Anesthesiology Expert Advises on Administration of Incorrect Drug During Surgery

ByKristin Casler

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Updated onDecember 20, 2017

Anesthesiology Expert Advises on Administration of Incorrect Drug During Surgery

An anesthesiology expert advises on a case involving a woman who was placed under anesthesia for her septoplasty surgery. She had suffered for years with chronic nasal congestion. During the operation, her surgeon injected what he thought was 1% Lidocaine Epi10cc for hemostasis. Immediately following the injection, which was in fact Epinephrine, the plaintiff’s blood pressure rose to a minimum of 165/115 with a heart rate was 105. The anesthesiologist responded with an injection of an unknown quantity of Labetalol to decrease her blood pressure. Her pressure dropped as low as 62/40 with a heart rate of 72. Following three doses of Ephedrine, her blood pressure remained low until the surgery concluded.

Following surgery, the plaintiff was screaming, moaning and not following commands. She could not recall simple facts. She was diagnosed with mental status changes, transient hypoxemia and non-ST segment elevation myocardial infarction. She spent four days in the hospital for what should have been a one-day stay.

The plaintiff filed a medical malpractice lawsuit alleging she suffered permanent injuries from the improper administration of drugs during surgery.

Question(s) For Expert Witness

1. Was the standard of care violated?

2. What actions constituted deviations from the standards?

Expert Witness Response

inline imageIt is my opinion to a reasonable degree of medical certainty that the anesthesiologist departed from the standard of care in his management of the plaintiff’s intra-operative hypertension caused by the surgeon’s administration of the Epinephrine injection (1:3000). Specifically, it is my opinion that the anesthesiologist departed from the standard of care by his improper attempt to manage her intra-operative blood pressure using a combination of Labetelol, Sevoflourane and Ephedrine.

inline imageThe anesthesiologist also departed from the standard of care in the management of the plaintiff’s persistent post-operative hypotension during which she remained under the effects of Labetelol and her stunned myocardium.

inline imageThe surgical center and anesthesiology group defendants departed from the administrative standard of care by failing to have policies and procedures reflecting the handling of drugs by nurses and staff to minimize medication administration errors. The above deviations from the standard of care caused or contributed to the plaintiff’s injuries.

inline imageThe expert is a physician who has actively practiced in these areas of specialty for three of the last five years and has performed anesthesia services in cases similar to this one.

About the author

Kristin Casler

Kristin Casler

Kristin Casler is a seasoned legal writer and journalist with an extensive background in litigation news coverage. For 17 years, she served as the editor for LexisNexis Mealey’s litigation news monitor, a role that positioned her at the forefront of reporting on pivotal legal developments. Her expertise includes covering cases related to the Supreme Court's expert admissibility ruling in Daubert v. Merrell Dow Pharmaceuticals Inc., a critical area in both civil and criminal litigation concerning the challenges of 'junk science' testimony.

Kristin's work primarily involves reporting on a diverse range of legal subjects, with particular emphasis on cases in asbestos litigation, insurance, personal injury, antitrust, mortgage lending, and testimony issues in conviction cases. Her contributions as a journalist have been instrumental in providing in-depth, informed analysis on the evolving landscape of these complex legal areas. Her ability to dissect and communicate intricate legal proceedings and rulings makes her a valuable resource in the legal journalism field.

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