Anaesthetic negligence claims

Anaesthetists are responsible for the patient’s oxygenation, level of consciousness and pain relief during surgery. Patients depend on anaesthetists to provide safe anaesthetic care in a range of healthcare settings and procedures. Anaesthetic negligence is any aspect of care by an anaesthetist which falls below safe and acceptable standards.

General anaesthetic allows surgery to take place whilst the anaesthetist keeps the patient relaxed and pain free in a state of controlled unconsciousness whilst keeping them oxygenated using a ventilator machine to manage their breathing. Local and regional anaesthetics numb specific areas of the body, leaving the patient conscious and pain free during their procedure.

The patient’s safety depends on the anaesthetist’s pre-operative assessment and management of their risk from anaesthesia; the correct administration of a combination of anaesthetic drugs; the anaesthetist’s skill during intubation, ventilation, and extubation; and vigilant monitoring of their condition throughout surgery.

Anaesthetic negligence can cause life-changing injury. Patients who are seriously injured as a result of negligent anaesthetic care may be entitled to make an anaesthetic negligence claim for compensation to provide the help and support that they need as a result of their disability.

Not all injuries during surgery or under anaesthetic are caused by negligence. Common claims for serious injury arising from negligent errors by anaesthetists include:

• brain damage caused by lack of oxygen:
• nerve damage, paralysis or spinal cord injury (SCI);
• PTSD from anaesthetic awareness - waking paralysed (from muscle relaxants) but unable to communicate whilst feeling intense pain during the operation;
• anaphylactic shock from severe allergic reaction to anaesthetic drugs;
• cardiac arrest (heart attack);
• stroke;
• organ damage from clinical shock;
• PVS or minimally aware state (coma);
• death.

Where a patient has suffered an injury during surgery or a general anaesthetic, our clinical negligence solicitors review the medical records to investigate whether their injury was caused by negligence or equipment failure, and if they are entitled to claim compensation.

The amount of compensation that an individual receives depends on the type of injury, its impact on their life and their additional needs arising from the injury.

Where the injury is severe, compensation may be recovered for:

• pain and suffering and disability;
• loss of earnings and pension and other financial losses;
• costs of care, assistance and case management;
• therapies, such as physiotherapy, occupational therapy (OT), speech and language therapy;
• private medical costs;
• rehabilitation, pain management and psychological treatments;
• adapted accommodation;
• assistive technology;
• specialist equipment, adapted vehicles;
• prostheses for limb loss, such as from anaphylaxis;

Where the patient’s death was caused by anaesthetic negligence, their dependent family may be able to claim compensation for funeral costs, a statutory bereavement payment and for the loss of the deceased’s income and services.

Where liability is admitted, we obtain early interim payments to ease our clients’ financial hardship and help meet their urgent needs arising from the injury. This means that while we work with our experts on valuing and preparing the case for settlement, our clients can begin to rebuild their lives.

It is part of the anaesthetist’s job to assess each patient’s personal risk before surgery. Many of the risks from having an anaesthetic cannot be predicted. It is not always possible to know how a patient who has never had an anaesthetic before will react to the anaesthetic drugs, so anaesthetists make their assessment based on general risks associated with having surgery under general anaesthetic and any additional risk arising from the patient’s own health, allergies, lifestyle, and type of surgery.

Patients having a general anaesthetic may have a higher risk of serious complications if they:

• are older;
• are having major surgery on organs, such as the heart, lungs, brain or bowel, or on major blood vessels;
• are having emergency surgery, or surgery for major trauma;
• are very unwell at the time of surgery or have other health conditions, such as diabetes, high blood pressure, heart disease, lung disease, liver disease, cancer;
• smoke or are overweight or very unfit;
• have allergies to medication.

The anaesthetist keeps the patient in a state of controlled unconsciousness during surgery. This is done by using anaesthetic which blocks the nerve signals to the brain, so the patient cannot feel anything during the operation.

As well as the anaesthetic, the patient is also given muscle relaxants to keep their body relaxed and still during surgery. The muscle relaxants leave the patient unable to breathe, so their breathing is managed via a ventilator machine, which provides oxygen to the patient through a tube.

The anaesthetist must monitor the patient throughout the operation, for example, to check their blood pressure, heart rate, respiratory rate and that the patient is receiving the correct amount of oxygen. They must be alert to warning signs of complications, including any sign that the patient is becoming conscious or feeling pain, or is losing too much blood and needs fluid, or is suffering from some other complication or reaction. If a warning sign appears, they must react quickly to correct the problem. In the case of a severe allergic (anaphylactic) reaction, this may mean stopping the operation.

After the surgery is complete, the anaesthetist is responsible for ensuring that the patient recovers consciousness and is able to breathe safely. They must monitor that the patient has come through the anaesthetic without any serious ill effects.

Anaesthetic errors which cause serious injury and lead to anaesthetic negligence claims for compensation include:

• risk assessment errors:
• negligent ventilation, oxygenation and airway management;
• intubation errors - incorrect procedure or placement of the endotracheal tube;
• extubation errors - removing the breathing tube or reviving the patient before muscle relaxants have worn off, leaving the patient unable to breathe;
• medication or gas errors – giving the wrong type or amount;
• faulty, blocked or defective equipment or alarms, or incorrect use of equipment;
• failing to monitor or recognise or react to signs that the patient is aware during surgery;
• delayed or failed resuscitation;
• anaphylaxis (allergies to drugs, latex) negligence;
• injections into the spinal cord or nerves;
• IV (intravenous) cannula flushing errors;
• negligent recovery or intensive care treatment.

The law states that, in most cases, someone who has been injured as a result of medical negligence has three years from the date of the negligence which caused the injury to issue court proceedings. If they fail to issue court proceedings within that time, their claim will be statute barred, meaning that they lose their right to make a claim for compensation.

There are the following exceptions to the three-year rule:

• if a child is injured before they are 18, their three-year deadline expires on their 21st birthday. In other words, their time doesn’t start to run until they are 18;
• if the injured person is mentally disabled (lacks mental capacity) then their time doesn’t begin to run at all, unless their mental capacity is restored;
• where the injured person has died as a result of negligent treatment, the three-year time limit expires three years after the date of their death;
• if the injured person did not suspect or could not reasonably think they had been injured by negligence, the three-year time period will start to run when the injured person first became aware (or should have suspected) that they had been injured by negligent care;
• the court has a general discretion to extend the time limit in cases where none of the above exceptions apply, but only does so in exceptional circumstances.

Regardless of your time limit, we recommend that you contact our medical negligence solicitors as soon as you can, even if you are only considering whether to make a medical negligence claim. By contacting us early, we can help you avoid later problems with deadlines and advise you on how to preserve your evidence to give you the best chance of obtaining compensation via a successful claim.