Facts

In October 2013, decedent began to experience discomfort in his left ear. He saw his primary care physician, and was then referred to Roe ENT on Nov. 26, 2013. Amoxicillin and Cortisporin eardrops failed to resolve the situation, so Roe ENT scheduled decedent for surgery at a surgi-center, a facility that conducts minor surgeries on an outpatient basis, to resect the ear mass.

The surgery took place on Dec. 27, 2013. That morning, decedent was noted to have a blood sugar reading of 379, which the surgi-center nurses testified that they informed both Roe anesthesiologist and Roe ENT. Decedent was assessed by Roe anesthesiologist as an ASA IV. The surgery was described as unremarkable. Anesthesia was reversed, decedent was extubated, and taken to the PACU.

Upon arrival in the PACU, decedent was apneic and unresponsive. He was assessed there by both Roe anesthesiologist and Roe ENT. Decedent remained apneic for 22 minutes, at which time 911 was called. While in the PACU, Roe anesthesiologist attempted to re-intubate decedent. The first effort resulted in an esophageal intubation. The second attempt was likewise not successful.

Paramedics arrived and decedent was taken to a nearby hospital. He remained in PEA/V fibrillation. Resuscitative efforts in the emergency room were unsuccessful and he was pronounced dead.

Plaintiffs are the decedent's wife and financially emancipated adult son.

PLAINTIFF'S CONTENTIONS:
Decedent was a 63-year-old male with comorbidities that included coronary artery disease with a four-vessel CABG, hypertension, diabetes and obstructive sleep apnea.Decedent did not have a nasal trumpet or an oral airway placed preoperatively to guard against an upper airway obstruction post-extubation. Patients such as decedent, with obstructive sleep apnea, are at risk for upper airway obstruction post extubation.

Plaintiffs contended that Roe anesthesiologist should not have allowed this elective surgery to go forward in a surgi-center given the fact that decedent was an ASA IV. Roe anesthesiologist should have not allowed the surgery to go forward at all in the face of a pre-operative blood sugar reading of 379. Roe anesthesiologist should have placed a nasal trumpet and/or oral airway in place prior to the surgery.

As concerns Roe ENT, plaintiffs argued that he, too, should not have allowed the surgery to go forward with a pre-operative blood sugar reading of 379 and, further, plaintiffs argued that when decedent became apneic in the PACU, he should have performed a tracheostomy.

DEFENDANT'S CONTENTIONS:
Defense contended that all care was within accepted standards, and that this was simply a very unfortunate outcome.

Damages

Decedent worked in Dental Sales, earning $88,000 annually. Defense argued that decedent's multiple co-morbidities would have foreshortened his life expectancy and his work life expectancy.

Result

The case resolved for $650,000 at mediation.

Other Information

MEDIATOR: Jay C. Horton.