Lawsuits filed against Arizona CRNA after multiple patients die within a year during elective dental sedation

[DazedWanderer]

Lawsuits filed against Arizona nurse anesthetist after two dental deaths, fire in mouth

An Arizona nurse anesthetist is facing multiple lawsuits after two of his patients died in separate dental procedures within a year.

www.abc15.com

- First patient died while under anesthesia due to hypoxic brain injury during elective teeth extraction to facilitate dentures
- Second patient died after inhalational burn injury caused by airway fire during laser procedure in which an unsafe FiO2 was administered.
- In at least one of these cases CRNA failed to perform a pre-anesthesia assessment and no anesthesia consent form was signed
- Dental office was not equipped for procedures under anesthesia, and the dentist did not hold certification to perform dental procedures under sedation
- Dental office paid a "mobile anesthesia" CRNA group to come in and sedate patients regardless of lack of adequate equipment or certification of facility
- Arizona Board of Nursing reviews cases and clears CRNA of any wrong doing, and refers to him as a "doctor" because he has a doctorate of nursing...
- Nursing Board member expresses sympathy for CRNA saying "I have to tell you, I am sorry. You have been through hell to say the least" due to the stress of having his professional conduct reviewed, while expressing no sympathy for family of patients who died.
- Nursing Board recommends against disciplinary action but rather for the CRNA to simply "review the Nursing Practice Act" with regards to reminding him of the mandatory performance of pre-op assessments.

... WTF?

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[narcotics999]

Lifeguard Anesthesia

Team — Lifeguard Anesthesia

www.lifeguardanesthesia.surgery

Nurse anesthesiologist

 

[Blockit]

Two dead office patients in five years of practice for this “nurse anesthesiologist”. They sure as hell scrubbed him quickly from their website.

 

[nimbus]

Lifeguard Anesthesia

Team — Lifeguard Anesthesia

www.lifeguardanesthesia.surgery

Nurse anesthesiologist

I like the diversity in that group

 

[sevo00]

Wow. Should be shown to arizona state legislators who are all for independent nurse practice

 

[deleted126335]

Wow. Should be shown to arizona state legislators who are all for independent nurse practice

In every state.

 

[Agast]

Lawsuits filed against Arizona nurse anesthetist after two dental deaths, fire in mouth

An Arizona nurse anesthetist is facing multiple lawsuits after two of his patients died in separate dental procedures within a year.

www.abc15.com

- First patient died while under anesthesia due to hypoxic brain injury during elective teeth extraction to facilitate dentures
- Second patient died after inhalational burn injury caused by airway fire during laser procedure in which an unsafe FiO2 was administered.
- In at least one of these cases CRNA failed to perform a pre-anesthesia assessment and no anesthesia consent form was signed
- Dental office was not equipped for procedures under anesthesia, and the dentist did not hold certification to perform dental procedures under sedation
- Dental office paid a "mobile anesthesia" CRNA group to come in and sedate patients regardless of lack of adequate equipment or certification of facility
- Arizona Board of Nursing reviews cases and clears CRNA of any wrong doing, and refers to her as a "doctor" because she has a doctorate of nursing...
- Nursing Board member expresses sympathy for CRNA saying "I have to tell you, I am sorry. You have been through hell to say the least" due to the stress of having her professional conduct reviewed, while expressing no sympathy for family of patients who died.
- Nursing Board recommends against disciplinary action but rather for the CRNA to simply "review the Nursing Practice Act" with regards to reminding her of the mandatory performance of pre-op assessments.

... WTF?

That’s a nice summary, but how did you miss that the CRNA in question is a man

 

[Potatoman1800]

Absolutely sickening

 

[chessknt]

Nursing board pretty soft on that too—what the hell? They should be held liable or as well

 

[coffeebythelake]

Assassins. Sounds like a couple clean kills by midlevel anesthesia nurses playing doctor.

They are ashamed to be nurse anesthetists. Calling themselves nurse "anesthesiologist" just goes to show how little respect they have for their own training that they have to try to hijack our title to mislead the public. Education and training matters.

