Propofol – A Killer?

Steven E. North, Esq.

Michael Jackson and Joan Rivers both lost their lives secondary to the anesthetic agent, propofol. Others have as well. You can too. You gotta be careful.

Many of those deaths can be avoided and part of the responsibility rests with the patient.

It is not the drug itself that is the culprit for it is an effective and fast acting anesthetic agent. It is the monitoring of the patient and the ability of an attentive physician to promptly act with the necessary staff and equipment that can make the difference between life and death.

Anesthesiologist, like airplane pilots, are essentially in a “watchful waiting mode” 99% of the time. It is when an untoward event occurs that they are called into action and, in both instances, their level of alertness, skill and response is critical.

An anesthesiologist, or in some instances, a nurse anesthetist, administer and overseethe sedation process. They must carefully watch for changes in blood pressure, oxygenation, patient reaction, and a myriad of other data. They are required to carefully document the process on virtually a minute to minute basis.

In some hospitals the anesthesiologists are allowed to read books during the surgery or, if not allowed, in fact will be seen doing that. Others have license to wear their headphones and listen to music. Under these circumstances, the unconscious patient is unable to appreciate the lack of attention that he or she might be entitled to.

So what cane the patient do to help protect himself? First, one should ascertain who infact will be rendering the anesthesia. Will it be a physician anesthesiologist or a nurse anesthetist. And, when patients speak up they do have options to effectuate a change. Some surgeons have their “favorite” anesthesiologist. This should be discussed with the surgeon.

It is also critical that the anesthesiologist is fully apprised of your medical history and any and all medications that you are or have been taking. These factors have direct bearing upon the services provided. And, if there is any history whatsoever of allergic reactions, that must be brought to the attention of the anesthesiologist.

Finally, the facility where the procedure is going to be done is critically important.In the Joan Rivers case, she underwent an endoscopy procedure in New York City at an outpatient facility. Some outpatient facilities are not as equipped as a hospital to render emergency care when a patient exhibit an acute breathing problem. So, although healthcare facilities are becoming more and more alerted to the prevention of anesthesia complications, it is important that the patient plays a role by investigating this aspect of care before undergoing surgery.

Having handled numerous medical malpractice cases in New York regarding anesthesia mishaps, the ultimate determination with regard to risk of the procedure versus malpractice will rest upon a careful analysis of the patient’s risk factors, candidacy for surgery, detailed assessment of the anesthesiology chart, the timing of intervention, the nature and dosages of the medications provided, the changes in vital signs, the acuteness of the attention provided and the response reaction to a sudden change.