$21 Million BOTCHED Anesthesia Case
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- Опубліковано 10 чер 2024
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#anesthesia #anesthesiologist #crna
When my father worked for a private hospital system, they tried replacing most of the anesthesiologists with CRNAs to save money. He tried to garner the support of his colleagues to prevent this from happening. However, his effort was futile, compelling him to start his own practice. Favoring profit over the lives of patients is a terrible thing
Sadly, welcome to healthcare
Yes. I busted my butt working 24 years in healthcare, retired at 60 and happily left the rat race workforce free of debt in 2021. It’s all about profits, profits, profits for these greedy, insatiably money hungry, wealth hoarding monster corporations; even at the cost of employees’ and patients’/consumers’ well-being. No more time consuming commutes to and from work in horrid traffic, no more expensive fuel consumption and cost; no more being micromanaged, no more B.S. workplace politics. No more fighting for my well earned annual merit increases. That sucked. Not to mention, extremely stressful. During my last merit evaluation, which was my best review, I finally realized all my hard work isn’t worth the effort only to be forced to fight for the reward. I was done with all their shiz! and “Quiet Quit” until I retired in 2021. Retirement is good. God is good😊. Now I enjoy my morning coffee in peace, swing in our backyard patio hammock, play and cuddle time with our dogs and sweet cats, spa day(small bin with water for our tortoise to soak in) with our turtle, sharing delicious home cooked meals and connecting with family and friends. Tasty food and good company just can’t be beat. Life is good. God bless.
@@happylistener4628 congrats, I just started my RN job lol, I see right through the industry
@@evano8312 Thank you. I appreciate you. I wish you all the best. Stay safe.
@@happylistener4628 Corporations have no business being in healthcare. My wonderful not for profit community hospital was purchased by HCA. They have ruined it. Nurse to pt ratios are at a critical level. I could go on and on.
This story is not simply about one really bad CRNA. The surgeon & the OR staff were all negligent in allowing this situation to occur. Apparently, they all kept their mouths shut about what really happened. Certainly SOMEONE SHOULD HAVE DEMANDED anesthesia coverage BEFORE the CRNA was allowed to leave the room.
How a CRNA bailed out on a surgery is insane
well, it's also not clear whether there was coverage or not, it simply says the CRNA stepped out. That could have been with coverage present
I'M AN EXPERIENCED BOARD CERTIFIED ANESTHESIOLOGIST. Thank you Dr. Cellini. You're analysis of this case is pretty spot on. I just wanted to add to what you've already laid out. First of all, this was a 27 year old patient who seemed relatively healthy as far as I can tell. These tend to be one of those anesthesia cases that we feel that even a beginning anesthesia resident should be able to handle. When these cases go wrong, it's usually something that's either horribly unfortunate, or gross medical misconduct. Second, I am really perfectionistic about my patients and I don't like supervising anyone in general, including residents or CRNAs. There are some fantastic CRNAs out there, don't get me wrong, but I have had many experiences with CRNAs who have intubated a patient without informing me, extubated a patient without informing me, performing epidurals without informing me, pushing back on my medical direction or even flatly refusing. I once ran into an OR where things got bad, and instead of calling the attending assigned to the room, he or she called his or her fellow CRNA. And another situation where I gave a CRNA a morning break only to realize that there was something seriously wrong with the breathing tube, and while trying to save the patient, the CRNA returns only to curse at me and "talk shit to me" while I'm trying to fix the emergency situation. Third, the 1:4 model really makes anesthesiologists so busy, that we are almost incapable of swinging by the ORs. It can work if most of the patients are healthy and the CRNAs are trustable, skilled, and quick to ask for help, but already that's a lot of "ifs." Fourth, I've seen a lot of hypotension in my life, and especially in a healthy appearing 27 year old, it's hard to believe that that was the real cause, unless the BP was maintained at 40/20 or worse for a long time. More likely IMHO is that there was some oxygenation issue caused by a misplaced endotracheal tube or LMA, running the anesthesia at needlessly deep levels or ventilator settings that were incompatible with life. Fifth, it's not uncommon for us to give each other breaks. That's a necessary part of our days so we can get more coffee, use the toilet, or stay fed. What is not acceptable is to leave a patient unattended to for 12 minutes. In closing, I will say that I'm critical even of my anesthesiologist colleagues as well, but IMHO in my experience, I've seen a difference and I'm certain that this will not be the only catastrophe of this sort, based upon what I have observed. There is a movement coming down the pipeline where the CRNA training program will be a PhD program so that they can introduce themselves to patients as "doctors" further confusing and deceiving patients.
Well I have to say I wouldn’t let a CRNA touch me and and only a board certified anesthesiologist and even then I have vetted all the doctors / surgeons and anesthesiologist that my and and our family have used . And when I say vetting we run federal back ground check on them , their schooling , the hospitals they work at and even their personal life. Med schools are popping out a bunch of inexperienced butchers and irresponsible frauds posing as professional when in realty are nothing more than lazy money hungry k-llers. No amount of money can bring back your lost loved one or reverse the damage because of CRNA or doctor’s neglect and malpractice. This is criminal and all you doctors need to be re-vetted and it has to be made public.
Your frustration is completely justified and entirely earned. This sounds like an awful situation. However, I also want to add that if you are not reporting these cases of gross medical overreach by the CRNAs you're overseeing, you are ethically and possibly also legally responsible for any adverse outcomes patients experience. Please report these dangerous practitioners working on patients independently when they have no right to, especially given I'd bet it's often without the patient's informed consent.
