The medical definition of anesthesia refers to the loss of sensation resulting from pharmacologic depression of nerve function. Pharmacologic depression, or the use of medications to depress particular aspects of the nervous system, however, results from human administration. This is the work of the anesthesiologist. It is also the source of most of the anesthesia errors that cause serious injury and death in hospital patients.
Studies have shown that the overwhelming majority of preventable anesthesia incidents involved human error. Opportunities for error are abundant. Breathing-circuit disconnections, unintended changes in gas flow, and drug syringe errors have occurred repeatedly.
Syringe swaps, in which two syringes are improperly switched and the wrong drug administered, can have catastrophic consequences. Other errors that can cause serious personal injury can include premature extubation of the patient’s trachea, mismanagement of fluid replacement, improper or negligent administration of oxygen during surgery, and dangerously prolonged sedation. Patient harm or death may also result from anesthesiologists or residents with inadequate experience, insufficient familiarity with equipment or the specific surgical procedure, inadequate communication, fatigue, and distraction.
Overt equipment failures are less common. Equipment designed with controls that are indistinguishable without visual inspection, however, may contribute to human error. Crowded, busy operating rooms may hamper the ability to read and adjust equipment quickly and accurately.
Anesthesiologist negligence may also lead to extreme emotional trauma. Delivery of anesthesia gas may be interrupted by exhaustion of a gas cylinder, inadvertent disconnection from a central gas supply, or the unintended closing of a valve. Such an interruption can lead to complications and the development of post-traumatic stress disorder. The patient may awaken during the procedure, a terrifying experience in which he or she may be paralyzed, unable to speak, and helpless to communicate his or her awareness. A patient who tries to signal the anesthesiologist by moving may face the administration of paralytic drugs while conscious. One anesthesiology awareness victim has described this as feeling “like ignited jet fuel coursing through your veins.”
Medical personnel failing to deliver an adequate level of care may be liable for medical negligence. Oregon courts define medical negligence, or malpractice, as the failure of a medical professional to meet the standard of care used in the reasonable practice of the medical profession in the same or a similar community. Like surgeons, nurses, and other skilled medical professionals, anesthesiologists must exercise due care to avoid preventable mishaps that may have serious or even grave outcomes.