So, Tory from anesthesia, if you are reading this, you should go back to being supervised by an actual anesthesiologist lest you kill more of your patients.

 

[coffeebythelake]

Lifeguard anesthesia?

 

[DazedWanderer]

That’s a nice summary, but how did you miss that the CRNA in question is a man

My mistake, I saw the nurse's first name was "Tory" and assumed female.

 

[coffeebythelake]

I like the diversity in that group

They did a damn photoshoot? Maybe they should spend more time learning about how to not make basic, unforced errors in anesthesia. For one, maybe intubate and avoid giving a ton of supplwmental oxygen when there is risk of airway fire?

 

[chessknt]

They did a damn photoshoot? Maybe they should spend more time learning about how to not make basic, unforced errors in anesthesia. For one, maybe intubate and avoid giving a ton of supplwmental oxygen when there is risk of airway fire?

Their mentor showed them this trick where you can decrease surgical infection rates in the mouth if you set it on fire.

 

[GassYous]

I wonder if my peers would commend my care too if I burned someone's mouth so bad that they died

 

[narcotics999]

Assassins. Sounds like a couple clean kills by midlevel anesthesia nurses playing doctor.

Calling themselves nurse "anesthesiologist" just goes to show how little respect they have for their own training that they have to try to hijack our title to command some respect. Education and training matters.

View attachment 345441

So, Tory from anesthesia, if you are reading this, you should go back to being supervised by an actual anesthesiologist lest you kill more of your patients.

you want to supervise him?

 

[Wolverines83]

I wonder if my peers would commend my care too if I burned someone's mouth so bad that they died

That comment shocked me too

 

[coffeebythelake]

Their mentor showed them this trick where you can decrease surgical infection rates in the mouth if you set it on fire.

This must be one of those special tricks they learned in nurse anesthesia school so they can bypass the extra years of training that doctors need from medical school and residency.

you want to supervise him?

Either he needs supervision or he retires. Allowing him to continue working as an unsupervised CRNA is a public health concern. Clearly nursing boards are not going to sanction him, and instead gave him a pat on the back. This assassin has his license to kill.. Wtf.

 

[IlDestriero]

If the nursing board is giving gross negligence and malpractice a pass that will prove to be a bigger problem than CRNAs and NPs practicing unsupervised.

 

[deleted875186]

“In regards to the case with the laser, job well done as far as I’m concerned,” she said. “I’m sorry for the outcome. But job well done."

Richmond responded, “Thank you. Appreciate that. Thank you.”


…. If this is an airway fire in the case of high FIO2, and an open airway is involved, essentially this is a clean kill by the CRNA. I’m hoping it’s not that negligent, because if the nursing board fails to condone that type of negligence, then why does the nursing board even exist?

 

[coffeebythelake]

Sooner or later this legal argument will play out big time in the court room. Anesthesia nurse claims to be a doctor and an anesthesiologist, givinh the patient and their family the false impression that they will be taken care of by an actual anesthesiologist. **** hits the fan. Bad outcome. Nurse scurries away with tail between legs and claims "just a nurse". Family sues that they were expecting a medical standard of care but were tricked into receiving a substandard midlevel nursing standard of care, and that if they knew a nurse was working unsupervised they would never consent to procedure.

 

[coffeebythelake]

“In regards to the case with the laser, job well done as far as I’m concerned,” she said. “I’m sorry for the outcome. But job well done."

Richmond responded, “Thank you. Appreciate that. Thank you.”


…. If this is an airway fire in the case of high FIO2, and an open airway is involved, essentially this is a clean kill by the CRNA. I’m hoping it’s not that negligent, because if the nursing board fails to condone that type of negligence, then why does the nursing board even exist?

Critical thinking is a medical standard of care. Equating laser, high levels of supplemental oxygen and the inevitable risk of airway fire must not quite meet the midlevel nursing cookbook standard.

