologist should have been present for the extubation based on the patient’s various comorbidities noted prior to surgery. If he had been present, they explained that the standard of care would have required him to prevent the CRNA defendant from extubating the patient.

Plaintiff’s causation and damages experts testified that the patient undoubtedly suffered a hypoxic brain injury because of her lacking oxygen following extubation. This could be seen on the patient’s MRI imaging taken while she was in a coma. The plaintiff further suffered a permanent major neurocognitive disorder, dissociative amnesia and frequent seizures all secondary to her hypoxic brain injury. Plaintiff’s experts testified that the plaintiff required 24-hour supervision for the rest of her life and that she was not capable of competitive employment for the rest of her life.

Defense experts, Thomas Pajewski, M.D., W. Paul Murphy, M.D., and Suzanne Wright, CRNA, countered that the plaintiff’s ventilatory data was impacted directly by her coughing and moving her arms. It was not unusual for a patient who was coughing to have aberrant values entered with the ventilatory data. They testified that based on the patient’s overall condition prior to extubation, including her being able to open her eyes and respond to commands, she was appropriate for extubation. They also explained to the jury that a laryngospasm is a known complication that can occur without any negligence and that the patient survived her complications due to the quick reaction from the CRNA and anesthesiologist.

Defense expert, David Cifu, M.D., explained that the patient had a hypoxic event, but did not suffer a hypoxic brain injury. He further explained that the patient’s current seizures and cognitive disabilities were not related to any complications from her surgery.

After a six-day trial, on the seventh day, the jury deliberated for over four hours before returning a verdict in favor of the defendant CRNA, anesthesiologist and their employer.”

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[aneftp]

The real reason the lawsuit was is in favor of the defendants is this: (and it’s the truth)

Juries want to see a half way dead paralyzed patient. The plaintiff was/is still functional walking around. Doing daily activities.

It’s all for show here folks.
Just the way our dumb ass malpractice system works on good old usa

I had a friend who has bilateral vertebral artery dissection. Stroke hospitalized on blood thinners. Young mom of 2 kids.

Missed vacations. Missed time from work

Chiropractor should be blamed for letting her out of the office after cracking her neck. Er docs missed diagnosed ordering ct
Head but not cta scans to determine dissection. Let her home.

I finally told her what to demand on return visit to ER the next morning.

But because she “recovered” after 6 months even after some memory lost. No big firms would even take the case.

It’s all about “optics” in malpractice. If a plantiff looks like they recovered pretty well. No big firms will bother taking it to trial. They will just hope for a settlement.

So far she’s only been offered 50k settlement. She’s suing for 1 million. Chiropractor should be blamed but they barley carry any malpractice.

Just the way the world works.

 

[BobLoblaw78]

Regardless of what happened and the things that we all see with every case that is similar to this.....dang. I can't help but sympathize with the patient and her family. I also feel bad for the people taking care of her as well. It scares me a little to think something like this could happen even when following SOC. Finally, how can they say with a straight face that her adverse outcome didn't ultimately come from the laryngospasm (I'm not assigning fault).

....Now the thread can be derailed by endless fingerpointing

 

[Dr. Rude]

Sometimes we lose cases (or pay settlements) that we shouldn’t have to. Based on the limited data provided, This sounds like a Case where the doc/CRNA won but should have lost.

Having been part of the former group, and being a vengeful bastard, it does provide me a small measure of comfort to see the system fück over a plaintiff law firm who undoubtedly spent 100K+ bringing this to trial.

 

[GassYous]

Regardless of what happened and the things that we all see with every case that is similar to this.....dang. I can't help but sympathize with the patient and her family. I also feel bad for the people taking care of her as well. It scares me a little to think something like this could happen even when following SOC. Finally, how can they say with a straight face that her adverse outcome didn't ultimately come from the laryngospasm (I'm not assigning fault).

....Now the thread can be derailed by endless fingerpointing

Well there's no information about her preprocedure baseline and patients who have laryngospasm and nppe can recover without sequelae.

