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The Risk Management Newsletter for Anesthesia Practices

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Issue Date Summary
Issue 53 October 2022

Recent Cases Highlighted: PPM Returns to the Courtroom Following Pandemic Pause

  • Combatting Prolific Plaintiffs’ Expert Testimony Against PPM’s Insureds
  • “Never Events” Not Always Cases of Liability
Issue 52 April 2022

A Patient’s Right to Refuse Medical Treatment

  • Case Studies & Analyses
  • Risk Management Strategies and Considerations for Patients Who Refuse Medical Treatment
Issue 51 November 2021

Wrong-Site Nerve Blocks: Getting Them Right

  • Case Studies
  • Risk Management Considerations, Strategies, and Resources to Prevent Wrong-Site Nerve Blocks
  • Underwriter’s Spotlight - Changing Places, Practices, Names, Email Addresses, etc.? Let Us Know
Issue 50 April 2021

Adverse Anesthesia Events: Did COVID-19 Change Anything?

  • Effective Preoperative Evaluation and Communication Critical to Prevent Aspiration
  • Top 5 Adverse Anesthesia Events Reported to PPM in 2020
  • Risk Management Analyses and Considerations
Issue 49 August 2020

Effective Preoperative Evaluation and Communication Critical to Prevent Aspiration

  • Case Studies
  • Risk Management Analyses and Strategies
Issue 48 August 2019

Cardiopulmonary Sentinel Events During ERCP: Oversedation or Air Embolism?

  • PPM Policyholder’s Perseverance Prevails After Sixteen Years of Litigation
  • Underwriter’s Spotlight – Treating Yourself, Family or Friends? Just Say No
Issue 47 March 2019

Some Things Never Change: Updated Dental Claims Guidelines

  • Identifying Patient Risk Factors
  • Avoiding Iatrogenic Causes of Dental Injury
  • Preanesthesia Evaluation and Documentation
  • Informed Consent
  • After a Dental Injury Occurs
  • Options for Handling Dental Claims
  • Case Studies and Risk Management Analysis
Issue 46 August 2018

“That Was Left Where?”

  • Preventing Retained Foreign Object Anesthesia Claims
  • Risk Management Strategies to Prevent Retained Guidewires
  • Other Retained Foreign Object Claims
Issue 45 March 2018

Catch Me If You Can: Patient Falls in the Anesthesia Workplace

  • Defending Patient Falls Litigation
  • PPM Secures 44th Consecutive Upper Extremity Nerve Damage Verdict
  • Underwriter’s Spotlight - PPM Cyber Liability Insurance Coverage Limits Increased
Issue 44 May 2017

