OUT OF THE OPERATING ROOM ANESTHESIA AND MONITORED ANESTHESIA CARE
Review of the ASA Closed Claims Project
database indicates that anesthesia at remote (out of the oper-ating room)
locations poses a risk to patients sec-ondary to hypoventilation and excessive
sedation. Remote location anesthesia care was more likely than operating room
anesthesia care to involve a claim for death (54% vs 29%, respectively). The
endoscopy suite and cardiac catheterization laboratory were the most frequent
locations from which claims were generated. Monitored Anesthesia Care (MAC) was
the most common technique employed in these claims. Overwhelmingly, adverse
respiratory events were most frequently responsible for the injury.
An analysis of the ASA Closed Claims Project database focusing on MAC
likewise revealed that oversedation and respiratory collapse most fre-quently
lead to claims. Claims for burn injuries suf-fered in operating room fires were
also found in the database. Supplemental oxygen, draping, pooling of flammable
antiseptic preparatory solutions, and sur-gical cautery combine to produce the
potential for operating room fires.