 

[ucladoc2b]

Sometimes we lose cases (or pay settlements) that we shouldn’t have to. Based on the limited data provided, This sounds like a Case where the doc/CRNA won but should have lost.

Having been part of the former group, and being a vengeful bastard, it does provide me a small measure of comfort to see the system fück over a plaintiff law firm who undoubtedly spent 100K+ bringing this to trial.

Why do you think they should have lost?

That vent data is kinda weak

 

[nimbus]

I think the plaintiff’s argument was flawed because in order to develop NPPE, you need good strong inspiratory effort against a closed glottis. It seems unlikely that there were inadequate ventilatory mechanics prior to extubation. It was an airway issue and the tidal volumes and ventilatory effort were likely very good immediately before extubation.

 

[nimbus]

Regardless of what happened and the things that we all see with every case that is similar to this.....dang. I can't help but sympathize with the patient and her family. I also feel bad for the people taking care of her as well. It scares me a little to think something like this could happen even when following SOC. Finally, how can they say with a straight face that her adverse outcome didn't ultimately come from the laryngospasm (I'm not assigning fault).

....Now the thread can be derailed by endless fingerpointing

The only deviation might have been not addressing the laryngospasm quickly enough to prevent NPPE. But NPPE still happens. Subsequent management including reintubation and transfer to hospital were well within standard. If it was a medical direction case, the only other deviation may be the absence of the anesthesiologist at extubation.

Contrast that with the Geoffrey Kim case.

 

[Arch Guillotti]

I think the plaintiff’s argument was flawed because in order to develop NPPE, you need good strong inspiratory effort against a closed glottis. It seems unlikely that there were inadequate ventilatory mechanics prior to extubation. It was an airway issue and the tidal volumes and ventilatory effort were likely very good immediately before extubation.

What about the prink frothy sputum?

 

[Maz777]

It depends on how quickly and effectively they responded to the laryngospasm, which is obviously a known and frequent complication. Not enough information here to evaluate. Two weeks of being intubated after NPPE is legit. We extubate people daily that aren't "ready" for extubation, so not a deviation there.

Kudos to the jury. I'm sure the lawyers still got paid though.

 

[nimbus]

What about the prink frothy sputum?

That’s characteristic of NPPE. Maybe I’m wrong but I did not think it was present before extubation. It likely developed after extubation and laryngospasm.

 

[UscGhost]

So the patient was responding to commands and then laryngospasm? Seems unlikely. Probably just a box the crna checked on the EMR.

Septoplasty are always a high risk due to secretions and bleeding.

My question would be how long did they wait before giving sux. NPPE was probably unavoidable but that doesn't cause acute hypoxic injury.

 

[Maz777]

So the patient was responding to commands and then laryngospasm? Seems unlikely. Probably just a box the crna checked on the EMR.

Septoplasty are always a high risk due to secretions and bleeding.

My question would be how long did they wait before giving sux. NPPE was probably unavoidable but that doesn't cause acute hypoxic injury.

You'll prolly never know the answer to the last question. I'm sure it was documented as given immediately when the sats dropped but likely not the case. Hard to prove there was a delay in giving sux.

 

[Dr. Rude]

Why do you think they should have lost?

That vent data is kinda weak

Totally elective surgery…the case is a dime a dozen and the patient has a catastrophic anesthesia complication from something that is easily treatable that we worry about for every case. (Laryngospasm and NPPE). I didn’t drill down into the details, but come on. Most likely they (just) didn’t give sux early enough. Other than that Mrs. Lincoln, how was the play?

 

[Lecithin5]

I go to one center that does paper charting, and I’ll be honest, at the end of a case as I’m starting to wake the patient up (and thus turning down/off gas and turning up flows), I don’t always exactly document this accurately… can make it look like I’m extubating with 2.2 end tidal sevo on board… a good reminder

 

[Dr. Rude]

….Hard to prove there was a delay in giving sux.