If you genuinely believe this will not be the only catastrophe, not reporting the nurses who seem to be okay with play cowboy with anesthesia will directly ensure more happen.
@@mangosteen4230 these cases individually are being investigated and yes I agree there has to be transparency and informed consent as to who is performing what on you. I also believe firmly the days before and not minutes before you must meet with both the Surgeon the anesthesiologist when meeting with the pre-op nurse when they are doing your pre-op testing. This is something many from personal experiences they won’t do often but you have to demand it. Especially if you have a history of predisposition to anesthesia. Note: this lack of transparency is occurring at some of the big name major hospitals and we we’re shocked how eager they want to put you in harms way and carry out procedures you as a patient are not comfortable with. We shouldn’t let them tell you what’s good for you only. The patient is the boss and they have to listen to the patients as well. But the use of CRNA’s has to come into more review based on the final outcomes of these cases. Thank you for your comment and professionalism and you and your family have a happy healthy new year. G-D bless 🙏
Nice way of throwing CRNA's under the bus. As a self described "experienced board certified anesthesiologist," you have done thousands of cases in your career, I presume. You have a way of cherry picking the few negative events involving CRNA's; yet, I don't see you complimenting or remarking on any of the times I'm sure they saved your ass when recognizing a mistake of yours, or catching something that you or or the rest of the healthcare team didn't. Also, don't forget it was an anesthesiologist who mishandled Joahnne Rivers's airway and caused her to have a hypoxic brain injury leading to her death days later. You conveniently forgot to bring that up in your analysis of anesthesia providers. If you're going to point out the few wrongs, how about mentioning the right's also. This would lend more credibility to your post. As someone whose worked in the medical field also, I can describe to you an a ten-fold number of times that I've seen lazy and incompetent MDA's who surgeons have chosen CRNA's to work with for a multitude of reasons......MDA not wanting to learn regional anesthesia or sucking at it, laziness on their part (It's 3PM I'm outta here!), overpaid based upon production (or lack of), cancel cases based upon very flimsy rationales, etc. etc.I could go on and on, but I won't, considering there are more aspects to point out.
I applaud your "perfectionist" approach; however, it is very much encroaching on judgmental. You admit this toward your own colleagues. Unless you are in a supervisory or chief role with anesthesiologists, stay in your lane. Do your own thing. You handle you, and let them do them.
Also, If you knew anything about CRNA's, then you would know that their largest association, the AANA, encourages ongoing education (as does every field of employment), but does not endorse providers from calling themselves "doctors" in front of patients. This is based off a study done several years ago in which patients were confused as to who had which role when providing care. So, your last sentence is another failed attempt to throw shade at CRNA's, only further showing your bias.
Finally, get used to CRNA's. They aren't going anywhere. CRNA's were here before MDA's, who only arrived when they figured out how to make anesthesia lucrative. For the majority of surgeries, CRNA training is more than adequate. MDA's are still needed, yes, absolutely. CT, high risk OB, transplants, pediatric cardio......yes I'd agree that you guys are still needed. However, should CRNA's get their own fellowships in the previously listed fields, well, things will continue to further change. As more facilities and governing boards see data that prove CRNA care is just as good as MDA care with better financial outcomes, the MDA-only model will continue to disappear. It is not a financially viable option any longer (due to many factors, the majority of which is bundled payments from insurance companies and reduced overall reimbursement).
Thank you Chris. I am a CRNA (many years of experience) and over the years have worked with excellent providers - both CRNA and MD- in military service, private practice, teaching hospitals, outpatient and office based clinics etc. But I have also worked with some less than stellar providers - both MD and CRNA - as well. So I agree, no one should be throwing CRNAs OR MDs under the bus. The particular practitioner involved in case and lawsuit is ONE provider. One. Doesn't matter the credentials.
My blood pressure dropped while I was in the ER and I stop breathing. I basically had a stroke at 23yrs old. I was in a coma for less than a month regain consciousness and now I’m paralyzed from the waist down. It’s been 17 yrs and I’m still paralyzed but I have learn to accept my fate.
No one understands what the sick go through in life
The cases of malpractice lawsuits (that we've heard) with CRNAs involved are cases of "non life saving" surgeries/procedure, like leg surgeries or dental procedure. So proving it was easier.
It makes me wonder if there was malpractice in "life saving" surgeries where CRNAs are involved.
Charts went missing in this case ... this dummy nurse should have gone to prision
What a horrible thing that could have been prevented! My prayers go out to this man and his family.
As a nurse, I think the most important factor in this is integrity. Therefore I think a person should have more experience in ICU care before being eligible for for nurse anesthetist training. A provider’s integrity is tested over time. That’s the biggest benefit to the residency training for physicians-they are tested over time.
I also believe the integrity of all anesthesiologists is crucial. I can’t help but think there is something fishy in this case. Corners were cut along the way for some reason.
I’ve always maintained that while patients think choosing their surgeon is the most important thing, being able to choose your anesthesiologist is at least as important!
>Therefore I think a person should have more experience in ICU care before being eligible for for nurse anesthetist training
Are we under the impression this CRNA did this out of lack of knowing? I thought it was negligence, but the comments here seem to be implying that the CRNA had no idea that leaving a patient with dangerously low blood pressure unattended for 12+ minutes is a bad thing.
@@xxMurmaiderxx What I intended was that if a person has to have more experience, there is more time to inspect or judge their integrity. Of course, that doesn’t necessarily mean they will be weeded out from a program. I would hope character would be part of what is evaluated.