Medication Errors: Intrathecal Injection of Tranexamic Acid and Other Mix-Ups

  • Defending Medication Errors Litigation
  • APSF Medication Safety Strategies
Issue 43 August 2016 Recent Cases Highlighted
  • No Good Deed Goes Unpunished: Iowa Anesthesiologist Defends Care through Two Trials
  • Cauda Equina Syndrome: Georgia Defense Verdict
  • Brain Damage: Colorado Defense Verdict
  • Surveillance Evidence Helps Secure Unanimous Defense Verdict
  • PPM Earns “A” Rating from A.M. Best
Issue 42 January 2016 Catastrophic Complications During Endoscopy
  • Risk Management Tips for Preventing Injury During Endoscopy with Deep Sedation
  • Underwriter’s Spotlight -- The Dark Side of the Moon: Moonlighting may increase anesthesia practice group’s liability exposure
Issue 41 October 2015 Placement of Gastric Calibration Tubes Inflates Anesthesiologists’ Liability Exposure
  • Risk Management Tips for Preventing Injury from Calibration Tube Placement
  • Underwriter’s Spotlight: Ethical and legal guidelines for treatment of non-patients or self-treatment
Issue 40 December 2014 Emerging Trends in Anesthesia: Cyber Liability
  • PPM Cyber Liability (eMD™) Insurance
  • PPM’s Risk Management Seminars Certified for CME
  • Underwriter’s Spotlight
Issue 39 August 2014 Asleep at the Wheel? Distractions in the Operating Room
  • Case Study
  • Underwriter's Spotlight
Issue 38 April 2014 Recent Cases Highlighted
  • PPM Secures 43rd Consecutive Defense Verdict in Upper Extremity Nerve Damage Litigation
  • Cardiac Arrest: Arizona Defense Verdict
  • Cardiac Arrest Following Colonoscopy: New Jersey Defense Verdict
  • PPM’s Risk Management Highlights Anesthesia Expertise
Issue 37 October 2013 Securing Narcotics: Standard of Care Evolves in Wake of Hepatitis C Outbreaks
  • Expert Testimony Suggests a Heightened Standard of Care for Securing Controlled Substances and Medications Likely to be Diverted
  • Risk Management Tips
Issue 36 April 2013 APSF Workshop Provides POVL Update and Recommendations
  • ASPF POVL Conference Highlights
  • Introduction to POVL by an Anesthesiologist Who Experienced It
  • APSF-Sponsored Conference on Perioperative Visual Loss Develops
    Consensus Conclusions
Issue 35 December 2012 Recent Cases Highlighted
  • Wrongful Death: Missouri Defense Verdict
  • IV Infiltration: Iowa Defense Verdict
  • Pain Management: Florida Defense Verdict
  • Nerve Damage: New York Defense Verdict
Issue 34 July 2012 Student Training Programs May Pose Significant Liability Exposures to Anesthesiologists
  • Risk Management Tips
  • Liability Exposure from Contractual Provisions in Training Agreements
  • Contract Review Tips
Issue 33 April 2012 No Day at the Beach: Catastrophic Injuries in Head-up Position Surgeries
  • Expert Witness Testimony Peer Review Programs
  • Risk Management Tips to Prevent Ischemic Injury in Beach Chair Position
Issue 32 November 2011 Drug-Induced Respiratory Depression in the Postoperative Period
  • APSF Conference Highlights
  • Defending Drug-Induced Respiratory Depression Litigation
  • APSF Essential Monitoring Strategies to Detect Clinically Significant Drug-Induced Respiratory Depression in the Postoperative Period
Issue 31 August 2011 New ASA Standard for Basic Anesthesia Monitoring
  • Coverage Alert: PPM Compliance Period Extended
  • PPM Medical Board Investigation Defense Expense Coverage
Issue 30 April 2011 Obstructive Sleep Apnea: The Not-So-Silent Killer
  • Risk Management Tips
  • Defending Obstructive Sleep apnea Litigation
  • PPM Earns A- Rating from A.M. Best
Issue 29 January 2011 Recent Cases Highlighted
  • Wrongful Death:  Arizona Defense Verdict
  • Nerve Damage:  Georgia Defense Verdict
  • Cardiac Arrest:  New York Defense Verdict
  • Nerve Damage:  New York Defense Verdict
  • Cardiac Arrest:  Rhode Island Defense Verdict
Issue 28 November 2010 Nerve Damage from Regional Blocks Placed in Anesthetized/Sedated Patients
  • Informed Consent
  • Supplemental Informed Consent for Regional Blocks placed during General Anesthesia
Issue 27 July 2010 Propofol Shortage Continues to Create Patient Safety Concerns and Risks for Anesthesiologists
  • Causes of Shortage
  • FDA’s Response to the Propofol Shortage
  • Implications for Patient Care
  • Rationing and Alternative Agents
  • $500 Million Jury Verdict Awarded Against Propofol Manufacturer and Distributor
Issue 26 April 2010 Risk Management Tips for Prevention and Management of Intra-operative Fires
  • The Fire Triad
  • Identifying High-Risk Procedures
  • Preventing Intra-operative Fires
  • Management of Intra-operative Fires
  • Defending Intra-operative Fires in the Courtroom
  • Conclusion
Issue 25 December 2009 Recent Cases Highlighted
  • Wrongful Death: New Jersey Defense Verdict
  • Brain Damage: Iowa PPM Policyholders Dismissed During Trial
  • Wrongful Death: PPM Policyholder Dismissed During Missouri Trial
  • Dental Injury: Rare Dental New Jersey Trial Results in Defense Verdict
  • Nerve Injury: New York Jury Returns Defense Verdict
  • Wrongful Death: New York Defense Verdict
Issue 24 November 2009 The Needle and the Damage Done: Anesthesia Workplace Addiction
  • Defending the Addicted Anesthesiologist
  • Defending Substance Abuse in the Courtroom
  • Identifying the Addicted Anesthesiologist
  • Legal Issues
  • Drug Testing
  • Zero Tolerance vs Impaired Physician Policies