The standard for civil trials is usually “preponderance of evidence” not “reasonable doubt” like in criminal trials. “Proving” and voting for the plaintiff requires you to be 50.1% certain that there was a breach of the standard of care AND that breach caused the plaintiff’s injuries. No way to know for certain, also we don't have access to the details, but based only on the very limited info we have, I am more than 50.1% certain that this was bad care that resulted in harm. Does anyone really think that is not the most likely case?

kudos to the defense attorneys for winning a case they probably should have lost. Hard to put that on a billboard, but I would hire them. This is our system. For better or worse.

 

[Maz777]

Totally elective surgery…the case is a dime a dozen and the patient has a catastrophic anesthesia complication from something that is easily treatable that we worry about for every case. (Laryngospasm and NPPE). I didn’t drill down into the details, but come on. Most likely they (just) didn’t give sux early enough. Other than that Mrs. Lincoln, how was the play?

I always wondered where they find these scabs to expert witness for the plaintiff.

 

[BobLoblaw78]

Well there's no information about her preprocedure baseline and patients who have laryngospasm and nppe can recover without sequelae.

I am certain she wasn't having seizures and could remember her life up to that point.

The only deviation might have been not addressing the laryngospasm quickly enough to prevent NPPE. But NPPE still happens. Subsequent management including reintubation and transfer to hospital were well within standard. If it was a medical direction case, the only other deviation may be the absence of the anesthesiologist at extubation.

Contrast that with the Geoffrey Kim case.

I wasn't implying there was a deviation. I am just stating even if you do follow SOC this can happen. I am going to assume we will never know the whole story given the fact that changes were made to the record that look suspicious. Regardless, I would be in the same boat for many cases that I extubate deep to avoid this exact situation. I can tell you that the patients aren't always moving 400+mL tidal volume. The irony is that had they pulled the ETT sooner they might have avoided this. The main critique I would have would be the reaction time and response to laryngospasm. (I also would consider Takotsubo cardiomyopathy causing pulmonary edema and ABI... but I admittedly didnt read through the case details. NPPE this bad would require pretty strong NIF for female)

 

[Dr. Rude]

I always wondered where they find these scabs to expert witness for the plaintiff.

I don't do expert witness work. Never have. Won't go near it. But I have lots of lawyers in my family. I understand how the legal system works. The same system that freed OJ also sent over 100 innocent people to death row. Lying, trickery, underhanded behavior is rewarded and celebrated. Understanding it is not the same as embracing it.

 

[Maz777]

I don't do expert witness work. Never have. Won't go near it. But I have lots of lawyers in my family. I understand how the legal system works. The same system that freed OJ also sent over 100 innocent people to death row. Lying, trickery, underhanded behavior is rewarded and celebrated. Understanding it is not the same as embracing it.

You should get into it. Plaintiff lawyers would love you.

 

[Dr. Rude]

You should get into it. Plaintiff lawyers would love you.

Based upon the limited data that we have, what do you think happened in this case?

 

[DaTruMD]

The real reason the lawsuit was is in favor of the defendants is this: (and it’s the truth)

Juries want to see a half way dead paralyzed patient. The plaintiff was/is still functional walking around. Doing daily activities.

It’s all for show here folks.
Just the way our dumb ass malpractice system works on good old usa

I had a friend who has bilateral vertebral artery dissection. Stroke hospitalized on blood thinners. Young mom of 2 kids.

Missed vacations. Missed time from work

Chiropractor should be blamed for letting her out of the office after cracking her neck. Er docs missed diagnosed ordering ct
Head but not cta scans to determine dissection. Let her home.

I finally told her what to demand on return visit to ER the next morning.

But because she “recovered” after 6 months even after some memory lost. No big firms would even take the case.

It’s all about “optics” in malpractice. If a plantiff looks like they recovered pretty well. No big firms will bother taking it to trial. They will just hope for a settlement.

So far she’s only been offered 50k settlement. She’s suing for 1 million. Chiropractor should be blamed but they barley carry any malpractice.

