Hemorrhage

Abstract

  1. Kutteruf, R.E., Stephens, L., Posner, K.L., Domino, K.B., Wells, D., Lee, L.: Injury and liability associated with spine surgery. Anesthesiology, A2159, 2015.  |  Subjects: Hemorrhage, Postoperative Visual Loss, Professional Liability Related, General Anesthesia, Eye Injury, Nerve Injury, Quality of Care  |  PDF icon click here for pdf.pdf
  2. Lee LA, Dutton RP, Posner KL, Stephens LS, Domino KB: Massive Hemorrhage: A Report from the Closed Claims Project. Anesthesiology, A3002, 2013  |  Subjects: Hemorrhage, Cardiovascular System Damaging Events  |  PDF icon Click here for.pdf

Journal Article

  1. Dutton, R.P., Lee, L.A., Stephens, L.S., Posner, K.L., Davies, J.M., Domino, K.B.: Massive Hemorrhage: A report from the Anesthesia Closed Claims Project. Anesthesiology 121:450-8, 2014.  |  NLM PubMed Link  |  Subjects: Hemorrhage, Quality of Care
    This article reviews factors related to massive hemorrhage in surgical and obstetric patients. The authors reviewed closed anesthesia malpractice claims from 1995 to 2011 from the Anesthesia Closed Claims Project. Hemorrhage claims were compared to all other surgical and obstetric claims to identify recurrent patterns and medicolegal consequences. Although massive hemorrhage claims are a small proportion of surgical and obstetric claims (4%), a high percentage resulted in death or permanent injury. Compared to non-hemorrhage claims, obstetrics and thoracic or lumbar spine surgery were overrepresented, mortality was higher, care was more often judged less than appropriate, and claim payments were higher. Common risk factors and clinical problems were identified, including poor team communication, and lack of timely diagnosis, transfusion, and re-operation.
  2. Coté CJ, Posner KL, Domino KB.: Death or Neurologic Injury After Tonsillectomy in Children with a Focus on Obstructive Sleep Apnea: Houston, We Have a Problem! Anesth & Analg 2014 June; 118(6), 1276-83  |  NLM PubMed Link  |  Subjects: Hemorrhage, Obstructive Sleep Apnea, Respiratory System Damaging Events, Pediatrics
    This article reviews factors related to adverse events occurring during or after tonsillectomy with a focus on obstructive sleep apnea (OSA). Cases were submitted via a survey to members of the Society for Pediatric Anesthesia and review of the Anesthesia Closed Claims Project. Death or permanent neurological injury occurred in 77% of reported cases. Events occurred across the care spectrum from surgery to post-release at home. Fifty-seven percent of the children fulfilled the at risk criteria for OSA. At risk children were more likely to be obese and have co-morbidities. These are of particular concern in association with reported opioid sensitivity in children with OSA. Obesity, a history of OSA, and the use of postoperative opioids increase the risk of postoperative respiratory events. Better evaluation of these risk factors must occur, postoperative follow-up and monitoring with at risk children must be in place, and some children are not candidates for out-patient tonsillectomy.

Closed Claims Bibliography

To access a complete bibliography of peer-reviewed journal articles from the Closed Claims Project, click here; Closed Claims Project Bibliography . You may also request delivery of the bibliography via e-mail, fax or postal mail.

Note to Patients

These studies are primarily designed to aid physicians in improving their clinical practice. We are sorry we cannot address individual patient questions or give medical or legal advice or provide data analysis.