12 Comments

What’s best? An intubation team doing its job in a reasonable manner, i.e. not breaking teeth. I have no idea whether or not breaking teeth during intubation is negligent, but if it is, why is the fact that the alternative to a broken tooth was death make a damn bit of difference? When you undertake actions, you must perform them reasonably.

My father got his tooth knocked out by the EMTs that scooped him up and brought him to the ER. Rather that sue he bought the firehouse steaks on the anniversary of his rescue.

Really James, ever attempted intubation? Try it.
This feels like a heart attack victim suing b/c the person performing CPR broke a rib or two (happens all the time).

Next time get a waiver. I’m sure that some one suffering a heart attack will be glad to sign and fetch a notary public.

Bob

By all means, let’s hold others, but not ourselves, to impossible standards of perfection that no one could hope to attain.

Bob, since break a rib or two is reasonable (even expected) in the practice of performing CPR, a suit for broken ribs would be absurd. However, breaking teeth while intubating is much, much rarer, and probably indicative of negligence. As I said before, if doing so is negligent, compensation is appropriate. That’s a big if. I’m not a doctor and I could be wrong about the rarity of breaking teeth, but I don’t think I am.

In the luxury of a clinical setting breaking a tooth occurs less often, bad technique, a weak tooth or bad karma. However, in the urgency of a resuscitation every second counts, “–it happens.” plain and simple fact.

They call it the practice of medicine for a reason, it lies somewhere between science and art, to me it’s more like a craft. I have seen events for which there was no explainable cause with both good outcomes and bad outcomes. If you want perfection in medicine, you’ll just have to wait for ObamaCare to kick in. Perhaps then people will look back with fond remembrance of just how good they really had it.

I’m an anesthesiologist for 20 years.
Breaking a tooth does occur rarely. Under elective situations it occurs while the anesthesiologist is in control of the situation. Using loaded words like ‘negligence’ do not allow people to easily get to the heart of the matter, but a dental injury under the elective case is one of those medical oops moments. Yes, I am going to apply some incidental force to a tooth, but whether this particular tooth can take it is never a certainty. The only question remaining how to indemnify the act. If it is the anesthesiologist’s money (and/or his insurer) then his rates must include this occasional cost. Our department has the policy that the patient is offered what our dentist states the repair is worth, then fight any claim beyond this.
Under the urgent/emergent situation then the presumption of slow deliberate gentle intubation attempts is gone. The patient needs/wants breathing ASAP and a presumption is that rational folks would in that moment want us to forego a little delicacy for saving their life. The standard for care in intubation changes in emergency because the consequence for delayed breathing (brain damage/death) is so totally different than a broken tooth.

I thank gasman for his instructive comment above. I inherited my parents bad teeth, and I envied my sister-in-law who had teeth suitable for mining diamonds. Still, my dentist had to work hard on extractions of my teeth over the years, and I was surprised by getting tooth destruction from tubulation. I thought that anesthesiologists gave up the mallet-blow to the head procedure a log time ago.

Ultimately, we know nothing about this case. Link to a link to a link without any real facts other than some blogger saying “It happened this way.” I hate these stories. How about a link to the story that was purportedly done on the case? Anything. If a story can’t be verified in any way, we are back to the Winnebago on cruise control. In this world, facts matter little and stories that are embellished or fabricated rule the roost.

What? You want to pretend like this is a real story? Okay. So be it.

Ultimately, the victim has a claim if they would not have gotten if the care was appropriate. Now, in this case, is it awful form to bring a claim for something like this? Absolutely. A jury would hate this claim. It is hard impossible to cut law so thin as to bar claims on the account of awful form.

Ron, I think you are being a bit unfair. On your own blog, if memory serves, you often relate stories from your experience as a litigator and negotiator that (understandably) do not use actual names of clients or opposing lawyers and are not in any sense checkable by outsiders. That doesn’t mean they aren’t valuable narratives that help educate us about the issues and frustrations that come up in lawyers’ work. I find the same to be true of many doctor sites, though of course we always need to be on our guard against unreliable narrations.

“Ultimately, the victim has a claim if they would not have gotten if the care was appropriate”

By this statement, you are saying the care was not appropriate. How do you know this?