Just the way the world works.

So is your friend still going to chiropractors?

 

[aneftp]

So is your friend still going to chiropractors?

Yes! But not that that one. And no necks obviously

 

[Maz777]

Based upon the limited data that we have, what do you think happened in this case?

No effin clue. Not involved in the case. No data available. Laryngospasm/NPPE is a known complication of anesthesia. Unless there was evidence of gross negligence (which is not apparent), I probably wouldn't throw colleagues under the bus based on a news article.

 

[Hoya11]

Totally elective surgery…the case is a dime a dozen and the patient has a catastrophic anesthesia complication from something that is easily treatable that we worry about for every case. (Laryngospasm and NPPE). I didn’t drill down into the details, but come on. Most likely they (just) didn’t give sux early enough. Other than that Mrs. Lincoln, how was the play?

this can happen to anyone of us

 

[Dr. Rude]

this can happen to anyone of us

Yes it can.

 

[Dr. Rude]

No effin clue. Not involved in the case. No data available. Laryngospasm/NPPE is a known complication of anesthesia. Unless there was evidence of gross negligence (which is not apparent), I probably wouldn't throw colleagues under the bus based on a news article.

You will note in my posts that I qualified every statement “based on limited data.”
Just because something is a “known complication” does not absolve the clinician from treating it promptly and appropriately.
I simply gave my opinion based on the limited data. If that is throwing under the bus I guess I am guilty.
When you say “no effin clue” you are being deliberately obtuse. There is a difference between gross negligence and ordinary negligence. The latter is apparently OK with you.

 

[coffeebythelake]

What about the prink frothy sputum?

it doesn't necessarily mean breathing against a closed glottis.
you can get NPPE from forcefully breathing through a small tube (i.e., a small ETT) even if you aren't biting down on it.
i'm sure you've seen a patient breathe so deeply and forcefully that it completely collapses the bag and generates a negative pressure alarm.
i've pulled ETT's out in this situation before to prevent NPPE. you do that or you deepen the patient quickly with some propofol and try again.

 

[<(^_^)>]

While I would echo everyone here that we can’t know the full details two things were most concerning to me.

1: Editing the vent record data. Really not a good look. Something I’ve never done and never will do. If I want to add my input, I will add a quick note. I don’t edit the actual imported data. It will only hurt you I think as everything is logged and it will look like you are trying to cover things up even if you’re genuinely trying to make the record more accurate.

2: The hypoxic event sufficient to cause seizures. I do wonder how quickly they reintubated. If previously not documented as a difficult airway this is the area where I see the most potential for improvement. I wonder if they laryngospasmed on the way to PACU which would explain the delay.

 

[caligas]

So obviously an electronic record. Is it really better to leave artifactual data that a plaintiffs expert could use against you? For example, record records a couple of very small title volume breaths right before extubation, or a artifactual high co2?

Why not correct with a note explaining the reason/artifact?

 

[Dr. Rude]

it doesn't necessarily mean breathing against a closed glottis.
you can get NPPE from forcefully breathing through a small tube (i.e., a small ETT) even if you aren't biting down on it.
i'm sure you've seen a patient breathe so deeply and forcefully that it completely collapses the bag and generates a negative pressure alarm.
i've pulled ETT's out in this situation before to prevent NPPE. you do that or you deepen the patient quickly with some propofol and try again.

All true….but based on the limited data provided in this case…what do you think is the most plausible explanation?

 

[neutro]

All I read from this is that anesthesiologist wasn’t called early?

 

[coffeebythelake]

So obviously an electronic record. Is it really better to leave artifactual data that a plaintiffs expert could use against you? For example, record records a couple of very small title volume breaths right before extubation, or a artifactual high co2?

Why not correct with a note explaining the reason/artifact?

