$1.576 Million Verdict in Intubation Death

2013 Medical Malpractice Trial Report

Doctor’s negligence causes need for "crash" intubation, resulting in patient’s death

The decendent was a 76-year-old man with multiple medical problems, including cardiovascular disease, severe sleep apnea and severe spinal stenosis. By the end of 2004, the spinal stenosis had rendered the decendent essentially unable to walk. The narrowing of the spine had also begun to compromise his ability to breathe normally due to compression of a nerve instrumental in breathing.

Because of his worsening symptoms, at the end of December of 2004, the decendent went to the emergency department and he was admitted to St. Vincent’s Hospital with a plan to perform surgery. On the first morning he awoke in the hospital as an inpatient, the decendent was found to be extremely lethargic and confused and there were signs that he was not breathing properly. He recovered from this incident after receiving BiPap breathing support and was scheduled for surgery on January 4th. The surgery was cancelled, however, because the decendent was still too anticoagulated.

Two days later, he was found before 7 am to be "obtunded. " Bloodwork at 7am showed a respiratory acidosis consistent with respiratory failure. The defendant failed to intubate at that time, but rather chose to attempt BiPap, which is a form of non-invasive respiratory support. By the time the defendant retested the patient’s blood, the respiratory acidosis was far worse, necessitating a crash intubation. Under those circumstances, the intubation failed on multiple occasions and the patient was insufflated with air in his esophagus and stomach, which was unable to decompress, resulting in ischemia to his intestines. The patient died from these complications shortly after a last ditch surgical effort to repair the ischemic bowel.

The defendants maintained that attempting BiPap was a reasonable exercise of the defenant’s judgment because it had worked previously for the patient. The defendant chose non-invasive ventilation with BiPap because there were risks to invasive intubation in a patient with his dgree of spinal stenosis. However, plaintiff’s expert in critical care medicine had testified that BiPap was contraindicated in this patient because he was obtuned and could not protect his own airway. Further, the plaintiff rebutted the claim of risk to intubation by proving that the plan for the surgery included general endotracheal anesthesia, which requires intubation. The defendant’s expert was confronted with medical literature that confirmed plaintiff’s expert’s opinion that BiPap was contraindicated.

Tried before a jury. Verdict, $1,576,532.00.

Lubin & Meyer represented the plaintiff in this medical malpractice wrongful death lawsuit. (Adam Satin: Worcester Superior Court)

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