Anesthesia Claims - Hawaii
Accidents and Personal Injury Claims

William H. Lawson, Attorney at Law

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The Deadline to File an Anesthesia Malpractice Claim

The deadline for filing most medical malpractice claims in court in Hawaii is two (2) years from the date when the plaintiff knew or should have known of the negligence of the medical care provider and that injuries resulted therefrom. It is not necessary for an expert to advise the injured party that there was professional negligence which caused the injuries before the statute of limitations will start running. It is sufficient to start the running of the 2 year period, if the injured parties have knowledge of the facts which establish an actionable claim. Buck v. Miles, Hawaii Sup. Ct. No. 20368 (Jan. 25, 1999). Some statutes appear to indicate that there is also a maximum limit of six (6) years from the date of the alleged negligence in which to file an anesthesia malpractice claim.

Anesthesia claim information

medical anesthesia injury

Anesthetized Patients require continuous monitoring during surgery

  • Introduction

The anesthetized patient has a loss of bodily sensation- frequently accompanied with a loss of consciousness- during surgery. Under such circumstances the patient undergoing a surgery has given up responsibility for his health- and often even for his very survival- to the vigilance and skill of his physicians. The anesthesiologist is responsible for monitoring the progress of the surgery. Proper monitoring can provide early warnings of adverse changes during the surgery so that injury and/or death can be prevented.
  • Requirements for proper administration of anesthesia

The American Society of Anesthesiologists has promulgated uniform standards for the administration of anesthesia. Standard I requires that qualified anesthesia personnel shall be present at all times during the procedure requiring anesthesia. Standard II requires that the anesthesiologist continuously evaluate the patient's oxygenation, ventilation, circulation, and temperature.

1. Oxygenation

To ensure adequate oxygen concentration in the blood during all anesthestics, the "concentration of oxygen in the patient breathing system shall be measured by an oxygen analyzer with a low oxygen concentraion limit alarm in use." In measuring blood oxygenation "a quantitative method of assessing oxygenation such as pulse oximetry shall be employed."

2. Ventilation

To ensure adequate ventilation of the patient, every patient shall have the adequacy of the ventilation continually evaluated. While reliance may be placed on qualitative clinical signs such as chest expansion, observation of the reservoir breathing bag, and auscultation of breath sounds, quantitative monitoring of the CO2 content and or volume of expired gas is encouraged. When an endotracheal tube is used, the anesthesiologist must verify its correct positioning in the trachea and identify carbon dioxide in the expired gas. When ventilation is controlled by a mechanical ventilator, the device capable of detecting any disconnection or malfunction of the components of the breathing system. The device should also be designed to give an audible alarm whenever a disconnection or a malfunction is detected.

3. Circulation

To ensure that the patient's circulation remains adequate during the procedure, every patient shall have an electrocardiogram which continuously displays circulatory function during the entire operative procedure. Blood pressure and heart rate shall be evaluated at least every 5 minutes. In addition to the above, circulatory function shall also be continually evaluated by pulse measurements and heart sounds.

4. Temperature

In order to assure appropriate body temperatures throughout the procedure, there shall be means readily available for measuring the patient's temperature.

  • The Anesthesia Record

A complete anesthesia record must be created during the operation for medical and legal purposes. The record must be made contemporaneously and continuously. The record must provide a detailed account of what took place during the course of the treatment and management of the patient. The anesthesia record includes recording fluid and blood replacement, estimated blood loss, urinary output, body temperaure, ECG findings, endtidal PCO2, arterial blood gases, central venous pressure and vital signs. While patient care takes precedence over record keeping, every effort shoud be made to keep the anesthesia record as current as possible. Information recorded only on the basis of the anesthesiologists's memory is suspect.
  • Complications During Anesthesia

There are numerous complications that can occur during anesthesia. Problems may arise during intubation of the trachea, while the tracheal tube is in place or after its removal. Problems may result from the body's rejection of the procedure, from improper administration of the procedure or from a combination of both.
  • Conclusion

The anesthetized patient is in the hands of his physicians. In order for the procedure to be completed successfully, the anesthesiologist must montitor the patient's oxygenation, ventilation, circulation and temperature. A record of the procedure must be kept and provides extremely valuable information to review and analyze to understand any problems which may occur with an anesthetized patient.

  • If you believe that you may have a claim of this type, please take a few moments to visit with a paralegal to outline the nature of your claim. Thank you!


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With proper foundation, the Hawaii courts recognize that a personal injury damage award should adequately compensate for actual losses sustained - past, present or future. "[D}ifficulties often arise in ascertaining... what sum will produce adequate compensation." The duty of juries in such cases is "to draw reasonable and probable inferences from the facts and circumstances in evidence and "to form, under proper instructions from the court, such reasonable and probable estimate, as in the exercise of good sense and sound judgment ... will produce adequate compensation." "There is no sound reason ... for throwing any part of the loss upon the injured party.". Coney v. Lihue Plantation Co., 39 Haw. 129 (1951)

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