Correct with what? Pulling numbers out of thin air? I agree that you should write a note that the patient was stable and breathing well and that the recorded data was artifact but changing the actual numbers seem like trying to conceal evidence

 

[caligas]

Correct with what? Pulling numbers out of thin air? I agree that you should write a note that the patient was stable and breathing well and that the recorded data was artifact but changing the actual numbers seem like trying to conceal evidence

In the past I’ve just deleted values that are obviously artifact, but maybe you are right better just to write a note

 

[Maz777]

You will note in my posts that I qualified every statement “based on limited data.”
Just because something is a “known complication” does not absolve the clinician from treating it promptly and appropriately.
I simply gave my opinion based on the limited data. If that is throwing under the bus I guess I am guilty.
When you say “no effin clue” you are being deliberately obtuse. There is a difference between gross negligence and ordinary negligence. The latter is apparently OK with you.

Let me rephrase this. You have zero evidence that anything negligent happened. Not "limited" data. Zero.

We have all had scary laryngospasms in healthy young adults. Could all have had this outcome if the sux didn't break it quickly. Glad I don't have a colleague like you armchair QBing and throwing me under the bus with zero data.

 

[Gasworks]

Only lesson I see here is don’t mess with the data on your paper chart or EMR ever. If the numbers are bad treat them. We had a vent fail in one of our endo rooms resulting in an adverse outcome. When biomed showed up to pull the data from machine and monitor I was shocked to just how much information is stored in the machine logs. Every single measurable value, key press and bag squeeze is stored and can be readily audited. I pass this info to all of our new docs and mid levels who just love to get in there and “make the chart look pretty”. There is a falsifying medical records issue here that is being totally glanced over. This should cost the crna his/her license.

 

[neutro]

Only lesson I see here is don’t mess with the data on your paper chart or EMR ever. If the numbers are bad treat them. We had a vent fail in one of our endo rooms resulting in an adverse outcome. When biomed showed up to pull the data from machine and monitor I was shocked to just how much information is stored in the machine logs. Every single measurable value, key press and bag squeeze is stored and can be readily audited. I pass this info to all of our new docs and mid levels who just love to get in there and “make the chart look pretty”. There is a falsifying medical records issue here that is being totally glanced over. This should cost the crna his/her license.

I never understood “making the chart look pretty”.

I never understood “ perfect train tracks” mindset.

 

[Dr. Rude]

Let me rephrase this. You have zero evidence that anything negligent happened. Not "limited" data. Zero.

We have all had scary laryngospasms in healthy young adults. Could all have had this outcome if the sux didn't break it quickly. Glad I don't have a colleague like you armchair QBing and throwing me under the bus with zero data.

What do you want videotape?

It is an OPINION based on LIMITED Data.

NOBODY on this thread has even offered another OPINION on what actually happened. Other than “FŨCKED IF I KNOW?”

I totally hate the medicolegal process, but that is a separate issue. Also I have made mistakes that have caused patients harm, that I have never been taken to task for. For which I am thankful.


Res Ipsa Loquitur.

 

[Maz777]

What do you want videotape?

It is an OPINION based on LIMITED Data.

NOBODY on this thread has even offered another OPINION on what actually happened. Other than “FŨCKED IF I KNOW?”

I totally hate the medicolegal process, but that is a separate issue. Also I have made mistakes that have caused patients harm, that I have never been taken to task for. For which I am thankful.


Res Ipsa Loquitur.

You're right. Let's given our strong opinion on something we know nothing about.

Others have correctly given their opinions about altering the chart after the fact. You're the only one to posit that they clearly and negligently managed laryngospasm improperly by not giving sux early (and that this is an easily manageable complication) without knowing anything. How do I add a clown emoji?

 

[Dr. Rude]

You're right. Let's given our strong opinion on something we know nothing about.

Others have correctly given their opinions about altering the chart after the fact. You're the only one to posit that they clearly and negligently managed laryngospasm improperly by not giving sux early (and that this is an easily manageable complication) without knowing anything. How do I add a clown emoji?

