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Appendectomy Hypoxia Wrongful Death Lawsuit

Downer v. Greenbelt Endoscopy Center

IntubationThis intubation error wrongful death claim was filed in Prince George's County after a woman was not properly ventilated during a simple surgery to treat her appendicitis. It was filed in Health Claims Arbitration on March 16, 2018, and it is the 130th medical malpractice case filed in Maryland this year.

Summary Of Plaintiff's Allegations

A 48-year-old woman presented to the emergency department of Doctors Community Hospital with a two-day history of worsening abdominal pain, nausea, vomiting, diarrhea, and painful urination. A CT scan showed that she had a burst appendix. The woman was suffering from appendicitis, an extremely common condition with a simple surgical solution. Unfortunately, the woman's physicians did not take her specific anatomy into consideration before beginning surgery.

Due to the women's obesity, short neck, and full stomach, the standards of medical care required her physicians to perform an assessment of her airway before attempting to intubate her. The physicians and anesthesiology team never performed an airway assessment, and they did not have the necessary equipment on standby in case of a difficult airway.

Inevitably, the anesthesiologist experienced difficulty intubating the woman and asked for a GlideScope which was not in the operating room. While waiting for a GlideScope to be delivered, physicians did not ventilate her properly and the woman's heart rate dropped. By the time the GlideScope arrived and the woman was intubated successfully, she was still not ventilated properly and her oxygen saturation levels continued to drop.

The woman went into cardiac arrest and a code was belatedly called. She was in arrest for at least eleven minutes, during which time her brain was deprived of oxygen and she suffered a devastating brain injury. After the woman regained normal sinus rhythm, her physicians noticed that her endotracheal tube cuff had a leak. Anesthesiologists attempted to exchange the tube with a new one, but mistakenly intubated her esophagus rather than her trachea, delivering oxygen to her stomach instead of her lungs.

After suffering an additional cardiac arrest, another code was called and the woman sustained additional brain damage. The woman was transferred to a specialty hospital for higher care and then transferred to a nursing home. Nearly two years after the tragic event, the woman died as a result of her brain damage.

Additional Comments
  • According to the claimant's expert witness, an anesthesiologist, the defendant physicians made four critical errors. Before the surgery began, the physicians should have taken two important precautions: performing an airway assessment and having emergency equipment on standby in the operating room. Because the physicians did not take these precautions, they had no way of knowing how resilient their patient would be to anesthesia and they had no tools to prevent further damage in an emergency situation.
  • After the woman's airway became difficult, the plaintiffs' malpractice lawyers are alleging the physicians made two more mistakes: failing to provide the woman with adequate oxygen using a laryngeal mask airway and failing to continuously monitor and protect her airway. As a result of these additional mistakes, the situation morphed from a momentarily difficult airway to hypoxia and fatal brain damage.
  • Prince George's County
  • Louis Ralph Turano, III, M.D.
  • Greenbelt Endoscopy Center, LLC
  • Doctors Hospital, Inc. d/b/a Doctors Community Hospital
Hospitals Where Patient was Treated
  • Doctors Community Hospital
  • Failing to carefully diagnose the woman's condition using adequate diagnostic tests and procedures.
  • Failing to continuously evaluate the woman's condition and the effects of treatment, adjusting the course of treatment in response to such ongoing evaluation.
  • Failing to properly monitor the claimant and her condition.
  • Failing to employ the proper treatments and procedures.
  • Failing to have a GlideScope available in the operating room, or appropriately use a laryngeal mask airway in the meantime.
Specific Counts Pled Plaintiff's Experts and Areas of Specialty
  • Charise Petrovich, M.D., anesthesiologist
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