During surgery, the anesthesiologist or nurse anesthetist are like umpires. If they do their job well, no one notices them. But when anesthesiologists make mistakes during surgery, the harm to the patient is often catastrophic.
This page discusses anesthesia medical malpractice lawsuits. If you believe you have a claim for a mistake and would like to speak with an anesthesia malpractice lawyer about your options, call 800-553-8082 or get an online case evaluation.
- Get verdicts and settlements in these anesthesia cases
Overview of Anesthesia
Approximately 58 million anesthetics are administered annually in the United States. These anesthetics fall into three main categories: local, regional, and general. Local anesthetics numb a small part of the body, regional anesthetics numb a larger area such as an entire limb, and general anesthetics render the patient completely unconscious and unable to feel pain during surgery.
Anesthesiologists or Certified Registered Nurse Anesthetists (CRNAs) provide these anesthetics in various settings, ensuring patient safety and comfort throughout medical procedures
Local Anesthesia
Local anesthesia is a method used to numb a specific, small area of the body to prevent pain during medical or surgical procedures. Unlike general and regional anesthesia, which affect a larger area or an entire region of the body, local anesthesia targets a distinct location and is often used for minor outpatient procedures.
Here’s a breakdown of local anesthesia:
- Method of Administration:
- Topical Anesthesia: Applied directly to the surface of the skin or mucous membranes in the form of creams, ointments, sprays, or drops. Commonly used for procedures like skin lesion removal or before inserting a needle.
- Infiltration Anesthesia: Involves injecting the anesthetic solution directly into the tissue that needs to be numbed. This is frequently used for minor surgical procedures like dental work, stitching a small wound, or removing a mole.
- Commonly Used Local Anesthetics: Lidocaine, bupivacaine, prilocaine, and tetracaine are examples of drugs used for local anesthesia.
- Duration: The duration of numbness varies depending on the specific drug used and its concentration. Some local anesthetics can provide numbness for a few hours.
- Benefits:
- Allows for pain-free minor surgical or medical procedures without affecting consciousness or deeper bodily functions.
- Avoids the potential side effects and risks associated with more extensive forms of anesthesia.
- Potential Side Effects and Risks:
- Local irritation or allergic reaction at the application site.
- In rare cases, if the anesthetic is absorbed into the bloodstream in significant amounts, it could lead to systemic side effects like dizziness, tremors, or, in very rare cases, more serious complications.
- Overdose can occur if too much of the local anesthetic is used.
Where you see a lot of anesthesiologist medical malpractice lawsuits is when doctors are unaware of the maximum recommended doses and potential interactions of local anesthetics. Patients should inform healthcare providers about any allergies or past reactions to local anesthetics and doctors have to connect the dots to avoid dangerous drug interactions and potential allergies.
Regional Anesthesia
Regional anesthesia is the technique of numbing a specific body region to prevent pain perception during surgical or medical procedures. Unlike general anesthesia, where the patient is rendered unconscious, a patient under regional anesthesia generally remains conscious but does not feel pain in the area being operated on. There are several types of regional anesthesia, and the choice depends on the surgical procedure, the patient’s health, and the preference of the anesthesiologist and surgeon.
Here are some common types of regional anesthesia:
- Epidural and Spinal Anesthesia: These techniques involve injecting anesthetic agents into the spaces around the spinal cord. They’re frequently used for surgeries of the lower limbs, pelvis, and abdomen and childbirth.
- Epidural: The anesthetic is injected into the epidural space, the spinal canal’s outermost part. This doesn’t involve puncturing the dura (a protective covering of the spinal cord); a catheter is often left to administer additional medication if needed.
- Spinal: The anesthetic is injected directly into the cerebrospinal fluid in the subarachnoid space, which is deeper than the epidural space. This provides a rapid and dense block but is typically a one-time injection without a catheter left in place.
- Peripheral Nerve Blocks: These involve injecting the anesthetic near principal nerve bundles that supply specific areas of the body, numbing that particular region. They are typically well-tolerated. Common examples include:
- Brachial plexus block for arm or hand surgeries.