You are just outraged that one doc would criticize another’s care. “Clearly and negligently” is a gross exaggeration of what I said. It is my best guess as to the most likely explanation as to what happened. I also suspect that more than one person agrees, But doesn’t want to commit the sin of publicly criticizing another doc and painting an ambulance chasing parasite as being on the right side for once.
Why don’t you reread my posts?

 

[Lecithin5]

Yes! But not that that one. And no necks obviously

For the life of my I will never understand why anyone would let a chiro anywhere near their neck…

 

[Maz777]

You are just outraged that one doc would criticize another’s care. “Clearly and negligently” is a gross exaggeration of what I said. It is my best guess as to the most likely explanation as to what happened. I also suspect that more than one person agrees, But doesn’t want to commit the sin of publicly criticizing another doc and painting an ambulance chasing parasite as being on the right side for once.
Why don’t you reread my posts?

I don't like scabs that throw colleagues under the bus. Sorry if that hurts your feelings. I'll mail you a sympathy card.

 

[Dr. Rude]

I don't like scabs that throw colleagues under the bus. Sorry if that hurts your feelings. I'll mail you a sympathy card.

May you depend on people who have the same degree of integrity and fidelity to the truth as you obviously do.

 

[Agast]

Is laryngospasm actually a malpractice event? It’s terrible that the recovery and sequelae was so damaging, but laryngospasm isn’t exactly a “never” event and that’s why we train for it. I think that’s the core of why the jury found for the defense. Just like a postop wound infection is terrible but if you gave antibiotics like you’re supposed to and the infection progressed anyway that’s not really malpractice that’s **** luck.

 

[gunnershow]

Is laryngospasm actually a malpractice event? It’s terrible that the recovery and sequelae was so damaging, but laryngospasm isn’t exactly a “never” event and that’s why we train for it. I think that’s the core of why the jury found for the defense. Just like a postop wound infection is terrible but if you gave antibiotics like you’re supposed to and the infection progressed anyway that’s not really malpractice that’s **** luck.

In theory it should never happen if you do academic wakeups, but people tend to make a habit of extubating in stage II for the sake of efficiency with the thought that they can easily break any spasm. That's probably negligence yeah, but impossible to prove.

 

[kidthor]

In theory it should never happen if you do academic wakeups, but people tend to make a habit of extubating in stage II for the sake of efficiency with the thought that they can easily break any spasm. That's probably negligence yeah, but impossible to prove.

Academic wakeups? I’ve seen patients opening eyes and fully following commands who still have laryngospasm when nasal surgery blood hits their cords. I don’t think any of that constitutes negligence since emergence and extubation are probably more art than science and the right time lies somewhere on a very broad spectrum.

 

[anbuitachi]

some people mentioned maybe they didnt give sux soon enough, or reintubate soon enough.
what is soon enough?? 5 seconds? 10? within 1 min? 10 min?

 

[Dr. Rude]

some people mentioned maybe they didnt give sux soon enough, or reintubate soon enough.
what is soon enough?? 5 seconds? 10? within 1 min? 10 min?

Soon enough: in time to prevent a catastrophic complication similar what this patient suffered.

We have all seen laryngospasm and NPPE.

Again, absent the details, e.g., depositions, medical records, etc.

Does anyone who has posted on this thread think that the most likely explanation is the simplest, I.e. the person(s) in the room didn’t give sux soon enough?

Please stand up.

 

[anbuitachi]

Soon enough: in time to prevent a catastrophic complication similar what this patient suffered.

We have all seen laryngospasm and NPPE.

Again, absent the details, e.g., depositions, medical records, etc.

Does anyone who has posted on this thread think that the most likely explanation is the simplest, I.e. the person(s) in the room didn’t give sux soon enough?

Please stand up.

so basically whenever there is a catastrophic complication from larygospasm and nppe, regardless of how soon that occurred, it means you didnt give sux fast enough. doesnt sound great for us! it takes time for sux to go from syringe to arterial system

 

[Agast]

And god forbid the patient has MH 🙃