Botched surgery ... is there any other type
1 year minimum is insane, idk why that’s even a thing. You’ve barely been out of orientation and already going to school to practice at a higher level
@@KD-vg2ynone year minimum AFTER orientation. Nonetheless, the average CRNA student has 3.5 years of ICU experience before matriculating as per the COA which is the accrediting body of nurse anesthesia programs.
Such a horrible case. And no amount of money will bring his quality of life back. I’m here in Texas. Baylor almost killed my daughter. Zero trust for them.
Which site? I work at one in Round Rock. 😬
@@Reclaim-the-Rainbow my daughter was at Waxahachie- but this was before they moved. I do believe they are better now. Not sure which location is the botched anesthesia though.
11:08 Ok so...... the article said a nursing degree and an extra year of training = a CRNA. It's actually 4 yrs of nursing school, 3+ years of ICU employment, and 3 years of anesthesia training in ALL specialties (OB, peds, cardiovascular, neuro, spine, ortho, etc.) and all types of anesthesia (incl. general, MAC, and regional incl. PNBs, spinals, epidurals) with over 2,000 hours of direct anesthesia care. ALSO, an anesthesiologist does NOT have to be board certified in order to practice anesthesia - in fact, less than 75% of U.S. anesthesiologists are board certified. As opposed to the requirement that ALL CRNAs have to be board certified and continuously renew their certification throughout their career.
I get that anesthesiologists have a whole different path and set of requirements, but why so blatantly lie about the discrepancy between the two professions? There are good and bad anesthesiologists and CRNAs, just as there are good and bad interventional radiologists, pediatricians, family doctors, nurses, etc. This case above all is about negligence - not training or knowledge.
You can apply to many CRNA schools with 1 year of ICU experience which is nothing. Barely out of orientation, definitely not a competent nurse
@@KD-vg2yn The average is 3yrs, though many SRNA have 10+ yrs experience as bedside RNs. A few have 1yr maybe, but I haven't met one myself because there's a lot of competition for just a few spots. Regardless, MDs do, always, become a resident anesthesiologists never having put in an IV, drawn up a med, given blood, or cared for a patient over a 12 hr shift. Med school in a classroom does not equate to caring for critically ill patients on the floor - but no one claims they're incompetent, because they're not, they just have to learn how to be anesthesia providers over a very rigorous program, just like the rest of us. Once we're in that position, CRNAs and residents learn about anesthesia from the same textbooks, taking care of the same patients.
Again, the back and forth is banal, we should be supporting each other as a profession, but it seems that some MDs only support CRNAs when it suits them - i.e. when it comes to providing care in rural areas with underserved populations and limited resources that are undesirable for MDs. Then, suddenly, CRNAs are viewed as perfectly capable.
@@jessicaalmondjoy7706 im not talking down on CRNAs, I’m pursuing that career path now. I’m just saying 1 year requirement is crazy because it negates the entire point of nursing advanced practice. The requirement should be higher. I do know two people who got in with 1 year experience and I wouldn’t want them putting me to sleep.
@@KD-vg2yn agreed, requirement should be higher.
@@KD-vg2ynas per the College of Accreditation (COA), which is the accrediting body of CRNA schools, the average CRNA student has 3.5 years of ICU experience (not including orientation) before matriculating into their respective programs. One year of ICU experience is a minimum and a relative rarity.
I've had anesthesia many times and always had my vitals monitored. How does the hospital think this is proper Care? The staff was negligent.
Thank you so very much for providing details about this unfortunate sad outcome.
From you covering this information it will help so many people as we will pass this along!
Many aren’t aware that as a patient we are permitted to be fully informed prior to procedures of those who are on the team throughout caring for us and have choices as well.
Oh wow. I always thought it was mandatory to monitor vitals while someone is in surgery/ after being given medication, etc. I can't believe someone would gamble with people's life like this.
I think with that horrific quote it's for legal reasons. "Never admit responsibility" even though this case clearly speaks for itself.. super sad and preventable. He probably immigrated here for a better life and this was his outcome. Just sad
It is!
It is but here in South America we don't monitor brain activity that often, we don't have ready access to monitors, but we have a extremely good record in surgery, just monitoring basic vitals as blood pressure and heart rate closely could have saved this patient from a life of pain, here we have 6 years of med school followed by a 3 year residency to become a anesthesiologist
@@Danoliveira3 what country?
This happens all the time, whats unusual is that it got uncovered and published
When I have had surgery the Anesthesiologist was there in the beginning and end and even checked on me in recovery. Thank goodness.
I had an outpatient procedure 6 weeks ago and asked if I could have the same anesthologist that had one year before for another outpatient procedure . I was bummed to hear the group dissolved. I really liked that anesthesiologist because I felt safe. He was very detail oriented. That CRNA changed many lives by his/ her negligence.
Thank you for the education for all people, this information is of paramount importance. Some patients may not be aware of questions to ask before their surgical procedure. I’m impressed you brought this to the surface. As an operating room nurse for over three decades (retired now), this and other information is overdue. Thank you for making patients safer through education.
Patients do NOT require "brain monitoring" in the majority of general anesthesia cases. If that were the case, such monitoring would be a standard of care, and it isn't.
I've seen many cases in hospitals where precious time is lost, brain and life, not "believing" what the blood pressure or oxygen levels were. So they retest, get another monitor or machine, and the patient ends up like this out worse.
