From Standards to Testimony: The Anatomy of Medical Legal Review

On This Episode:

Today we’re going to dive into an interesting topic: some medical legal considerations. And we’ll talk a little bit about being an expert witness. We’ll cover anesthesia standards created and published by the American Association of Nurse Anesthesiology, and share some of our own experiences acting as expert witnesses in medical legal complaints filed on behalf of patients. Perhaps just as important though, we’re going to talk about ways that you can keep yourself out of hot water and keep your patients safe.

It’s important that as providers we periodically review the standards by which we’re expected to practice. Both for the benefit of our patients and to make sure that we’re practicing at the highest levels of anesthesia care every single day.

 

Here’s some of what we discuss in this episode:

  • Reviewing the Standards for Nursing Practice from the Professional Practice Manual.
  • The most common problems that I have seen that have resulted in litigation fall into four main categories.
  • Who evaluates whether or not the standard of care has been satisfied?       
  • The difference between a deposition and trial testimony and how it impacts you.

 

References

American Association of Nurse Anesthesiology (AANA) Professional Practice Standards: https://www.aana.com/practice/professional-practice-manual/

Adams, J. P., Bell, M. D. D., & Bodenham, A. R. (2012). Quality and outcomes in anaesthesia: lessons from litigation. British Journal of Anaesthesia : BJA, 109(1), 110–122. https://doi.org/10.1093/bja/aes188

Argo, A., Zerbo, S., Lanzarone, A., Buscemi, R., Roccuzzo, R., & Karch, S. B. (2019). Perioperative and anesthetic deaths: toxicological and medico legal aspects. Egyptian Journal of Forensic Sciences, 9(1), 1–12. https://doi.org/10.1186/s41935-019-0126-6

Chattopadhyay, S., Rudra, A., Ray, M., Sengupta, S., & Goswami, S. (2016). Legal Aspects in Obstetric Anesthesia. Nepal Journal of Obstetrics & Gynaecology, 10(2), 3–9. https://doi.org/10.3126/njog.v10i2.14327

Cook, T. M., Morgan, P. J., & Hersch, P. E. (2011). Equal and opposite expert opinion. Airway obstruction caused by a retrosternal thyroid mass: management and prospective international expert opinion. Anaesthesia, 66(9), 828–836. https://doi.org/10.1111/j.1365-2044.2011.06650.x

Crosby, E. (2007). Medical malpractice and anesthesiology : literature review and role of the expert witness. Canadian Journal of Anesthesia, 54(3), 227–241. https://doi.org/10.1007/BF03022645

Dutton, R. P. (2023). Expert Advice for the Expert Witness. Advances in Anesthesia, 41(1), 111–125. https://doi.org/10.1016/j.aan.2023.06.001

Early, D. S., Lightdale, J. R., Vargo, J. J., Acosta, R. D., Chandrasekhara, V., Chathadi, K. V., Evans, J. A., Fisher, D. A., Fonkalsrud, L., Hwang, J. H., Khashab, M. A., Muthusamy, V. R., Pasha, S. F.,

Court of Appeals of Texas, First District, Houston. (2015, November 5). Mangin v. Wendt, 480 S.W.3d 701. 2015 Tex. App. LEXIS 11495. (Mangin v. Wendt, 480 S.W.3d 701). (Overview: Expert anesthesiologist’s report and curriculum vitae did not demonstrate his qualification to offer specific expert opinions regarding the care rendered by a cardiologist when a coronary artery was perforated during a catheterization and during subsequent complications, contrary to Tex. Civ. Prac. & Rem. Code Ann. §§ 74.401(c) and 74.351(a))

Hollingsworth v. Springs, 353 S.W.3d 506, 2011 Tex. App. LEXIS 7028 (Court of Appeals of Texas, Fifth District, Dallas, August 30, 2011, Opinion Issued). https://advance-lexis-com.ezp.twu.edu/api/document?collection=cases&id=urn:contentItem:53NT-CN51-F04K-B0P3-00000-00&context=1516831.

Saltzman, J. R., Shergill, A. K., Cash, B. D., & DeWitt, J. M. (2018). Guidelines for sedation and anesthesia in GI endoscopy. Gastrointestinal Endoscopy, 87(2), 327–337. https://doi.org/10.1016/j.gie.2017.07.018

Ferreres, A. R. (2022). Expert Witness Testifying Against Colleagues. In Difficult Decisions in Surgery: An Evidence-Based Approach(pp. 241–254). Springer International Publishing. https://doi.org/10.1007/978-3-030-84625-1_18

Informed Consent: AANA document ([mentioned but not directly linked in the podcast]): https://www.aana.com/

Iyer, P. W. (2020). The Expert Fact Witness: Medical Summary Preparation and Testimony. In Legal Nurse Consulting Principles and Practices (4th ed., Vol. 1, pp. 775–796). Routledge. https://doi.org/10.4324/9780429283642-32

Liang, B. A., & Walman, A. T. (2003). Who can be an expert in anesthesia malpractice suits? A case of general anesthesia, cardiopulmonary risk, and patient death. Journal of Clinical Anesthesia, 15(5), 395–397. https://doi.org/10.1016/S0952-8180(03)00104-1

