Man died while anesthesiologist was called to handle two different patients – $3.5 Million Verdict

This case involved the wrongful death of a 32-year-old man who was survived by his mother and adult brother. The individual anesthesiologist was nonsuited and the case proceeded to trial against his employer at the time of the events, Sheridan Anesthesia Services of Virginia Inc. The anesthesiologist was called to testify at trial during plaintiff’s case in chief as an adverse witness.

The events occurred in 2014 when the decedent presented to the ER with a dental infection, which had caused cellulitis of the soft tissues of the mouth, the cheek, the neck, and the epiglottis. He was admitted for treatment of the infection with antibiotics and steroids and also to monitor his airway because it was at risk of occluding. A CT scan demonstrated edema of the soft tissues as well as some mass effect on the airway without occlusion at that time. On day two of admission it was decided to discontinue the steroids because of the thought that it was masking the infection. At the time that decision was made, the patient’s condition had improved, and he was moved from the ICU to the step down unit.

A few minutes before 5 a.m. on day 3, the hospitalist on duty received a telephone call from the nurse regarding the patient and during the call the hospitalist could hear the patient gurgling in the background which was concerning to her. When she arrived at the patient’s room, the patient had increased secretions, was unable to speak, tripoding, and on exam had stridor and decreased breath sounds.  Because the hospitalist knew this would be a difficult intubation because of all of the swelling, she called the anesthesiologist in the hospital to come intubate the patient. At the time, he was the sole anesthesiologist on duty, but had call responsibilities for all patients in the hospital who needed anesthesia services, including emergent intubations. During the first call from the hospitalist, the anesthesiologist informed the hospitalist that he was unable to come intubate the patient at that time and that he was getting ready to take a patient to the OR for a D&C due to bleeding and a spontaneous early abortion. Although the defense argued the D&C patient was an emergency, she had stable vitals with some drop in her hematocrit and hemoglobin levels that were still within normal limits and never required her to have a transfusion. At the time of that first call, the anesthesiologist had not administered any drugs to the D&C patient.

The call ended and within a minute, the patient seized due to respiratory distress. The Medical Response Team was called and the hospitalist placed a second call to the anesthesiologist when a Code Blue was called. During this second call, the hospitalist told the anesthesiologist that the Code Blue patient she had called about a few minutes before that needed intubation and that he needed an emergent airway now. The anesthesiologist stated that he was now in the OR with the D&C patient and could not come to intubate. He told the hospitalist to call the emergency department for help instead. The records of the D&C patient showed that just prior to the second call, the anesthesiologist had administered 2mg of Versed to relax the D&C patient but had not yet administered any anesthesia.

The hospitalist, who had limited experience in intubations, was left to handle the code. She made several attempts to intubate the patient and after approximately eight minutes, she successfully placed the tube, but it was unclear whether or not the endotracheal tube was in the trachea or the esophagus. The emergency room physician arrived and attempted to confirm proper placement of the ET, but because of all of the swelling he could not visualize the vocal cords and he had reading of 0 on capnography, no color change on ETCO2 spectrometry, and was unable to confirm proper placement with a video laryngoscope. The code was ended and the patient was pronounced dead.

Plaintiff called one standard of care expert who opined that there were three deviations from the standard of care: (1) Failure to call in the on-call CRNA as back-up at approximately 3:45 a.m.  when the anesthesiologist was first made aware that the D&C patient would be going to the OR around 5:00 a.m; (2) Failure to come to patient’s bedside to intubate at the time of the first call from the hospitalist; and (3) Failure to come to patient’s bedside to intubate at the time of the second call. Plaintiff’s expert and defendant’s expert both testified that the dose of Versed the anesthesiologist had given at that time did not require the anesthesiologist to stay with the D&C patient and that she could have been left in the care of the surgeon and PACU nurses.

The defense argued that there was no physician-patient relationship between the anesthesiologist and the patient so there were no standard of care violations. The defense argued that the anesthesiologist had a physician-patient relationship with the D&C patient and that is who he owed a duty too. They also argued that even if the anesthesiologist did owe a duty to the hospitalist’s patient, he was not required to go intubate the patient because he did not know it was emergent.

The defense also contested causation. First, the defense argued that the hospitalist had successfully placed the endotracheal tube which failed to revive the patient so whether or not the anesthesiologist came made no difference in the patient’s outcome. Second, the defense argued that due to the condition of the patient at the time of the calls and the difficulty of his airway, even a skilled anesthesiologist would not have been able to successfully intubate the patient in time to save him.

The beneficiaries were a great family and the loss of their son and brother was palpable. Plaintiff called her treating psychologist to teach the jury about complicated grief and its effects like depression, anxiety, and sleep deprivation.

[18-T-131]

Type of action: Wrongful Death/Medical Malpractice

Injuries alleged: Death

Name of case: Sheila Wilson, as Administrator of the Estate of Matthew Lee Wilson v. Sheridan Anesthesia Services of Virginia, Inc.

Court: Prince William County Circuit Court

Case no.: CL15-3841

Tried before: Jury

Name of judge or mediator: Judge Carroll Weimer

Amount: $3,500,000.00 ($2,500,000 to mother and $1,000,000 to brother)

Attorneys for plaintiff: Charles J. Zauzig, Melissa G. Ray, and Jill M. McCann, Woodbridge