Chapter 10: Medical and Legal Aspects of Anesthetic and Operative Deaths

Demyelination

________ and obliteration of axons was also observed and at times, infarction of the basal ganglia.

Surgical mishaps

________ such as unintentional accidental tearing or cutting of a major blood vessel during surgery resulting in death and therefore such deaths are detectable only at autopsy.

Elbows

________ should be protected as allowing them to lie unprotected against table can cause ulnar nerve palsy.

Hypoventilation

________ and hypoxia due to hyperventilation by the anesthetic agents may cause depletion of carbon dioxide, during the recovery- period.

Improper

________ labeling can lead to the wrong drug being administered.

Anesthetic mistakes

________ being physiological are no longer appreciable after death except where overdose with specific drugs is involved.

Anesthetists

________ who are using improper technique, improper equipment or one who has no familiarity with the equipment, having no adequate experience, or unable to adopt precautions when indicated, or careless in the methods, etc.

Negligence

________ primarily due to Anesthesia and surgeon has no role to play.

anesthetic procedure

Every ________ requires close monitoring of vital signs at regular intervals.

Technical errors

________ due to inefficiency in skills required or due to poor design of the equipment and apparatuses.

Anesthetic agents

________ may sometimes result in hypersensitivity reactions resulting in death of the patient.

Cardiac arrest

happens due to either oxygen deprivation or carbon dioxide accumulation as a result of failure of technique or fault in technique

Asphyxia of Myocardium

Hypovolaemia and some diseases of the cardiovascular system carry an enhanced risk

Reflex Vagal Stimulation

Hypoxia, sudden asystole can stimulate vagus nerve resulting in slowing of the heart

Proper vigilance

It is the cornerstone of anesthetic practice

hypersensitivity

Anesthetic agents may sometimes result in _______ reactions resulting in death of the patient.

respiratory inadequacy

The use of certain drugs, which can create myoneural blockage, may give rise to death due to *_______.*

malignant hyperpyrexia

There is evidence that *halothane* can cause *liver necrosis* resulting in *_______* which is characterized by abrupt rise to dangerous temperature and also may be associated with tachycardia, hyperpnoea, cyanosis and stiffening of the muscles and may ultimately lead to death.

hemoglobinopathies

patients with _____ are unduly susceptible to low oxygen tension in blood and this may pose a hazard to the unaware surgeon or anesthetist.

Cardiac arrest

happens due to either oxygen deprivation or carbon dioxide accumulation as a result of failure of technique or fault in technique.

Mistaken Identity

It can result in mismatched transfusion leading to serious complications.

Proper vigilance

It is the cornerstone of anesthetic practice. Vital signs should be recorded every five minutes. Continuous monitoring of oxygenation and cardiac output should be done.