Confidential settlement – patient dies when et tube removed
A chief executive of a hospital in Modesto, CA, suffered a catastrophic anoxic event during what was mistakenly expected to be a routine extubation following a successful coronary artery bypass surgery. The anesthesiologist required multiple attempts to intubate the patient prior to the surgery. There were six attempts over 15 minutes which is considered to be a difficult intubation. This caused significant trauma to the soft tissues of the airway resulting in inflammation and swelling. When the ET tube was removed, the swollen tissue expanded and blocked off the airway. Many attempts were made to re-intubate the patient who had stopped breathing. Finally, after 25 minutes a surgical airway was established, but it was too late. The patient suffered severe brain damage from oxygen deprivation and was taken off life support resulting in his death.
The anesthesiologist testified that he gave the surgeon a report about the difficult intubation and assumed the surgeon was in the operating room and knew of the difficult intubation. He further testified that he assumed appropriate precautions would be taken during the extubation of the patient. The surgeon testified he did not receive a report of the difficult intubation; although he knew that it took several attempts to intubate the patient. However, the surgeon issued routine orders for extubation soon after the surgery. The ICU nurse and ICU respiratory therapist testified that no one told them it was a difficult intubation. The extubation occurred too soon without a physician present and without appropriate hospital equipment immediately available. We contended the extubation should have been delayed until the next morning and should have been undertaken by a physician with appropriate emergency medical equipment immediately available. We represented the wife who had had a wonderful 35 year marriage with her husband and their two adult children.