- Femoral nerve block for surgeries on the front of the thigh or knee.
- Sciatic nerve block for surgeries on the back of the thigh, lower leg, ankle, or foot.
- Intravenous Regional Anesthesia (Bier Block): This technique involves injecting anesthetic into a vein of a limb after the blood flow has been restricted using a tourniquet. It’s primarily used for short procedures on the limbs and is relatively safe.
However, like all medical procedures, regional anesthesia carries risks, including bleeding, infection, nerve damage, and adverse reactions to the anesthetic drug. The decision to use regional anesthesia is made after carefully considering the potential benefits and risks for each patient.
Anesthesia errors are becoming more rare. But they can be deadly. A small mistake in dosing or monitoring can lead to brain damage or death.
MZ
General Anesthesia
General anesthesia is what you think it is: being “put under” where you are if done right, unconscious, and have no memory of the procedure. This type of anesthetic is used for more severe procedures: heart, lung, brain surgeries, etc.
During a surgical procedure, anesthesia is usually initiated with an intravenous injection. Following this, its maintenance is achieved with the help of inhaled anesthetics and gases. To ensure proper breathing throughout the surgery, an endotracheal tube or another suitable airway device may be inserted into the patient.
Throughout the entire procedure, a trained anesthesiologist or nurse anesthetist is responsible for closely monitoring the patient’s vital signs. They also adjust drug dosages as required and make certain the patient remains in an unconscious state for the duration of the surgery.
After the surgical procedure concludes, the administration of anesthetics is discontinued. This enables the patient to gradually wake up and regain consciousness, typically in a dedicated recovery room.
Anesthesiologists in operating rooms are responsible for providing a continuous medical assessment of the patient, including monitoring vital signs (heart rate, blood pressure, temperature, respiratory rate, etc.) and administering anesthesia to control the patient’s pain level and unconsciousness. This is a big deal. Neglecting to keep an eye on a patient’s vital signs can lead to catastrophic outcomes, including brain damage from lack of oxygen or death.
After surgery, they are responsible for the post-anesthetic evaluation and maintaining patients in a state of comfort.
Anesthesia Malpractice Lawsuit Injuries
The rate of anesthesiologist malpractice has been thankfully declining over the past several years due to advancing medical practice as well as the ASA Closed Claims Project initiative. The ASA Closed Claims Project was started in 1985 to review malpractice in anesthesia to understand potential areas of concern and to address and prevent occurrences in the future. The ASA has generated a database of 9214 closed insurance claims from cases of anesthetic malpractice. (The database does not include dental anesthetic malpractice claims, which are the most common of anesthetic malpractice claims.)
Types of anesthesia malpractice include burns from materials or devices heated and used to warm patients (e.g., heating pads, IV bags, warming lights, and hot compresses), cautery burns/fires, eye damage, nerve damage (e.g., cervical cord injury), awareness, trauma, and drug allergies or interactions. Trauma includes, but is not limited to, intubation problems, endotracheal tube insertion, and removal of tubes.
Intubation problems can occur due to misdirection of the tube down the esophagus, which may damage the throat structures (thyroid cartilage, larynx (voice box)). Endotracheal tube malpositioning can lead to lung or heart damage. It is also critical that the anesthesiologist is aware of the patient’s current medications and allergies so adverse reactions can be anticipated and managed accordingly.
Anesthesia-associated nerve injury is a common cause of anesthesia error suits. The most common injury was to the brachial plexus, followed by ulnar nerve injury, radial nerve injury, peroneal nerve injury, paraplegia, lumbosacral injury, and various “other” injuries. Studies have found that for most Anesthesia-associated nerve injury lawsuits, a reoccurring issue is the lack of proper intraoperative protective padding and errors in patient position. There are also many malpractice lawsuits from anesthesiologists misusing the tourniquet during a procedure.
Pregnant women and kids are two groups with a further risk for complications with anesthesia. Obstetric anesthesia malpractice claims include maternal death, maternal brain damage, newborn brain damage/neonatal death (which usually involves difficult intubation), maternal nerve injury (due to regional anesthesia), headache, and back pain. Though maternal brain damage, maternal death, and newborn brain damage/death have decreased over time, there has been an increase in claims for maternal nerve damage and back pain.
