Delay in surgery for acute appendicitis due to low potassium. (Case #297)

• Medical Probability: 6 / 10
• Medical Error Summary: The fact that the surgeon allowed potassium replacement to proceed before operating suggests it was not an emergency surgery. The surgeon should have pressed upon the anesthesiologist about the case's...
• Causation Probability: 6 / 10
• Causation Summary: Delay in treating acute appendicitis can lead to rupture and the resulting additional injuries. Delays in receiving care by everyone involved likely contributed to the outcome. The patient probably ha...
• Expert Summary: I am an anesthesiologist who has worked in academic and community environments taking care of trauma and acute care surgical patients for over five years. This is a very typical patient I see.
• Similar Summary: I encounter acute appendicitis requiring operative management quite often in my practice. I don't recall delaying a case of appendicitis (regardless of the patient's condition).

Permanent hemidiaphragm paralysis after interscalene block (Case #344)

• Medical Probability: 6 / 10
• Medical Error Summary: Transient phrenic nerve palsy is associated with nearly 100% of interscalene blocks. However, with this patient, their palsy persisted long after surgery. This is an exceptionally rare complication, w...
• Causation Probability: 6 / 10
• Causation Summary: Phrenic nerve palsy can result in a 20-25% reduction in the forced vital capacity of the lung on the affected side. In a patient with COPD, OSA and obesity, this may be enough to reduce the effectiven...
• Expert Summary: I am a board-certified fellowship-trained regional anesthesiologist who has performed several thousand nerve blocks. I am a board examiner and sit on the board of a pain medicine society.
• Similar Summary: I routinely take care of patients such as the one described.

56yo has rotor cuff repair, initial supraclavicular block and second rescue block. Develops pneumothorax. (Case #414)

• Medical Probability: 6 / 10
• Medical Error Summary: Based on the information provided: Supraclavicular Brachial Plexus Block: The initial block was performed under ultrasound guidance, which is considered standard practice to reduce complications an...
• Causation Probability: 6 / 10
• Causation Summary: In this case, establishing a direct causation between a potential medical error and the injury (pneumothorax) requires careful consideration of several factors: Pneumothorax Risk: The supraclavicul...
• Expert Summary: As an experienced fellowship-trained regional anesthesiologist with extensive clinical and advisory experience in pain management and anesthesia, I comprehensively understand the complexities associat...
• Similar Summary: I have seen this complication once, and it was identified and managed before the patient was discharged.

Failure to secure IV, monitor, and assess patient in prone position on OR table. (Case #432)

• Medical Probability: 8 / 10
• Medical Error Summary: I contend that several factors contributed to this unfortunate event, which I believe constitutes a failure of the standard of care expected in such procedures. Specifically: Inadequate Anesthesia:...
• Causation Probability: 7 / 10
• Causation Summary: Yes, there appears to be a direct causation between the medical error and the injury. Several key factors suggest that the medical error led to the patient’s injury: Failure to Administer Prop...
• Expert Summary: As an expert, I possess a background in clinical practice and medical leadership, which enables me to offer insight into the technical and systemic aspects of this case. Here are the key factors that ...
• Similar Summary: As an anesthesiologist and pain physician, I regularly encounter situations where patient safety, anesthesia management, and positioning during surgery are critical. While I do not encounter cases ide...

66 year old women with significant comorbidities including prior heart infarct and lung process, dies during non-emergent exploratory laparoscopy for bowel obstruction. (Case #445)

• Medical Probability: 5 / 10
• Medical Error Summary: Despite having roughly 36 hours before an “urgent-but-not-emergent” laparoscopy, they skipped the minimum cardiac and pulmonary checks that current ASA and ACC/AHA guidelines require once a patien...
• Causation Probability: 8 / 10
• Causation Summary: The most plausible immediate cause of death was a massive CO₂ gas embolism that occurred the moment the Veress needle was used; that event is fundamentally surgical and can be lethal even in optimal...
• Expert Summary: Here’s why I’m a strong fit to serve as an expert on this anesthesia-related wrongful-death case: Board-certified anesthesiologist and ABA examiner. I hold an active, unrestricted ABA certifica...
• Similar Summary: In my current clinical mix, I provide anesthesia for a broad spectrum of inpatient general-surgery cases, many of them urgent “exploratory laparoscopy or laparotomy for bowel obstruction” in ASA I...