Issue 23 June 2009 Defending the #1 Anesthesia Claim: Dental
  • Options of Handling Dental Claims
  • Defending Dental Injury Lawsuits
Issue 22 March 2009 Wrong Site Surgery Update: 2009 Universal Protocol Moves in Right Direction
  • Changes to Universal Protocol
  • Overview of 2009 Universal Protocol
  • Problems with the 2009 Universal Protocol
  • Risk Management Tips to Prevent Wrong Site Surgical Mistakes
Issue 21 December 2008 Recent Cases Highlighted
  • PPM’s Aggressive Strategy Leads to 38th Consecutive Defense Verdict in Upper Extremity Nerve Damage Litigation
  • Wrongful Death: Missouri Defense Verdict
  • Compartment Syndrome: Texas Defense Verdict
  • Wrongful Death: Arizona Defense Verdict
Issue 20 August 2008 Awareness: How Often Does It Really Happen
  • Defending Awareness Cases in the Courtroom
  • Brain Function Monitors
  • ASA Task Force Concludes Brain Function Monitors are not Standard of Care
  • Risk Management Analysis
Issue 19 May 2008 Expert Witness: To Be or Not To Be
  • Expert Witness Testimony Peer Review Programs Reduce Questionable Testimony
  • Most Prolific Plaintiff’s Experts
  • In the News: Nevada Hepatitis Scare Focuses on Anesthesia Techniques
Issue 18 January 2008 Wrong Site Surgery: Universal Protocol Misses the Mark
  • Problems with the Universal Protocol
  • Common Mistakes
  • Risk Management Tips to Prevent Wrong Site Surgical Mistakes
Issue 17 September 2007 Recent Cases Highlighted
  • Pain Management: Texas Defense Verdict in Overdose Case
  • Nerve Damage: Nevada Defense Verdict
  • Pain Management: Texas Defense Verdict Handed Down
  • Risk Management Analysis
Issue 16 December 2006 Informed Consent
  • Informed Consent: The Verdict Is In
  • Defense Verdict: New York Jury Finds in Favor of Pain Management Specialist
  • Implementing an Effective Anesthesia Consent Form
Issue 15 March 2005 Recent Cases Highlighted
  • Wrongful Death Case: New York Defense Verdict
  • Ulnar Nerve Damage: Kentucky Defense Verdict
  • Intubation Injury: Missouri Defense Verdict
  • Wrongful Death: Texas Defense Verdict
  • Dental Injury: Rare Dental Trial Results in Defense Verdict
Issue 14 March 2004 Risk Management for Postoperative Vision Loss
  • ASA Postoperative Visual Loss Registry: Preliminary Analysis of Factors Associated with Spine Operations
  • POVL: Michigan Defense Verdict
  • PPM Aggressively Pursues Recovery of Costs
Issue 13 June 2003 Recent Cases Highlighted
  • Radial Nerve Damage: Arizona Defense Verdict
  • Editorial: Expert Witnesses
  • Brain Damage and Death: Cook County, Illinois Defense Verdict
  • Brain Damaged Baby: Kentucky Defense Verdict
  • Risk Management
Issue 12 July 2002 Preventable Anesthesia Malpractice Claims
  • Nerve Damage from Regional Blocks placed under General Anesthesia
  • Misuse of Forced-Air Warming Equipment Leads to Avoidable Injury
  • Wrong-Sited Surgery and Patient Mix-ups
  • Burns from Warmed IV Bags
  • Intra-operative Fires
Issue 11 July 2001 Surgical Mix-Ups and Wrong-Sited Surgeries
  • Risk Management Tips to Prevent Patient Mix-ups and Misidentification of Surgical Sites
Issue 10 April 2001 Recent Cases Highlighted
  • Arizona Defense Verdict in Death Case
  • Defense Verdict in Florida Death Case
  • Illinois Jury Returns Verdict Against Co-Defendants
  • Texas Defense Verdict in Videotaped Awareness Case
Issue 9 August 2000 Recent Cases Highlighted
  • Pneumothorax: Florida Jury Rejects Stress Induced Recurrence of Cancer
  • Pulmonary Damage: Defense Verdict in West Virginia
  • Cervical Injury: New York Court Grants Motion to Dismiss During Trial
Issue 8 December 1999 Patient Safety – A Y2K Reminder
  • Y2K Resources on the Web
Issue 7 April 1998 Burns: A Significant Source of Anesthesia Malpractice Claims
  • Intra-operative Fire: Connecticut Jury Finds Against Anesthesiologist
  • Credentialing: Reporting Your Claims History
Issue 6 August 1997 Pre-Operative Discussions should be included in Informed Consent Process
  • Eye Injury: Defense Verdict in Connecticut Peribulbar Block Case
  • Awareness: High on List of Anesthesia-related Injuries
  • Risk Management Analysis
Issue 5 January 1997 Recent Cases Highlighted
  • Ulnar Nerve Damage: New Hampshire Defense Verdict
  • Ulnar Nerve Damage: Defense Verdict in Missouri
  • Femoral Nerve Damage: Directed Verdict in Florida Case
  • Risk Management Seminars
Issue 4 October 1996 Nerve Damage Claims
  • Median Nerve Damage: West Virginia Defense Verdict Entered
  • Nerve Damage Claims are the Third Most Frequent Injury
  • Risk Management Analysis
Issue 3 July 1996 Top Ten Anesthesia Claims Analyzed
  • Dental Injury Leads List of Most Common Claims
  • Vision Loss after Peribulbar Block: Iowa Jury Returns Plaintiff’s Verdict
  • Risk Management Analysis
Issue 2 April 1996 Recent Cases Highlighted
  • Ulnar Nerve Injury: Connecticut Trial Court Enters Verdict
  • Epidural Hematoma: Texas Jury Returns Defense Verdict
  • Wrong-sided Surgery: Texas Jury Finds for Anesthesiologist
  • Pain Management: West Virginia Defense Verdict
Issue 1 October 1995 Inaugural Issue
  • Jury Returns Defense Verdict for Insured Anesthesiologist
  • Supervised Anesthesia Received Unfavorable Media Attention
  • Florida Jury Finds in Favor of Policyholder
  • Warmed IV Bags Continue to Result in Claim Settlements
  • Intraoperative Fires Lead to Allegations Against Anesthesiologists