Autopsy utilization in medicolegal defense of anesthesiologists.

Background: The rate of autopsy in hospital deaths has declined from more than 50% to 2.4% over the past 50 yr. To understand the role of autopsies in anesthesia malpractice claims, we examined 980 closed claims for deaths that occurred in 1990 or later in the American Society of Anesthesiologists Closed Claims Project Database.

Liability associated with obstetric anesthesia: a closed claims analysis.

Background: Obstetrics carries high medical liability risk. Maternal death and newborn death/brain damage were the most common complications in obstetric anesthesia malpractice claims before 1990. As the liability profile may have changed over the past two decades, the authors reviewed recent obstetric claims in the American Society of Anesthesiologists Closed Claims database.

Complications associated with eye blocks and peripheral nerve blocks: an american society of anesthesiologists closed claims analysis.

Background And Objectives: Concern for block-related injury and liability has dissuaded many anesthesiologists from using regional anesthesia for eye and extremity surgery, despite many studies demonstrating the benefits of regional over general anesthesia. To determine injury patterns and liability associated with eye and peripheral nerve blocks, we re-examined the American Society of Anesthesiologists Closed Claims Database as part of the American Society of Regional Anesthesia and Pain Medicine's Practice Advisory on Neurologic Complications of Regional Anesthesia and Pain Medicine.

Methods: Claims with eye or peripheral nerve blocks performed perioperatively from 1980 through 2000 were analyzed.

A case of bilateral brachial plexus palsy due to shoulder braces.

We report the case of a 32 year-old man who underwent a laparoscopic-assisted sigmoid colectomy and who developed bilateral upper trunk brachial plexopathy. The complication occurred with intraoperative signs of neurovascular compression. Failure to recognize the significance of a decrease in pulses in the upper extremities, with resulting lack of remedial action, may have been a major factor leading to patient injury.

An early example of evidence-based medicine: hypoxemia due to nitrous oxide.

Diffusion anoxia. By Bernard Raymond Fink. Anesthesiology 1955; 16:511-14.

An update on pediatric anesthesia liability: a closed claims analysis.

Background: Respiratory complications were associated with half of pediatric malpractice claims from the 1970s to 1980s in the ASA Closed Claims Database. Advances in pediatric anesthesia practice have occurred in the 1980s and 1990s and may be reflected in liability trends.

Methods: We reviewed 532 pediatric (age < or =16 yr) malpractice claims from our database over three decades (1973-2000), using logistic regression analysis to evaluate trends over time.

Trends in anesthesia-related death and brain damage: A closed claims analysis.

Background: The authors used the American Society of Anesthesiologists Closed Claims Project database to determine changes in the proportion of claims for death or permanent brain damage over a 26-yr period and to identify factors associated with the observed changes.

Methods: The Closed Claims Project is a structured evaluation of adverse outcomes from 6,894 closed anesthesia malpractice claims. Trends in the proportion of claims for death or permanent brain damage between 1975 and 2000 were analyzed.

The American Society of Anesthesiologists Postoperative Visual Loss Registry: analysis of 93 spine surgery cases with postoperative visual loss.

Background: Postoperative visual loss after prone spine surgery is increasingly reported in association with ischemic optic neuropathy, but its etiology is unknown.

Methods: To describe the clinical characteristics of these patients, the authors analyzed a retrospectively collected series of 93 spine surgery cases voluntarily submitted to the American Society of Anesthesiologists Postoperative Visual Loss Registry on standardized data forms.

Results: Ischemic optic neuropathy was associated with 83 of 93 spine surgery cases.

Injury and liability associated with monitored anesthesia care: a closed claims analysis.

Background: To assess the patterns of injury and liability associated with monitored anesthesia care (MAC) compared with general and regional anesthesia, the authors reviewed closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1990.

Methods: All surgical anesthesia claims associated with MAC (n = 121) were compared with those associated with general (n = 1,519) and regional (n = 312) anesthesia. A detailed analysis of MAC claims was performed to identify causative mechanisms and liability patterns.

Management of the difficult airway: a closed claims analysis.

Background: The purpose of this study was to identify the patterns of liability associated with malpractice claims arising from management of the difficult airway.

Methods: Using the American Society of Anesthesiologists Closed Claims database, the authors examined 179 claims for difficult airway management between 1985 and 1999 where a supplemental data collection tool was used and focused on airway management, outcomes, and the role of the 1993 Difficult Airway Guidelines in litigation. Chi-square tests and multiple logistic regression analysis compared risk factors for death or brain damage (death/BD) from two time periods: 1985-1992 and 1993-1999.

Injuries associated with regional anesthesia in the 1980s and 1990s: a closed claims analysis.

Background: The authors used the American Society of Anesthesiologists Closed Claims Project database to identify specific patterns of injury and legal liability associated with regional anesthesia. Because obstetrics represents a unique subset of patients, claims with neuraxial blockade were divided into obstetric and nonobstetric groups for comparison.

Methods: The American Society of Anesthesiologists Closed Claims Project is a structured evaluation of adverse anesthetic outcomes collected from closed anesthesia malpractice insurance claims of professional liability companies.

Injuries and liability related to central vascular catheters: a closed claims analysis.

Background: To assess changing patterns of injury and liability associated with central venous or pulmonary artery catheters, the authors analyzed closed malpractice claims for central catheter injuries in the American Society of Anesthesiologists Closed Claims database.

Methods: All claims for which a central catheter (i.e.

Chronic pain management: American Society of Anesthesiologists Closed Claims Project.

Background: The practice of chronic pain management has grown steadily in recent years. The purpose of this study was to identify and describe issues and trends in liability related to chronic pain management by anesthesiologists.

Methods: Data from 5,475 claims in the American Society of Anesthesiologists Closed Claims Project database between 1970 and 1999 were reviewed to compare liability related to chronic pain management with that related to surgical and obstetric (surgical/obstetric) anesthesia.