Newborn brain damage/death makes up approximately one-fifth of anesthesia medical negligence claims. These cases often include allegations of poor communication, poor anesthesia care in response to intubation, and anesthesia delay. In terms of average settlement, some of the largest anesthesiologist cases are inadequate ventilation because these are often lifetime brain injury or death cases. Other common injuries to the child in anesthetic malpractice claims in pediatric care include respiratory and cardiovascular injuries.
MZ
Example of Most Common Anesthesia Negligence Lawsuits Our Lawyers See
Not in any particular order, the most common types of anesthesia malpractice lawsuits our lawyers see are:
- Anesthesia Awareness: Patients experience consciousness during surgery without the ability to move or communicate, leading to potential psychological trauma. This really is just an awful experience for a patients. Anesthesia awarness lawsuits arise from failure to monitor anesthesia depth adequately. We discuss this in more detail in a moment.
- Dosage Errors: Incorrect dosing can lead to under-sedation, causing awareness during surgery, or over-sedation, leading to respiratory depression, brain damage, or death.
- Delayed or Failed Intubation: Delays or failures in securing the airway can result in oxygen deprivation and subsequent brain damage or death.
- Medication Errors: Administering the wrong drug or incorrect drug combinations can cause severe adverse reactions or ineffective anesthesia.
- Monitoring Failures: Inadequate monitoring of vital signs and oxygen levels during surgery can result in undetected complications such as hypoxia or cardiac arrest.
- Postoperative Complications: Issues such as failure to monitor for and manage postoperative nausea, vomiting, or pain can lead to aspiration, infections, or prolonged recovery.
- Nerve Damage: Incorrect administration of regional anesthesia (e.g., epidurals or nerve blocks) can result in nerve injury, causing long-term pain, numbness, or paralysis.
- Informed Consent: Failure to adequately inform patients of the risks associated with anesthesia can result in lawsuits if complications arise and patients were not aware of potential outcomes.
A study by The Doctors Company, incidentally a malpractice insurer known to be difficult to deal with, analyzed 640 closed claims from and found that the most frequent anesthesia-related injuries were teeth damage (20.8%), death (18.3%), nerve damage (13.5%), and organ damage (12.9%).
Free-Standing Ambulatory Surgery Centers Versus Hospital-Based Operating Rooms
A study analyzing anesthesia-related malpractice claims from 2015 to 2022 compared free-standing ambulatory surgery centers and hospital-based operating rooms. The findings revealed that free-standing ambulatory surgery centers accounted for 44% of these claims, with 22% involving severe injuries, compared to 34% in hospital-based operating rooms.
Common injuries in both settings included dental injuries and nerve damage, but free-standing ambulatory surgery centers reported a higher incidence of burns (6% versus 2%) and communication issues between providers and patients or their families (20% versus 10%).
The anesthesia malpractice cost to the malpractice insurer is also very different. The average cost per claim was approximately $167,000 in free-standing ambulatory surgery centers, significantly lower than the $332,000 average in hospital-based operating rooms. These results suggest that while free-standing ambulatory surgery centers experience fewer severe injury claims—likely from less serious anesthesia needs—there is a need to address specific safety concerns, particularly regarding burn prevention and enhancing provider-patient communication.
Anesthesiology Lawsuits on the Decline
There are not as many medical malpractice lawsuits against anesthesiologists as there were 30 years ago. Back then, the profession was riddled with malpractice claims. Juries were repeatedly hitting these doctors with large malpractice verdicts.
Now, there are far, far fewer claims. Why? The answer is medical malpractice lawsuits. Instead of crying for tort reform—okay, they did that too, actually—anesthesiologists simply got better. They revised flawed procedures, changed work rules to fight fatigue, and demanded and got the equipment they needed to keep patients safe.
As a result, the mortality rate from anesthesia nose-dived from 1 in 6000 administrations to 1 in 200,000. Look at those numbers again. It is amazing. Today, while the settlements and verdicts in these cases are still very high, anesthesiologists have some of the lowest malpractice insurance rates of any significant medical specialty.
