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Abstract
Introduction
Medical professionals other than anesthesiologists at times administer sedation for procedures. The aim of this study is to identify the adverse events, and their root causes, resulting in medical malpractice litigation in the United States related to procedural sedation administration by non-anesthesiologists.
Methods
Cases containing the phrase “conscious sedation” were identified using Anylaw, an online national legal database. Cases were excluded if the primary allegation was not malpractice related to conscious sedation or the listing was a duplicate.
Results
Of the 92 cases identified, 25 remained after application of exclusion criteria. The procedure type most commonly involved was dental (56%), followed by gastrointestinal (28%). The remaining procedure types were urology, electrophysiology, otolaryngology, and magnetic resonance imaging (MRI).
Discussion
By reviewing malpractice case narratives and outcomes, this study offers insight and opportunities for practice improvement among non-anesthesiologists providing conscious sedation for procedures.
DATA AVAILABILITY
The data that support the findings of this study are publicly available in Anylaw at http://anylaw.com.
Notes
1 See generally American Society of Anesthesiologists, Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists, 96 Anesthesiology (Apr. 2002), at 1004-17.
2 Id. at 1005-6.
3 Nathan G. Reuter et al., Death Related to Dental Treatment: A Systematic Review, Oral Surg. Oral Med. Oral Pathol. Oral Radiol. (Feb. 2017), at 194-204.
4 Id.
5 See generally Thomas Benzoni & Marco Cascella, Procedural Sedation (StatPearls Publ’g 2022).
6 Helen H. Lee et al., Trends in Death Associated with Pediatric Dental Sedation and General Anesthesia, Pediatr. Anesth. (Aug. 2013), at 741-46.
7 Id.
8 J. Patrick Waring et al., Guidelines for Conscious Sedation and Monitoring During Gastrointestinal Endoscopy, 58 Gastroint. Endosc. 317, 317-22 (2003).
9 See generally Committee on Standards and Practice Parameters, Standards for Basic Anesthetic Monitoring, Am. Soc’y Anesthesiologists (Dec. 13, 2020), https://www.asahq.org/standards-and-guidelines/standards-for-basic-anesthetic-monitoring; see also ASGE Standards of Practice Committee, Guidelines for Sedation and Anesthesia in GI Endoscopy, 97 Gastroint. Endosc. 327 (2018); see also Guidelines for the Use of Sedation and General Anesthesia by Dentists, Am. Dental Ass’n (Oct. 2007), https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/publications/cdt/anesthesia_guidelines.pdf.
10 American Society of Anesthesiologists, Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology, Anesthesiology (Mar. 2018), at 437-79.
11 Guidelines for the Use of Sedation and General Anesthesia by Dentists, Am. Dental Ass’n (Oct. 2007), at 5-6, https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/publications/cdt/anesthesia_guidelines.pdf.
12 Waring et al., supra note 8.
13 American Society of Anesthesiologists, supra note 1.
14 American Society of Anesthesiologists, supra note 10.
15 Guidelines for the Use of Sedation and General Anesthesia by Dentists, supra note 11.
16 American Society of Anesthesiologists, supra note 1.
17 Waring et al., supra note 8.
18 American Society of Anesthesiologists, supra note 1.
19 Waring et al., supra note 8.
20 anylaw, https://www.anylaw.com (last visited January 10, 2023).
21 See generally Guidelines for the Use of Sedation and General Anesthesia by Dentists, supra note 11.
22 Id. at 7, 9.
23 American Society of Anesthesiologists, supra note 1.
24 Ruud Hortensius and Beatrice de Gelder, From Empathy to Apathy: The Bystander Effect Revisited, 27 Curr. Dir. Psych. Sci. 249, 249, 254 (2018).
25 B. Sonny Bal, An Introduction to Medical Malpractice in the United States, 467 U.S. Med. Malpract. 339 (2009).
26 Id.