Electronic notes are not failsafe. I’ve been in offices where the computer crashed and now everyone just stands around incapacitated. I’ve also been in a computerized hospital undergoing surgery and my file has someone else’s pre-op info on it. Very scary because I was given allergies I don’t have and the surgical team doubted what I said. I had to re-do all the blood work to re-confirm everything. Then after all the blood was drawn, just as I was about to be released to be re-scheduled; they found my actual medical file. Phew!
EPIC fail!!
@@dianeridley9804 yes it was probably EPIC
Hey Dr. C! I am confused: Why didn't the OR RN or Surgeon not notice there was no CRNA/Anesthesiologist?
Did you watch the video to the end
@@sdm889 yes
I am a retired RN. I also was wondering why other surgical staff were not aware of monitor alarms or changing BP while CRNA was gone from room? Did other staff attempt to page him/her back to room. Also, I wanted to say that I have worked with some CRNA s in critical care who were very focused and serious about their work, extremely knowledgeable, and I have personally have had them care for me during various procedures without any problems whatsoever. Thank you. My thoughts and prayers go out to this young man and his family.
I have surgery scheduled for Monday 11/21/22. I've been through many surgeries due to a drunk driver & grateful to all the excellent care I've received. Now that I'm older, all of the sudden I am nervous about this anesthesia. Thx for helping me with a few more questions to talk to my anesthesiologist before surgery.
I work with CRNA’s during MRI anesthesia and they watch that blood pressure like hawks!
Watching blood pressure closely and knowing how to treat it effectively if it falls outside of acceptable range can be two completely separate skills. CRNAs may not be as good with the latter.
When I say watch I mean watch and treat appropriately.. the anesthesiologist isn’t just sitting in our department too.
@@AllisonChains08 crna aren’t anesthesiologists
@@SK-mr6ov ?
I’m aware they’re not anesthesiologists. I didn’t say they are.
@@AllisonChains08 they hate to see other people being capable unless they have the title physician.
Didn’t even know we had an option…thank you for the insight! Missed seeing the educational videos, so this was a nice surprise!
You can't stop the tide. MD groups want the money CRNAs bring, hospital systems want the money they save on CRNAs.
If it leads to bad patient care, the tide certainly will be stopped.
@@Bobbert12345 since when? lol
Good video Dr. C
Valuable information
I Thank God that when I broke (compound) my leg I live just a 15 minute ambulance ride to North Carolina's premier Medical school. I was introduced to my anesthesiologist prior to surgery and he was introduced as "doctor". Of course I have no idea if he was the only one during my 4 hour surgery. All I know is that my leg was saved and my brain still seems intact 🙂. However, when we lived in a different city, my neighbor was an anesthesiologist at our local hospital. He was supervising the CRNA for a patient undergoing knee surgery. The patient died for lack of oxygen. The jury trial determined that the MD was at fault because even though the CRNA inserted the tube, the Anestestiologist approved the placement. Tragic.
I had an anesthesiologist openly brag to me after surgery that I was not in fact allergic to a medication that I told him I was. I was dumb founded. The entire time he refused to believe that I was allergic to Zofran. After the fact, I reported his behavior to the surgery center and my surgeon. I later found out that he pushed the med with steroids and benadryl. I have since (accidentally) been given it again and the nurse and surgeon watched as the hives spread up my arm. I now yell every anesthesiologist, that I am highly allergic, received the medication 3 times after knowingly reporting it as an allergy and now my anesthesiologists tell me they remove it from the room to ease my mind. I'm tempted to write it on my forehead now!
Wow, eye opening, very informative, thank you
Thank you for educating us on these medical situations. It's very important to be aware.
I later went on to Med School, but started as a CRNA. My IQ is 166. The CRNA program I attended in the 70's was taught by an Anesthesiologist who felt that CRNA didactic training should be similar to M.D. as he just came from teaching Anesthesiologists. He was big into Chem, Pharm and Physiology. (the backbone of Anes.). Our hospital served mainly patients with Black Lung and Malnutrition so the most were ASA Class III+ patients with little lung capacity or health reserve. He arraigned Neuro Affiliations for us to travel to Large Univ. with Neuro programs. Our trauma experience was mostly crush injuries from Coal Mine Cave-ins. And since it was still the Hatfields and McCoys, we have more gunshot wounds than Detroit receiving (where I later worked) He made sure we were all proficient in Spinal/Epidural/Regional Blocks. We had to all become proficient with Central Line and Swanz Line Placements to keep track of Blood/Fluid replacement with wedge pressures with all the massive blood loss cases we managed. Even though outdated, he made us learn open drop ether anesthesia using gauze layers rubber banded over a stainless steel sieve like mask. Using eye signs and respirations to determine Anes. Depth. Our OR's still had carbon impregnated floors, machine tubing and tires and we wore shoe covers with a carbon strip that tucked against our skin inside our socks. To prevent static sparks that could cause explosions.
The program exceeded CRNA Accreditation Standards and he was notified the he was spending too many hrs with unnecessary didactic classes. That did not stop his teaching. He had been a Missionary and made us learn to do Anesthesia with old outdated equipment in case we found ourselves in a Foreign 3rd World Country (Military etc), we could still safely adm. Anes. Just so happened that I ended up in 3 of those Countries and the MD's did not have a clue how to use the equip. I spent the first day making cheat sheets for everyone (Copper Kettle Vaporizers). And "J" tanks for O2 and N2O. No EKG Monitors and few ET tubes. I taught them how to hold a mask with their pinky finger in front of the ear to monitor the rate and quality of the pulse and the other hand on the breathing bag and constantly looking at the bleeding in the operative field to eval. SaO2.
