Technology  escalating impact on perioperative  care : Clinical,compliance and medicolegal considerations

Brian J Cammarata and Brian J Thomas

APSF newsletter,Volume 29N1 1-24 June 2014–07–06

Vignette

A 57 year old female presents for a laparoscopic cholecystectomy

Following the uneventful induction of general anesthesia, the patient is prepped and surgery begins.

Intraoperatively, the patient becomes acutely hypotensive and tachycardic.

Despites intravenous fluids and phenylephrine, the hypotension persists.

The patient is ultimately resuscitated but slow to awaken postoperatively.

MRI of the head reveals an ischemic infarction.

She regains consciousness on postoperative day 1, but has persistent right sided weakness

The spouse and the surviving children bring suit against the anesthesiologist for failing to appropriately treat the hypotension resulting in a cerebro vascular accident.

During discovery, the circulating nurse and scrub technician testify that the anesthesiologists was on her cell phone and checking e-mail immediately prior to the event.

Plaintiff's attorney subpoenaed the cell phone and hospital computer records validating the allegation.

Comments - Cell phone and hospital computer records are discoverable and may be admissible evidence at trial.
In this case, the anesthesiologist's defensible care is compromised by the proven allegation of electronic distraction during the anesthetic