Anesthesiology: Failure to Perform Proper Presurgical Evaluation
A recent case that we investigated highlights the critical importance of proper presurgical evaluations. In one case, the failure of an internist/family practitioner to fully evaluate a patient before he underwent surgery for very mild case of hemorroids resulted in the patient suffering complete paralysis from the chest down. The patient had an undiscovered congenital heart problem that would have easily been detected by an EKG. Instead, the physician did not perform the EKG and the patient was given general anesthesia during the surgery. Had the EKG been performed, the patient would have been given local anesthesia and would not have suffered any paralysis or other problems.
The internist later testified that he intended to perform the EKG, but thought that it was going to be performed by the hospital nursing staff. Believing that the nursing staff would routinely perform an EKG before any surgery, the internist never ordered the test. The staff nurses testified that they expected the doctor would order the EKG and were surprised when it was not ordered, but they never followed up on this “surprise”. The doctor thought the nurses would order the test, the nurses thought the doctor should order the test, consequently this simple routine test was never performed and the patient suffered catastrophic damages.
Many of the serious injuries and deaths caused by medical malpractice could have been eliminated if there was simple coordination and clear communication between the various health care providers responsible for treating and evaluating a patient. Before you or a family member submits to any surgery, be sure to thoroughly question the admitting doctor and any consultants concerning exactly the tests and evaluations that will be performed, why they are being performed and which health care providers will be performing the tests. If you are not comfortable asking these questions, or are not physically able to question your doctors due to your medical condition, request that a family member or close friend ask these questions.