MEDICAL NEGLIGENCE IN THE RECOVERY ROOM (PACU)
Failure to recognize & treat respiratory problems following surgery can cause a patient to experience respiratory failure, cardiopulmonary demise, & cardiac arrest (a crash or code situation).
When a patient is given general anesthesia for surgery – or sedation / analgesia for minor surgical / invasive procedures – the patient must be closely monitored during and after surgery. Sometimes, patients experience airway problems in the post anesthesia care unit (PACU – also known as the “recovery room”). If patients aren’t monitored very closely and the staff fails to act quickly when there are airway problems, the patient may “code” or “crash,” and sometimes, the results can be fatal.
One area of negligence occurs when a patient’s breathing tube is removed (extubation) before the patient is ready to breathe on her own. Following a premature extubation, the patient may not be properly monitored, and the staff may fail to notice and/or appreciate signs of respiratory problems. When respiratory problems go unrecognized and untreated, the patient may have to work really hard to breathe, which can cause the patient to go respiratory failure, and this can be quickly followed by cardiopulmonary arrest.
In one case, a young patient presented to the hospital for a surgical procedure in which he was supposed to be able to go home the same day. Prior to the surgical procedure, he was given a breathing tube (he was “intubated”). Following the surgery, the staff failed to properly assess the patient to determine if he was ready to be extubated. His breathing tube was removed, and he did not tolerate this. His oxygen level and heart rate dropped and he experienced bronchospasm, meaning his airway was constricted. The staff did not try to intubate him again for about twenty-five minutes, with the patient struggling to breathe during this time. When they did try and put the breathing tube back in, they had a lot of difficulty and it took several attempts. The patient experienced low oxygen levels and a severely high blood pressure throughout the time of extubation and the difficult re-intubation.
During the multiple attempts at re-intubation, the patient struggled to breathe against his obstructed airway. This struggle (trying to breathe against the bronchospasm PLUS trying to breathe against the breathing tube and intubation equipment during the multiple unsuccessful attempts at intubation) caused a cascade of events that quickly resulted in the patient having fluid in his lungs; he had developed a condition called negative pressure pulmonary edema (NPPE). The patient remained unstable, with very high blood pressures. Nonetheless, the staff removed the patient’s breathing tube less than an hour after the difficult re-intubation.
Sadly, the surgeon and anesthesia team failed to recognize that the patient had NPPE / fluid in his lungs, and they did not seem to appreciate that he was unstable. In fact, for a very long time, the staff did not perform a chest x-ray or do any meaningful tests to assess how well the patient’s lungs were functioning, even though they documented that the patient was experiencing difficulty breathing and had lung sounds that were abnormal with “crackles,” which usually means the patient has fluid in the lungs. More and more fluid was building up in the patient’s lungs and his breathing was becoming increasingly difficult. His blood pressure and heart rate were high and his oxygen level was low, but the staff failed to diagnose the fluid in his lungs. They also failed to give him a breathing tube and put him on a breathing machine to help him ventilate and to help reduce the work of breathing and eliminate fluid in the lungs.
The patient thus had no help to breathe and was working really hard to breathe against all the fluid. His heart was becoming more and more taxed, and his blood pressure was clinically in a crisis (hypertensive crisis). The patient was requiring increasing levels of oxygen, but the staff still did not give the patient anything to help reduce the labor of breathing or to help remove the fluid – and to help stop the events that were causing the fluid to accumulate. The patient’s NPPE and cardiopulmonary / cardiovascular issues remained completely untreated until finally, the patient became unresponsive. At this point, the staff finally intubated him again, but it was too late. Too much fluid had been allowed to build up, the patient’s heart had been working way too hard, and the patient was allowed to be unstable for too long. He suffered multiple cardiac arrests and passed away on the night of his surgery.
If you believe that you or a family member experienced medical malpractice shortly before surgery, during surgery, or in the recovery room, please contact our team of experienced Michigan medical malpractice lawyers. The medical malpractice team at Grewal Law is comprised of attorneys and healthcare professionals, including an on-site physician, registered nurse, pharmacist, paramedic, and respiratory therapist. The team also works with the best experts in the country. Our attorneys are licensed in Michigan and Florida, and we help victims of medical malpractice in these states. Grewal Law’s medical malpractice attorneys and medical staff are available to speak with you 24/7.