Courts, Justice, Lawyering

Surgery Fires

Submitted By Mark Esposito, Guest Blogger

As if anxiety over the common risks of surgery weren’t enough, a strange story from Florida points up the dangers of flash fires during routine procedures.  Kim Grice entered North Okaloosa Medical Center Outpatient Surgery Center  in Crestview, Fla. for simple surgery to remove cystic growths from her scalp. After about two hours of surgery, an ambulance pulled up to the clinic and emergency personnel rushed past Grice’s mother, Ann, to transport her 29-year-old daughter to the South Alabama Medical Center due to severe facial burns.

“I am in shock,” Ann Grice said. “This is not what happens with a routine outpatient surgery. She had headaches and the doctor was going to remove three cysts and biopsy them. But something went bad wrong and my daughter is now in a burn unit with burn specialists and I still don’t know what happened. No one will tell me why or how this happened to her.”

Health care experts estimate that 650 flash fires occur in operating rooms around the country every year.  Most patients are left with some scaring and smoke inhalation injuries, but some patients die.

Dr. David Cowles attributes the rise in this type of incident to a “trifecta” of circumstances. Oxygen, alcohol prep, and ignition sources like electro-cautery devices and lasers can combine to produce the disastrous results. The FDA has launched an initiative to prevent surgical fires which the government agency deems highly preventable.

As for Kim Grice, she is less concerned now about what happened than seeing her kids. “I am so ready to see my babies,” she told the local newspaper in a telephone interview Thursday from the South Alabama Medical Center’s burn unit. “But I don’t want them to see me this way.”

Kim may never know exactly what happened as some hospitals can make the legendary silence of the police about police negligence look positively gabby, but the law won’t protect the surgeons or the hospital. Under the common law of most states, prevailing  tort principles won’t tolerate a conspiracy of silence in cases like this.  Kim will likely be able to prove her case  under the doctrine of res ipsa loquitur.

The common law doctrine as applied here allows the jury to infer medical negligence even though a patient is unable to present evidence of just what occurred while under sedation. In Ybarra v. Spangard, 93 Cal.App2d 43 (1949), a patient undergoing an appendectomy  experienced arm and shoulder complications as a result of the surgery, but it could not be determined exactly which member of the surgical team had breached his or her duty. The Court held that the surgical team all breached, because it was certain that at least one of them was the only person who was in exclusive control of the instrumentality of harm. The doctrine only applies when the harm could not have occurred but for the negligence  of someone in the OR.  The Plaintiff must still prove that injury resulted and that the negligence complained of was the legal (lawyers would say the “proximate”) cause of the injury.

Source: msnbc

Mark Esposito, Guest Blogger

5 thoughts on “Surgery Fires”

  1. It seems to me that the doctors and hospitals are blowing it, for all their complaining about malpractice insurance. The patient is only entitled to halfway decent care; the standard of care in place at the time.
    These standards should be written down ahead of time, not argued about afterwards. No doubt the standards would be outrageous, as they would place all the risk on the patient (if I puncture your small intestine, I will immediately stop. Best of luck.)

    There is a movement in medicine to use checklists. Perhaps the two efforts could be combined, or are the same.

    In addition, all surgery should be videotaped. So we don’t have to say “she may never know exactly what happened….”

  2. 650 per year!

    I must say that’s a horrifying number I would have never suspected. If you’d asked me cold to guess a number, I wouldn’t have gone above 10 or 15. Being that an operating theater has live oxygen lines, I’d think that containing possible ignition sources would be of primary concern in both design and facilities management.

  4. This is a horrifying tale, yet one played out frequently enough to cause concern. Errors by medical personnel happen all the time. While recovering from my heart transplant an intern improperly inserted a “Pick Line” into a main artery in my neck to ensure the could quickly introduce needed medication in case of an emergency. This caused clots that traveled to my lungs and necessitated emergency lung surgery to save my life. Was this a act of negligence I doubt it, inexperience perhaps, by a practitioner that was definitely trying to do a good job.

    However, in this instance, this woman appears to have permanent damage, that may require future surgery. What are the damages and who should pay? This is why we have a legal system because answers to these questions are difficult for entities and individuals to resolve on their own. The common-law concept of equity must somehow be an integral part of tort law because sometimes people become victims, without a “victimizer”.
    “Deep pockets” judgments aren’t necessarily bad.

Comments are closed.