An anesthesiology expert witness advises on a case involving the decedent, who was in his 60s, was seen in the emergency room for severe abdominal pain. He was evaluated and diagnosed with an incarcerated ventral hernia. He had a significant history of COPD. Late at night, he was taken to the operating room for emergency repair of the hernia and release of a small bowel obstruction. After administration of anesthesia, the anesthesiologist performed a rapid-sequence intubation. After surgery, decedent was taken to the recovery room, where he was intubated and ventilated. It was determined that the endotracheal tube should be moved and it was withdrawn several centimeters. Soon after this, significant subcutaneous air was noted, and it was discovered that he had a large tracheal injury. This injury proved fatal.
Decedent’s survivor filed a negligence action against the hospital and anesthesiologist.
Question(s) For Expert Witness
1. Was the standard of care breached?
2. What evidence is there of a breach?
Expert Witness Response
I have reviewed the medical file of decedent, the coroner’s report and a patient log/diary constructed by the decedent’s family. In this case, to a reasonable degree of medical probability, the defendant fell beneath the accepted standard of care. Although airway injury from endotracheal intubation is a known complication, such injury is usually more proximal and involves more vulnerable structure than the trachea itself. The location and size of this injury — 1cm x 3 cm distal trachea extending into the right mainstern bronchus — suggest management below the standard of care. Moreover, it is my medical opinion to a reasonable degree that the aforesaid breach of the standard of care by defendant caused this injury that ultimately lead to the patient's death following several weeks of mechanical ventilation and ICU care.
The expert is board-certified in internal medicine and anesthesiology and is chief of anesthesiology at a hospital. He also is a professor of anesthesiology.
About the author
Kristin Casler
Kristin Casler is a seasoned legal writer and journalist with an extensive background in litigation news coverage. For 17 years, she served as the editor for LexisNexis Mealey’s litigation news monitor, a role that positioned her at the forefront of reporting on pivotal legal developments. Her expertise includes covering cases related to the Supreme Court's expert admissibility ruling in Daubert v. Merrell Dow Pharmaceuticals Inc., a critical area in both civil and criminal litigation concerning the challenges of 'junk science' testimony.
Kristin's work primarily involves reporting on a diverse range of legal subjects, with particular emphasis on cases in asbestos litigation, insurance, personal injury, antitrust, mortgage lending, and testimony issues in conviction cases. Her contributions as a journalist have been instrumental in providing in-depth, informed analysis on the evolving landscape of these complex legal areas. Her ability to dissect and communicate intricate legal proceedings and rulings makes her a valuable resource in the legal journalism field.
