Anesthesia Malpractice Lawsuit in Montgomery County

This is an anesthesia malpractice lawsuit filed in Rockville, Maryland after a man receives anesthesia before surgery, despite his medical history. It was filed on February 16, 2017, in Maryland Health Claims Arbitration. It is the 82^nd Maryland malpractice case filed in 2017.

A man arrives at the emergency room of Shady Grove Adventist Hospital with right groin pain for two days. He has a history of hypertension, confirmed by the ER staff that day. They also document that he has high cholesterol, water retention, and bilateral leg swelling. The hospital staff categorizes him as not being about to eat or drink, in case they have to perform surgery.

The hospital does an ultrasound to rule out deep vein thrombosis. The ultrasound does not reveal that, but it does show evidence of an incarcerated right inguinal hernia. A CT scan confirms this. The same day, the doctors decide surgery is necessary. Defendant doctor performs a pre-anesthesia evaluation. He deems the man to be in satisfactory condition for anesthesia. This decision is made despite his history of hypertension, that he was hypovolemic, was not able to eat or drink, and that the surgery would be long. Plaintiff's lawyers also allege that an IV drop that was large enough to administer an adequate amount of fluids in case of a drop in blood pressure should have been in place.

After the anesthesia is administered, the man's blood pressure drops almost 50%. Accordingly, the standard of care requires the doctors to reduce the concentration of the anesthetic agent and to administer additional IV fluids and pressor agents. The man's blood pressure slowly climbs back up, and the surgery is complete in about an hour. He is transferred to the PACU.

When the man's son visits him after the surgery, he observes that his father is not acting like himself. He has slurred speech, trouble forming sentences, and is hallucinating. After a few days, the cognitive condition of the man is not improving. He develops physical limits, including difficulties balancing and the inability to walk without assistance. He is discharged to a rehabilitation facility.

After the surgery, the man is diagnosed with gait apraxia (also called bruns apraxia or frontal ataxia). This is a cognitive mobility disturbance. His cognitive and physical functions declined, which led to an increase in his need for care. He alleges that if the defendants had acted properly, he would not have suffered permanent and irreparable brain damage.

• One critical question in this claim is going to be how tight the brain injury case is on causation and the extent and scope of that injury. If the man needs ongoing care as a result of a brain injury that can be linked to medical malpractice, this could be a significant damages case. But the complaint does not explain the mechanism of injury or how the damage is linked back to the alleged malpractice. There is a lot of smoke. But the question is specifically what fire most likely caused the injury? Was it that he should never have gone to surgery in the first place or was it the failure to properly react to the patient's changing condition? The expert report will give the answer.
• This case is another Maryland medical malpractice case filed on the eve of the statute of limitations.

• Montgomery County

• Adventist Healthcare, Shady Grove Adventist Hospital
• First Colonies Anesthesia Associates, LLC
• Edward Chen, M.D.

• Shady Grove Adventist Hospital

• Failure to conduct appropriate and timely examinations and to recognize the plaintiff's serious medical condition
• Failure to appropriately react to symptoms, signs, and findings illustrative of plaintiff's true condition
• Failure to take appropriate precautions in monitoring and treating plaintiff
• Failure to react to the positive history, symptoms, signs, physical findings, and other data illustrative of plaintiff's condition
• Failure to properly recognize that plaintiff was at risk for significant or prolonged drop in blood pressure during surgery
• Failure to recognize plaintiff's hypovolemic status before surgery
• Failure to properly evaluate plaintiff for appropriate anesthesia related needs before surgery
• Failure to administer IV fluids before surgery
• Failure to intraoperatively lower the anesthetic concentration when appropriate

• Medical Negligence
• Informed Consent

• None at this time

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