 

[deleted875186]

No preoperative assessment and no anesthesia consent? What universe are we in. If any bad outcome and no preoperative assessment and consent, you are hosed, doesn’t even matter if your actions were by the book otherwise.

 

[coffeebythelake]

No preoperative assessment and no anesthesia consent? What universe are we in. If any bad outcome and no preoperative assessment and consent, you are hosed, doesn’t even matter if your actions were by the book otherwise.

With Lifeguard Anesthesia, they don't need to tied down by silly things like informed consents or truthfulness in representing oneself.

 

[RemyMcswain]

There’s a right way and a wrong way to do things in medicine. Regardless of the field.

Lying about your credentials, cutting corners, covering up for colleagues. Terrible.

 

[The Duck Knows]

What are y’all’s thoughts on trying to bring midlevels under the board of medicine? It would definitely be great to have a single board of medicine holding anesthetists and NPs to the same standard as physicians, but I could also see it further blurring the lines and bringing unearned credibility to those physicians.

But it’s an absolute joke that this joker was verbally consoled and applauded for MS4 level care

 

[deleted126335]

What are y’all’s thoughts on trying to bring midlevels under the board of medicine?

Fought and lost decades ago. ZERO chance.

 

[Wolverines83]

I wouldn’t want them under our board. They’d end up eventually running the board of medicine and we’d end up working for them. They’re more aggressive, more organized and most importantly, have more time to pursue their political agenda.

 

[VA Hopeful Dr]

I wouldn’t want them under our board. They’d end up eventually running the board of medicine and we’d end up working for them. They’re more aggressive, more organized and most importantly, have more time to pursue their political agenda.

In many states PAs already are with basically no representation on the board.

 

[pgg]

They did a damn photoshoot? Maybe they should spend more time learning about how to not make basic, unforced errors in anesthesia. For one, maybe intubate and avoid giving a ton of supplwmental oxygen when there is risk of airway fire?

Marketing is literally the only thing they have going for them.

 

[Planktonmd]

Marketing is literally the only thing they have going for them.

Unfortunately this works when the vast majority of society lacks basic education and are as a result very vulnerable to believe anything.
It's really shocking to see how gullible the majority of people are and how they can be made to buy anything that looks shiny in an add.
We live the the golden era of snake oil salesmen and crooks.

 

[Wolverines83]

In many states PAs already are with basically no representation on the board.

PAs and CRNAs aren’t exactly apples to apples, though. One group is full of the most aggressive, type a personalities in all of nursing and the other is more….normally distributed

Hey hopefully I’m just paranoid and it wouldn’t happen but oh boy it’d be a disaster if it did.

 

[caveat87]

Whoever runs that nursing board ought to be litigated because they are clearly not doing a thoughtful or thorough analysis of what happened.

 

[fittipaldi1of1]

This needs to be put on the front page of every newspaper, funded by the ASA

 

[deleted126335]

Whoever runs that nursing board ought to be litigated because they are clearly not doing a thoughtful or thorough analysis of what happened.

Most likely have very very broad Immunity. Both the board and the individuals who sit on it. Absent criminal behavior-e.g., accepting a bribe in exchange for a favorable ruling.

 

[coffeebythelake]

Whoever runs that nursing board ought to be litigated because they are clearly not doing a thoughtful or thorough analysis of what happened.

Obviously the AANP and other nursing organizations are doing this to push their agenda and propaganda of "advanced practice" midlevel nursing. Sweep bad things under the rug. Everything was done perfectly. Pat on the back to Tory for being in the forefront for safe anesthesia care

 

[coffeebythelake]

Most likely have very very broad Immunity. Both the board and the individuals who sit on it. Absent criminal behavior-e.g., accepting a bribe in exchange for a favorable ruling.

You are talking about criminal conspiracy. I would think these nursing boards are broadly open to civil litigation for essentially saying anesthesia nurse-cum-assassin Tory did everything right, while on the other hand allowing nurses to misrepresent themselves to the public as doctors who have much more training and education than they actually have.