Anesthesia Awareness
Anesthesia awareness, a rare but distressing complication, occurs when a patient becomes conscious during surgery while being unable to move or communicate due to muscle paralysis. Statistics indicate that anesthesia awareness happens in approximately 1 to 2 out of every 1,000 general anesthesia cases, with higher rates in high-risk patients such as those undergoing emergency surgeries or procedures with reduced anesthesia for medical reasons.
The American Society of Anesthesiologists (ASA) Closed Claims Project reports that anesthesia awareness can result from light anesthesia (37% of cases) and problems with anesthesia delivery (28% of cases), while in about one-third of the instances, the cause remains unknown.
Patients at increased risk include those with a history of substance use disorders, severe anxiety, or certain medical conditions like cardiac issues. Preventive measures such as using depth-of-anesthesia monitors like the Bispectral Index (BIS) can help reduce the risk of anesthesia awareness by providing real-time data on the patient’s level of consciousness.
You do not see many anesthesia awareness settlement amounts, but the payouts tend to be high because the suffering is very relatable to a jury.
Anesthesia Malpractice: Lawsuits, Settlements, and Verdicts Examples
Below are examples of anesthesia lawsuit settlement amounts and jury payouts, along with their story. You will notice the absence of Maryland cases. Most malpractice lawsuits against anesthesiologists in Maryland settle before trial. Here are a few lawsuits against anesthesiologists filed in Maryland:
- Milad v. Mercy Medical Center: This is an extubation wrongful death case
- Morton v. Mercy Medical Center: another anesthesia lawsuit filed against Mercy Hospital, this one alleging that too much anesthesia led to her losing vision in one eye
- Kenney v. Western Maryland Health Systems: wrongful death case alleging that decedent should have been given a local anesthetic instead of general anesthesia because of her poor health
- Douglas v. Dimension Health Corporation: wrongful death case alleging plaintiff should never have been gotten anesthesia for liposuction
Anesthesia Settlement Ranges
We like giving settlement numbers out just to pass along our lawyers’ opinions and experience. But you should not take these too literally:
Anesthesia Error | Potential Injury | Estimated Settlement ($) |
---|---|---|
Anesthesia Awareness | Patient remains conscious but paralyzed during surgery, leading to severe psychological trauma. | $250,000 – $5,000,000 |
Dosage Errors (Overdose or Underdose) | Respiratory failure, cardiac arrest, brain damage, or death. | $500,000 – $5,000,000+ |
Delayed or Failed Intubation | Oxygen deprivation leading to brain injury, permanent disability, or death. | $1,000,000 – $10,000,000 |
Medication Errors (Wrong Drug Administered) | Toxic reactions, seizures, cardiovascular collapse, other severe injury, or death. | $500,000 – $6,000,000 |
Failure to Monitor Oxygen Levels | Hypoxia, brain damage, organ failure, or death. | $1,000,000 – $15,000,000 |
Nerve Damage from Regional Anesthesia | Permanent pain, paralysis, or loss of function. | $250,000 – $2,500,000 |
Lack of Informed Consent | Undisclosed risks lead to severe complications. | $100,000 – $1,500,000 |
Anesthesia Malpractice Cases Examples
You can use these jury payout and settlement amounts to understand your case’s possible settlement value better. But that is all you will get from these stories. There is no way to use this kind of data to calculate your case’s exact anesthesia malpractice settlement amount. Jurisdictional differences, caps on non-economic damages, and other factors make it impossible to compare one case to another and calculate a claim’s settlement value.
Here are some example anesthesia malpractice cases:
Finding an Anesthesia Malpractice Lawyer
If you live in the Baltimore-Washington area and believe you have been a victim of negligent administration of anesthesia in Maryland, call 800-553-8082 or get a free online consultation.
More Information
- Finding an expert in anesthesiology for your case
- Get anesthesia overdose verdicts and settlements
- What is the value of your medical malpractice case?
- Example anesthesiologist lawsuit
- Verdicts and settlements in brain injury medical malpractice cases