Before Med School, worked Anes. Dept Head over 17 CRNA's and 7 MDA's. Fired a few CRNA's who I felt were incompetent and worked with the MDA Group Head to get him to train his low performing MDA's They came mostly from the UofM and were big with egos and little with clinical skills that still needed developing as they were all new grads.
Not suggesting this was ideal, but these high mountain probracitos would never have received needed surgical intervention. It was that or nothing.
Later in Med School the only thing new to me was Virology and Embryology. (Straight A's) I became particularly proficient in Virology. Thankfully, it made me realize what a dunce Fauci is, Few know this but his training is in Allergy Medicine and NOT VIROLOGY.
Since CRNA School, I spent at least 1 hr/day reading research and new techniques, and continued while in Med School.
So, Dr. Cellini, I present to you it is not the title but the training and drive of the individual that makes the difference in Pt. care and Safety. And I might add that CRNA were the first formally trained Anesthesia Providers in the USA. It all started with the Mayo Brothers Clinic insisting on only using Alice McGraw to provide they Ether Anes. She ended up writing a book of Techniques of Ether Anes. and Published in the Lacet. Doctors came the world over to learn to safely administer Ether Anes. from her.
Her delivery of fourteen thousand anesthetics without an anesthesia-related death established a record for the safety of the practice of anesthesia by nurses.[3] She incorporated hypnotic anesthesia and the Open Drop method in her work, needing less chemical anesthesia with both techniques which helped reduce the risk of overdose.
Holy shit that was ALOT to take in, but amazing. Thank you!
As someone who is new in the medical field, thank you for sharing your story. I picked up so many things just from that short anecdote and I can’t imagine the wealth of knowledge you have built up over the years.
Botched Spinal Anesthesia - my case - healthy 52 yr old admitted for broken femur surgery- the Anesthesiologist put my spinal in wrong location and I was awake so they weren’t monitoring me. I went into cardiac arrest and they didn’t notice until I turned blue. I arrested and they resuscitated me 3 times. I now have Action Myoclonus and it has destroyed my life.
Things in this case are just not adding up. As a former recovery RN, I've worked with some amazing CRNA's and some ding dong anesthesiologists. It was my experience that MD's were in on the more complicated cases and CRNA's on the more elective cases. Our patients also never were given the option to choose one over the other. They were always monitored and everything recorded electronically unless there was some kind of system wide EMR outage, which still happens, then it would be paper charting which the copy of was given to the recovery RN along with a report and another copy scanned into the system. Also, the pt would NEVER be left unattended. And, where was the surgeon or the surgical RN? Because when any of the vitals fall outside of set parameters, there are LOTS of alarms that go off. I feel like there is missing info. Poor patient.
You are right on point !
Thank you , RN 30+ years & a patient of a CRNA When my own surgery went very wrong as in I woke up during the surgical procedure!!!! As my Ass signed
CRNA was being shouted at by the OR Nurses & all the alarms going off !! Yes, it could of been a horrible outcome not just a Horrific experience. I wish they would have given me a few extra doses of Midazolam during & after, so could have forgotten all of that. Now that I have to have two more surgeries coming up.
I am making sure in writing that I advocate for my care during anesthesia. And yes The Big Medical Center Hospital tried everything unethical to cover up the "Incident" while they were as you said, Giving me," Excellent Care"
The reason fax machines are still utilized is they are not part of Hippa compliance as telephone lines are not considered electronic transmission which is what Hippa is all about and an easy way to share patient reports quickly
And also a very clunky and not secure way to send patient information. Nothing like papers with patient data sitting in the fax machine for anyone to see
E-faxing is not always reliable because institutions or medical offices are not upgrading their servers. Enormous amounts of data packets keep pinging an already too full lines
My X had an anesthesia error when he had open heart surgery (at a major world class hospital) and was awake during the whole procedure. The surgeon after surgery said he didn't know when the patient (my X) would wake up because he had such a bout of high blood pressure. After 4 days when the ventilator came off, my X blurted right out - "I felt the whole thing". The nurse in attendance said... "Well, it is our word against his". What a strange reactive comment. So I asked the surgeon when he made rounds what he made of the fact my X believed he was awake - the surgeon said... well, he very well might have been - that's probably what caused his blood pressure to spike so high. My X did not want to pursue legal action because he felt his life was in the hands of this hospital for ongoing medical problems - so we didn't. I will probably always believe his was a case of the anesthesiologist either being grossly negligent or was a resident/ingern or CRNA without proper supervision. Sadly, we willl never know - but has bothered me ever since. My X has since passed away.
Being awake and feeling the surgical procedure is rare but does occur. It’s one of every anesthesia provider’s nightmares. If your X had a cardiac surgery it was definitely not a CRNA who provided the anesthesia. For very high acuity surgeries, they only use anesthesiologists. I had a procedure and woke up toward the end, I could hear and feel everything but couldn’t move. All I could do was cry and hope someone noticed my tears. It sucked 😢
@@surgerystudio7654 Al the more concerning since this was at a world-class hospitall and the response from the nurse to basically prove it. The surgeon when confronted did acknowledge - would have made a big difference if they had acknowledged it up front. Thanks for responding. Sorry it happened to you. It is so traumatic. What was the hospital's response when you told them?