 

[deleted126335]

You are talking about criminal conspiracy. I would think these nursing boards are broadly open to civil litigation for essentially saying anesthesia nurse-cum-assassin Tory did everything right, while on the other hand allowing nurses to misrepresent themselves to the public as doctors who have much more training and education than they actually have.

Not a lawyer, but I strongly suspect that have very strong immunity. Both the State Board and the individual members.

State Sovereign Immunity​

Under the doctrine of state sovereign immunity, a state cannot be sued in federal and/or state court without its consent. While the Eleventh Amendment limits immunity to two specific situations in federal court, the Supreme Court held immunity derives not from the Amendment, but from the structure of the original Constitution itself. In its own state court, a state can invoke immunity even when sued under an otherwise valid federal law and the state has full authority to define the scope of its immunity from suits based on its own state law.

What is Sovereign Immunity?

Knowing how sovereign immunity came to be can help keep the public informed on their legal rights and what a government actor can or cannot do.

feldman.law

 

[Blockit]

You are absolutely correct. In most of the states if not all these board members can say and do whatever the hell they want. There was a well publicized case I believe in Maryland sometime back where some quack doctor had his license pulled. Through suing the board for defamation he was able to get in discovery all of the boards emails that documented them conspiring to defame him and ruin his life. He won an initial judgment in the millions against the board which was subsequently reversed on appeal because the appeals court decided that the board had complete immunity to do whatever they wanted.

 

[jwk]

You are absolutely correct. In most of the states if not all these board members can say and do whatever the hell they want. There was a well publicized case I believe in Maryland sometime back where some quack doctor had his license pulled. Through suing the board for defamation he was able to get in discovery all of the boards emails that documented them conspiring to defame him and ruin his life. He won an initial judgment in the millions against the board which was subsequently reversed on appeal because the appeals court decided that the board had complete immunity to do whatever they wanted.

Amazing that the nursing board (which included a CRNA) expressed sympathy for and fully supported THE CRNA despite two bad outcomes..

 

[coffeebythelake]

Amazing that the nursing board (which included a CRNA) expressed sympathy for and fully supported THE CRNA despite two bad outcomes..

This is the standard of care they (AANP, AANA, nursing boards) want. Bad outcomes mean nothing. As long as they can continue their charade of pretending to be doctors, pushing their agenda, and as long as the money keeps rolling in.

 

[Blockit]

Amazing that the nursing board (which included a CRNA) expressed sympathy for and fully supported THE CRNA despite two bad outcomes..

I agree. And I also think it’s a horrible look.
I have no idea what the individual composition of this particular nursing board is, but I always wonder with these boards whether or not they are populated with the same types of providers who end up working as JCAHO inspectors.

 

[pastafan]

This is one of the situations where lawyers may be the savior. When lawsuits start to fly for this behavior things will change. In the remote past patients would fall out of bed with regularity and break hips, etc. Lawyers started to sue and all of a sudden guardrails were utilized and the occurrence of this type of injury became a rarity. Monetary penalties change behavior more than logic or truth.

 

[jwk]

I agree. And I also think it’s a horrible look.
I have no idea what the individual composition of this particular nursing board is, but I always wonder with these boards whether or not they are populated with the same types of providers who end up working as JCAHO inspectors.

Ya know - I get that not all of us are perfect. Having ONE death that one knows he personally contributed to would make me question my career choice, because I'd personally just be devastated. But having TWO in a year? How does one continue to practice with a clear conscience? And how does any regulatory board charged with protecting the public not only publicly clear but sympathize with the CRNA in question? That says a lot about their nursing board. Of course keep in mind we're talking about AZ, where the gurus of independent CRNA practice reside.

 

[Urzuz]

Ya know - I get that not all of us are perfect. Having ONE death that one knows he personally contributed to would make me question my career choice, because I'd personally just be devastated. But having TWO in a year? How does one continue to practice with a clear conscience? And how does any regulatory board charged with protecting the public not only publicly clear but sympathize with the CRNA in question? That says a lot about their nursing board. Of course keep in mind we're talking about AZ, where the gurus of independent CRNA practice reside.

