The human body needs a constant flow of oxygen to survive. Normally we maintain oxygen supply by breathing - oxygen comes in and carbon dioxide goes out. When medical patients undergo surgery or certain other medical procedures they may not be able to breathe on their own. Airway Management refers to the medical procedures undertaken to prevent or relieve airway obstruction and ensure that a patient continues to breathe and receive oxygen when unable to do so on their own.Intubation
Tracheal intubation or "intubation" is an advanced airway management procedure in which a flexible breathing tube is inserted into the trachea (the "windpipe") to prevent blockage and ensure airflow into the lungs. Intubation is accomplished non-surgically with an endotracheal tube that is routed through the mouth or through the nose and into the trachea. Once inserted the tube is usually hooked up to some sort of ventilation machine that pumps air in and out. There are also surgical methods of intubation the most common of which is called a tracheotomy. Surgical intubation is usually done for patients that will need prolonged airway management.
Intubation is a highly invasive procedure involving significant discomfort so it is preferably done only after the patient is given general anesthesia and/or a muscle relaxant. In emergency situations, however, intubation can be done with only local anesthesia. Intubation is often done with the aid of a laryngoscope which allows the doctor to see inside a patient's throat to ensure accurate placement of the tube. Extubation refers to the process of removing the endotracheal breathing tube when it is no longer needed.Intubation Malpractice and Injury
Intubation is a medical procedure that requires skill and training to perform. That being said, a properly trained and experienced doctor should be able to perform an intubation without harming the patient. When a patient is injured as a result of intubation or extubation it is commonly due to negligence on the part of the doctor. As a result, intubation injuries frequently lead to malpractice lawsuits. Intubation malpractice typically falls into one of the following categories: tube misplacement (tube is mistakenly inserted into esophagus); negligent delay; and tube dislodgement.
What makes intubation malpractice somewhat unique is that small mistakes can quickly result in very severe injury and even death. If the brain is deprived of oxygen even for a short time it can result in permanent brain damage or death.
The intubation procedure is usually performed by an anesthesiologist. The anesthesiologist is also the doctor that is directly responsible for monitoring the breathing tube after it is in place to make sure it does not become dislodged, etc. In most cases, however, intubation and airway management is a team effort so other doctors and hospital staff will also have some liability for intubation malpractice.Settlements & Verdicts
We have not seen many airway management verdicts and settlements in Maryland and confidentiality rules prevent us from being about to provide results in many of our cases. Here are a few recent verdicts and settlement in extubation and intubation cases around the country.
New Jersey (2018) $17 million: in this case a 7 year patient was intubated during surgery. After the surgery the doctors removed the breathing tube (extubation) prematurely and the patient was not able to breath on her own once the tube was removed. She suffered permanent brain damage as a result and would require assistance the rest of her life. The doctors were found negligent because they only did a cursory 10 min test to ensure the patient was able to breathe before the extubation when the standard of care called for 30 min to 2 hours. A jury in Monmouth County, New Jersey awarded the plaintiff $17,000,000.
Illinois (2017) $3 million: in this case a patient at a Chicago hospital died on the operating table when his breathing tube became dislodged during the surgery. The suit alleged that the doctors were negligent in failing to properly perform the intubation and then failing to properly monitor and maintain the breathing tube during the surgery allowing it to dislodge. The case was settled for $3,000,000.
New York (2017) $435,000: the 54-year old plaintiff in this case was intubated for liver transplant surgery at Presbyterian Hospital in New York. He filed suit claiming that he suffered a stroke and vocal cord damage because the hospital was grossly understaffed and failed to properly monitor and maintain his breathing tube and ventilator. A jury awarded $435,000.
Pennsylvania (2017) $1 million: in this case the hospital and doctors needed to perform an emergency intubation on a 23 year patient. They were not prepared with the required equipment to respond fast enough and by the time the doctors performed the intubation and obtained an open airway the patient had already died. The suit filed in Philadelphia alleged negligent delay in intubation and was eventually settled for $1,000,000.
If you or someone you know may have been injury in connection with negligent intubation or airway management, contact our office at 1.800.553.8082 or submit a request for a free consultation.