Had surgery for a shoulder injury at work, a 90 minute surgery had me out for almost 6 hours, I haven't been right since
My shoulder surgery wasn’t wonderful in fact after they discharged me thank god I woke up at home due to the fact the anesthesiologist punctured the top of my lung and they never caught it, needless to say I was suffocating from the inside out, 3 chest tubes later, 10 days total in CCU I made it out alive! Oh during emergency surgery to put first chest tube in ER dropped the scalpel passing it off to nurse while I was under and just missed my carotid artery in my neck (required more stitches)… guess what couldn’t sue cause scars weren’t over 2 inches long and since I was fortunate my lung did fully regenerate and I didn’t die or have long term issues there was no “medical malpractice!” Talk about learning do not trust anyone or ever sign papers!!!
what! no criminal charges? If this kind of negligence happed to any one other then Priests, Cops or Medicine; you bet there would be charges. When a dr murder my wife due to negligence the hospital changed her medical records too. In my case they forgot to delete the original ones. I got sh!t for my pain and lost and no one went to jail.
Interesting. If I was to have surgery, I would say the same thing. I would want a board certified anesthesiologist. What about the attending surgeon. As a double board trauma cardiothoracic surgeon, I am always aware of every possible situation; including blood pressure adjustments at all times. This was a negligent surgery. Plain and simple.
Agree with your view on excellent care, with the staffs review on this one.
Dr. Heshmatpour his credentials are impeccable. Effingham IL
Wow I’m pretty sure the whole show Dr Death showed most of his mistakes happened at Baylor Medical in Texas. Something needs to change that’s negligent for sure.
Baylor Scott and White in Dallas accepts more healthcare plans including Health Insurance marketplace and medicare plans. Parkland and Dallas Presbyterian are ranked higher as far as having doctors of more experience however. This is something to consider as well
I would say in many cases patients don't know/don't ask who will be giving them anesthesia. This scares me to death. If I need to have surgery I usually pick the doctor that will provide me with the best care/outcome. Fast forward to the day of the surgery your surgeon who you picked is ready to do your surgery and in most cases, you have not met the person who will put you to sleep who is arguably the most important freaking person in the room. If you have met them it is in passing Hi I'm so and so I will be doing your case today. I might not have surgery if I can put it off but if not I pick Kristina Braly for my Doctor :)
I have to wonder if he had an anaphylaxis reactions to some medication.
That can cause a sudden and rapid decrease in blood pressure.
Hi Being a RN , we only have a certified anaesthetist which by the way are called here in the UK .and is illegal for a RN to be involved with any anaesthesia.we only take over the care of the patient once he or she has regained consciousness and has been transferred to recovery .
Yeah. In the UK we don’t have CRNAs as such but the Royal College of Anaesthetists in 2021 announced the development of the new role of an “Anaesthesia Associate” (AA). These will be people who either have a biomed/biological science undergrad degree who go on to do an AA post-grad degree OR an allied health professional (including ODPs, nurses etc) who have worked for 3 years clinically before doing the AA post-grad degree. So frankly, not too dissimilar to a CRNA.
Hi , well after my neuroscience post grad degree , i know i am looking forward to my retirement , its not too long now ,its getting far to tedious now and to be frank i am getting tired and i think i might well retire early ,as we have lots of talent coming through , so yes nursing has changed dramatically from when i first qualified and with ongoing training , life is not your own any longer . but its good to know that nursing is moving on .
my regards liz .
Why don’t the Hospitals give us the option??? I’ve had too many surgeries n I need total knee replacement on right knee. I’ve been dealing with it. When n if I have it done, you best believe I’ll have these questions when I talk with anesthesiologist. Thank you. I love the information you pass on
Scrub tech here. When we do orthopedic cases, sometimes the surgeon will ask for the BP to be artificially lowered to prevent gross blood loss. It bleeds a lot during orthopedic surgery. Some procedures are unable to use a tourniquet (I kinda wonder if this was a TFN)
I wonder if this is what happened- the surgeon asked the BP to be artificially lowered and the CRNA just got careless with it.
I’ve watched some anesthesiologists deny their request for patient safety. Some of them lower it a tiny bit. Just curious if this was the case…
Just looked it up- apparently it was a tibial fracture. Really wonder if it was a plate or a nail. Which is odd; my surgeons use tourniquets for those. Then again, my co workers have told me they worked with some ortho guys at other places that didn’t use a tourniquet at all.
Really odd.
I work for a //very// small long term care and rehab facility. We just changed over from paper to electronic. It was a huge shift for many of the staff who were use to the paper charts. It not just the cost of the program, and training. It is the cost of taking nurses off the floor, and any staff who work on charts. You have to pay them for training, and pay agency or other staff overtime to cover their shifts if you need to. It is so much money. Plus you have to invest in computers for people to use, and equipment to make the shift easier. We are a few months in and still hitting bumps. We are what I call the odd hybrid phase where we are 75% electronic but 25% paper on some things still. I am not surprised if some departments just aren't able to make the shift without literally pausing for a day or two just to make things smooth/safe for patient care.
Decades ago, at hospital I worked at, a young man undergoing cosmetic surgery suffered anxoxia resulting a vegetative state. The anesthesiologist fell asleep during the surgery and never noticed the ET had slipped and the patient was not getting oxygen.