The first thing they did was express sympathy to the CRNAssassin rather than sympathy to the patients’ families. That should tell you all you need to know.

 

[drmwvr]

19. CRNA Richmond was the nurse anesthetist who was responsible for administering and monitoring the IV sedation and supplemental oxygen given to Ralph Chapman during the Laser Surgery. 20. Prior to the Laser Surgery, gauze throat packs and a bite-block were placed in Ralph Chapman intraorally on orders of Dr. Houser. 21. Throughout the Laser Surgery, CRNA Richmond administered supplemental oxygen to Ralph Chapman by nasal cannula at 6 liters, per minute.

Just from a technical point of view....throat packs? Without an ETT? Laser or no.... A complete novelty to me....lacking any more information, seems the surgeon is the co-assassin here....

23. Ralph Chapman was not properly advised of the risks of the use of a laser in this type of Laser Surgery.

Whatever 'risks' of 'this type of surgery' there were, they paled in comparison to the *way* in which this surgery/anesthetic was conducted.

How do you consent for bat s**t crazy?

 

[coffeebythelake]

19. CRNA Richmond was the nurse anesthetist who was responsible for administering and monitoring the IV sedation and supplemental oxygen given to Ralph Chapman during the Laser Surgery. 20. Prior to the Laser Surgery, gauze throat packs and a bite-block were placed in Ralph Chapman intraorally on orders of Dr. Houser. 21. Throughout the Laser Surgery, CRNA Richmond administered supplemental oxygen to Ralph Chapman by nasal cannula at 6 liters, per minute.

Just from a technical point of view....throat packs? Without an ETT? Laser or no.... A complete novelty to me....lacking any more information, seems the surgeon is the co-assassin here....

Dentist telling a CRNA how to do the anesthetic, and the CRNA blindly following orders. No thinking involved. Blast the patient on q bunch of oxygen and just sit back. What could go wrong

 

[GassYous]

19. CRNA Richmond was the nurse anesthetist who was responsible for administering and monitoring the IV sedation and supplemental oxygen given to Ralph Chapman during the Laser Surgery. 20. Prior to the Laser Surgery, gauze throat packs and a bite-block were placed in Ralph Chapman intraorally on orders of Dr. Houser. 21. Throughout the Laser Surgery, CRNA Richmond administered supplemental oxygen to Ralph Chapman by nasal cannula at 6 liters, per minute.

Just from a technical point of view....throat packs? Without an ETT? Laser or no.... A complete novelty to me....lacking any more information, seems the surgeon is the co-assassin here....

23. Ralph Chapman was not properly advised of the risks of the use of a laser in this type of Laser Surgery.

Whatever 'risks' of 'this type of surgery' there were, they paled in comparison to the *way* in which this surgery/anesthetic was conducted.

How do you consent for bat s**t crazy?

This is worse than I thought

 

[Justice4all]

Wow wow wow. On their page, their selling point is that the dentist/surgeon will not be liable for the action of the anesthetist

 

[deleted126335]

Wow wow wow. On their page, their selling point is that the dentist/surgeon will not be liable for the action of the anesthetist

Sounds like they were "honestly mistaken"

The plaintiffs' attorneys are likely to open a can of whup ass on the dentist and their corporation

Sec 32-1634.04. Certified registered nurse anesthetist; scope of practice, Article 2. Licensing and Certification, Chapter 15. NURSING, Title 32. Professions and Occupations, Arizona Revised Statutes

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az.elaws.us

Section R4-11-1301 - General Anesthesia and Deep Sedation, Ariz. Admin. Code § 4-11-1301 | Casetext Search + Citator

Read Section R4-11-1301 - General Anesthesia and Deep Sedation, Ariz. Admin. Code § 4-11-1301, see flags on bad law, and search Casetext’s comprehensive legal database

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