Murphy, E. K. (2005). The expert nurse witness. AORN Journal, 82(5), 853–856. https://doi.org/10.1016/S0001-2092(06)60278-0

Nicholson, E. (2014). Dallas Anesthesiologist Being Sued Over Deadly Surgery Admits to Texting, Reading iPad During Procedures. Retrieved from: https://www.dallasobserver.com/news/dallas-anesthesiologist-being-sued-over-deadly-surgery-admits-to-texting-reading-ipad-during-procedures-7134970

Radvansky, B. M., Farver, W. T., Svider, P. F., Eloy, J. A., Gubenko, Y. A., & Eloy, J. D. (2015). A Comparison of Plaintiff and Defense Expert Witness Qualifications in Malpractice Litigation in Anesthesiology. Anesthesia and Analgesia, 120(6), 1369–1374. https://doi.org/10.1213/ANE.0000000000000673

Second victim phenomenon: https://pubmed.ncbi.nlm.nih.gov/37688607/

Semo, J. J. (2014). Legal Aspects of Ambulatory Anesthesia. Anesthesiology Clinics, 32(2), 541–549. https://doi.org/10.1016/j.anclin.2014.02.009

Stevens, A. (2011). Reliability and cogency of expert witness evidence in modern civil litigation. Anaesthesia, 66(9), 764–768. https://doi.org/10.1111/j.1365-2044.2011.06857.x

Weaver, J. M. (2009). What is the standard of care for anesthesia? Who determines it? Anesthesia Progress, 56(1), 1–2. https://doi.org/10.2344/0003-3006-56.1.1

White, S. M. (2014). Ethical and legal aspects of anaesthesia for the elderly. Anaesthesia, 69(s1), 45–53. https://doi.org/10.1111/anae.12519

Wright, G. (2010). Pediatric Anesthesia 2009: the child who refuses to undergo anesthesia and surgery: a case scenario-based discussion of the ethical and legal issues. European Archives of Paediatric Dentistry, 11(2), 101-.

 

Help us grow by leaving a review: https://podcasts.apple.com/us/podcast/beyond-the-mask-innovation-opportunities-for-crnas/id1440309246

 


SHARE THIS EPISODE

Facebook
Twitter
LinkedIn

SUBSCRIBE

EXPLORE MORE

Current Events

Dysphoria: Current Understanding & Recommendations to Prevent Post-Op Cognitive Decline

Today we’re exploring a topic that goes deeper into the realms of medicine and neuroscience, and it’s something that affects us all: cognitive health post-surgery. Adam Flowe, Chief CRNA at Duke University Hospital, brings his 20 years of experience and a personal connection to the table, discussing the intricate relationship between anesthesia, surgical stress, and the brain. With the aging population and the rise in surgeries, the question of how these procedures affect our cognitive function is more pressing than ever.

LISTEN NOW »
CRNA Careers

Like Mother, Like Daughter: Discover the Unique Bond of a Mother-Daughter CRNA Team

In this heartfelt episode of Beyond The Mask, a story of unique dynamics when working alongside family in the world of anesthesia comes to life. Jeremy and Sharon sit down with a remarkable mother-daughter duo, Melody Secrest and Emily King, both CRNAs, who share their experiences working in the same hospital department. We uncover the challenges and triumphs that come with balancing professional boundaries and personal relationships in the operating room.

LISTEN NOW »
Clinical

Ventilating the Future: CRNAs at the Forefront of Lung Protective Strategies

In this episode, hosts Terry and Garry take listeners on a journey through the evolution of anesthesia, reflecting on the remarkable changes witnessed since their early days in the field. From manual adjustments of OR beds to sophisticated ventilator technologies, they explore the transformative advancements that have revolutionized patient care.

LISTEN NOW »

SUBSCRIBE

NEW EPISODES EVERY WEEK!

Apple PodcastsGoogle PodcastsSpotifyStitcherTuneIniHeartRadio

HAVE A QUESTION OR WANT TO BE GUEST?

RECENT REVIEWS

J. Cross CRNA
Read More
This podcast is very well put together. I love the hosts Sharon & Jeremy, they do a fantastic job at presenting topics as well as getting great speakers on the show! This is my morning commute podcast everyday! Thank you for all that you do!
Bill.Nye
Read More
I enjoy listening every morning. Great content and always a pleasure to learn something new.
biggestbaseballfanever
Read More
I started listening to this podcast religiously early on in my CRNA journey, a year before applying to CRNA school. The content in this podcast was one of my most helpful resources for getting into my first choice school, Wake Forest! It has also been a huge motivator for getting involved with the AANA now and throughout my career. I highly recommend this podcast to every prospective CRNA I meet.
Trvlgrl1
Read More
I appreciate hearing the latest and greatest in the world of Nurse Anesthesiology while also getting Class B credits. Just listen on your commute for a win/win experience. I love the perspectives from Jeremy and Sharon who both ask varied and insightful questions!
doubledownmoney
Read More
If you’re a CRNA or any medical professional, I highly recommend giving this podcast a listen. Hosts have a great rapport.
Previous
Next

READ MORE REVIEWS OR LEAVE YOUR OWN!