Wow…..that’s awful 😢
I guess it really just depends on the person not the job title
More videos like dizzzzz!!! Loveeeeeit!💕
My husband was a CRNA for 35 yrs. The anesthesiologist was always there for induction and extubation. If there were issues with patients the anesthesiologist was called. The education now is a minimal of a masters degree. They are considered nurse practitioners in anesthesiologist. The reason I know about this is that I was an peri-operative nurse in the same hospital for 40 years. As an OR nurse I was always at the patient’s side during induction and extubation. I have never seen any anesthesia person ever leave the patient’s side. An operating room can be loud at times and most of our RN circulators can tune the noise out but we can hear a Sat monitor going down and are at the head with anesthesia and can call our MD covering and they’re right away in the room. I kind of was angry about the comments about the education of CRNA. They have to have a bachelor of Nursing degree, experience in the ED, ICU, CCU then they go for their masters degree, then take their Anesthesia Boards. They always shadowed with another MD or CRNA for a period of time. They never work alone on call. Anesthesiologist is always there on call. I trust any of the CRNA’s with my care and my family’s care.
They have a minimal of a doctorate now
That was just being mentioned in New Hampshire
As a matter of fact that is false. CRNAs are not nurse practitioners in anesthesia. They are either Doctors of Nursing Practice - Nurse Anesthetists (DNP-NA), which is not the same thing as a nurse practitioner (NP). Or they are Doctors of Nurse Anesthesia Practice (DNAP), which again is not the same thing as a nurse practitioner. The training between a CRNA is vastly different than that of a NP. The same way a Certified Nurse Midwife (CNM) is not the same as a NP. Even though the CNM is required to get a DNP.
Oh, to be a fly on the wall while that case was in progress. Or when the department heads got wind of it.
2024 and we still shuffle a lot of paper.. and our PACS system is at least 20 years old!! We still have to burn CDs!! Who has CD drives in their computers?? The scheduling system is well over 20 years old. We have to SCAN our hand written documents. It's crazy.
Love these suing cases playlist
A similar situation... Caused great difficulties
Patients should be fully informed whether an anesthesiologist or CRNA will be doing the anesthesia.
I came out of a hysterectomy surgery convulsing but aware......been left with Temporal Lobe Epilepsy from this.
After surgery I woke up with retinopathy in my left eye. Much later, after eye exams and tests, I realized it was from BP drop during my surgery. Of course there are never any notes about this so there is no way to prove it. If I had asked the doc while I was in the hospital I am sure I would have gotten something close to the truth. But now I realize that I was lucky it was not worse. I have had many surgeries since then and when I go in, I always ask who's there, did they get enough sleep the night before, etc...
I had 2 surgeries in 24 hours. Scary to have to go under twice back-to-back.
I live in area where several Baylor Hospitals. My friends and I all have had complications. My complications were serious with mistakes. I now use Seton.
Thanks for the insightful and rational discussion of this case. I'm in medical school now but before this, I was an RN who considered the CRNA route. It just did not sit right with me that they perform the job of a board-certified anesthesiologist with so much less training so I decided to go to med school instead. A BSN and having ICU experience are nothing close to physician training. The balance of implementing mid-level providers is tricky and it's unfortunate patient safety is at risk. Of course many other factors involved but that's my 2 cents.
Crna's often have many years of icu experience before going back to school and and crna training is quite rigorous. This case does not reflect all Crnas. Negligence and complacency can lead to these types of mistakes, but MDs and Crnas, PAs, NP, and RNs can make that mistake.
@@shorty06111
And yet many of these organizations that lobby for “physician lead care” always point to extreme outliers to prove their point, while simultaneously ignoring similar instances of incompetence at the hands of physicians.
Look, no one in their right mind would argue that CRNA training is on par w/ an anesthesiologist, but to appeal to extremes is intellectually dishonest.
It is malpractice if a CRNA or anesthesiologist left the OR with an anesthetized patient without another replacing them. I doubt that happened.
Excellent discussion. Spot on Dr. Cellini.
I work at a level 1 trauma center with 1300 beds and anesthesia uses paper chart now that I see your video I understand why the use paper charts to hide vitals
You use a fax machine because it is the most secure way to send client documents. The financial industry also uses fax machines to send client documents for this very same reason. Both industries have rules requiring private client information be protected, thus we use fax machines to send documentation to avoid use of other modes such as email. The document is then scanned into a secure system for others to view.
`So secure that literally anyone on the receiving end of the fax can see the patient info if you're not there the second it comes in. It's not 1996 anymore, there are better options.
Yup, in my experience it often sits on the fax machine for a while where anyone walking by can see it.
@@willguthrie5186 You make a good point. Someone in the office might see the fax. Maybe you can list some of the better options that you think have been invented since 1996?
This is gold!!!
How do we know a blood clot didn’t get dislodged and cause the brain injury, which could have caused the hypotension
The institutions and nursing organizations are much more powerful than most people realize. $$$$ drives a lot of things. Many states, because of nursing lobbying, allow CRNAs to operate independently, and without any physician supervision. I do not think that is wise.
Based on what research don’t you think it’s wise?
Since you have so much to say about CRNAs…talk about the anesthesiologist in NY that BOTCHED several epidurals.
I was at a hospital a few weeks ago and the anaesthetist was drawing graphs by hand
I am in nursing school for my BSN. And all three hospitals that I work in use electronic charting exclusively. I would decline employment from any nursing facility that uses paper charts.
Multiple outcome studies demonstrate that for routine and lower risk surgeries, there is absolutely no difference btw CRNAs and anesthesiologists. Clearly, in this case, the CRNA should have contacted the attending ASAP after hypotension developed.
I'm going to have a minor outpatient procedure this week a colonoscopy plus a minor surgery under general anesthesia for the first time now I'm scared to death
Yo! Why do all the malpractice cases happen at Baylor lol
You'd have to dig around to compare them to other hospital SYSTEMS.
I just looked it up. It's huge. This is from their website.
"Today, Baylor Scott & White includes 51 hospitals, more than 800 patient care sites, more than 7,300 active physicians, over 49,000 employees and the Scott & White Health Plan."
I have been getting care at one of their hospitals over the last 7 months that I'm happy with.
Managed to get out of Venezuela to live in a better placer and then this happens to him. Really sad
Could it have been a pulmonary embolism, and cardiovascular collapse considering its a lower extremity fracture?
My question is, did she administer the medications before or after her 12 minute absence?
also interesting to know the total # of malpractice cases and awards by both physician anesthiology and crna's as well as what % of each gets sued.
Hmmm, I wonder if there were other doctors and nurses in that particular surgery. They all were covering up something?
Because of poor oxygen blood flow, can a person end up with hydrocephalus? Also, if I was poorly positioned, can one have ulnar nerve damage? in the supine position
How truly devastating!!!! THIS is why there is SO much redundancy built into Healthcare!!!!!!! So cases such as this didn't happen! I'm truly surprised bcuz Baylor is normally SUCH a good hospital
I work for 2 hospital systems in TX - Ascension and Baylor Scott & White. I have worked in PACU for over 7 years and the patient is always brought to the recovery room by the CRNA or AA (anesthesiologist assistant) and OR nurse. I don’t believe the patients are given a choice about what type of provider they get. It just is what it is. I’ve never heard of a patient demanding that only an anesthesiologist take care of their anesthesia needs, but it’s probably happened.
you kno what's even scarier, patients that are sedated 24/7 on ventilators in the ICU with only nurses monitoring the patients (there is no anesthesiologist or even CRNA present monitoring that sedation that is going 24 hours/day). it's just a person with the training of a nurse (which im not discrediting nurses but that's not a huge amount of training even with ICU experience). and each nurse has 2-3 patients they're taking care of at once. a blood pressure can drop at any point and there isn't always someone right there watching the patient's vitals 24/7. the nurse could be in another patient's room or on a lunch break. and when nurses take a break, that means another is nurse is covering that nurse's patients as well as their own patients since most hospitals don't have break nurses to do the lunch breaks. that is not close monitoring whatsoever for a patient that is in an incredibly critical and vulnerable state. there is a charge nurse in the ICU but they're not straight up sitting there staring at every single patient's vitals 24/7 and a lot of times they are away from the nurses station in one patient's room at a time. the patients are always "under" a nurse's care all the time but there is no dedicated person that is giving attention to all the sedated patients 100% of the time
I have had 2 nurse anesthetists. No issue. Now MDs use CRNA. They pay the CRNA a small amount in salary. The MDs get the big bucks. Pure greed
I’m in TX and Baylor uses EPIC so that’s odd.
Very odd. Doubt it was done during a scheduled downtime
@@jeannesherrill I agree. The symbol for anesthesia providers is the lighthouse their Job is to make sure you stay alive in surgery and watch you the entire time. I think it would be interesting to get Kristina Braley MD view she’s an anesthesiologist in Houston but Baylor hospitals are all over Texas. She’s a well known UA-camr.
I found this a very scary topic, thinking of past surgeries and hopefully no future ones.
On the last video I was in disagreement with your views. But, in this, I am in total agreement.
And, living in Texas, you have opened my eyes on a very serious subject that affects me. Thank you, Sir
1:4 is a poor ratio, it's 1:2 in France. But money...
I thought there was a cap on malpractice damages of $250k in Texas?
You can be sure CEO pay is quick to change and only up!
It’s clear to me that this doctor does not know how much school CRNA go through and training. It’s unfortunate what happened to his family, praying for them
What about the ET tube? Dislodged? Then drop bp?
One of our anesthesiologists was adamant against electronic records. If the BP machine was to malfunction for example it might show a normal reading one minute, something else. Nothing wrong with the BP, but if it’s on the electronic record; Potential malpractice 8:15
Which Baylor hospital? I think there are 51 of them in Texas. My Baylor hospital uses electronic medical records (EPIC).
In Texas CRNA’s can practice independently of anesthesiologists
How is a nurse administering anesthesia at all?? They are not qualified to do this !
CRNA - Certified nurse anesthetist
I recently moved from a metropolitan city to a much more relaxed town. So while the quality of my lifestyle improved with less traffic, less congestion and less crime but the doctors here all seem like they graduated last in their class.
Where does anesthesia come from?
Why do CRNA’s even exist? You know, when properly trained Anesthesiologists are out there
(I’m a foreigner so I just don’t get it)
It's a usa thing worldwide.. in the whole other world nurses are nurses and doctors are doxtors
Did I hear him say at 7:46 that “CRNA’s are doing that”: go a block to get coffee? Putting other professionals down 😮😱🙄
Why would the patient be left alone by the nurse anesthetist? That makes no sense.
Lol, ‘THE BALOR" medical center. 98% of hospitals in the United States have some sort of EHR. Now, 94% have implemented CPOE (computer practitioner order entry). Very very few hospitals have no EHR.
You need to be able to continue treating patients in the event of a power outage or your computer malfunctions, able to write it out.
Dr. Should Hospital in ICU train students to take care patients without supervision?