Joan Rivers made us laugh, cry, and sometimes cringe. We are sad to lose such a talented and vivacious entertainer, a loss that may have been premature and preventable.
Joan went to the Yorkville Endoscopy Clinic in Manhattan complaining of sore throat and a hoarse voice. She saw a gastroenterologist, who told her a routine, minor procedure known as an endoscopy was necessary to evaluate and diagnose her condition. The doctor suspected acid reflux (a condition where stomach acids splash up into the windpipe) was causing the sore throat and hoarse voice. In an upper-gastrointestinal endoscopy the doctor uses an endoscope—a small, flexible tube with a light—to see the lining of the upper gastrointestinal tract (windpipe). Endoscopy is a routine medical procedure, but for an 81-year-old with a history of heart arrhythmia (irregular heart beat) and bulimia, the minor procedure posed much higher risks – risks a reasonable gastroenterologist performs in a hospital, not in an outpatient clinic with less resources available to address an emergency. Unfortunately for Joan, the minor medical procedure caused serious complications. Joan Rivers slid into cardiac and respiratory arrest during the outpatient procedure and was transferred to Mount Sinai Hospital where she eventually died. Her death reminds us all there is no such thing as a minor medical procedure. Doctors privately joke with one another: “Surgery is only minor if it happens to someone else.” All medical procedures and treatments carry risk, risks that need to be fully disclosed by the physicians and carefully evaluated by patients who have been informed before they occur.
The unfortunate death of a beloved celebrity like Joan Rivers should be a wake-up call for improving patient safety.
Even Minor Procedures Can Have Major Risks
No medical procedure is risk free. Do not rush into a medical procedure. Be carefully screened by your treating physicians to make sure you are healthy enough, such as by your cardiologist or internist who knows you, before electing to undergo a medical procedure. A large part of the risk of minor medical procedures is sedation-related complications, including respiratory distress or cardiac change. If given too much, or not monitored properly, sedatives or pain medication used in minor medical procedures can be deadly. For any patient undergoing a medical procedure, particularly if anesthesia, narcotics (opioids), or sedatives are involved, it’s crucial to know patient medical history, including medical conditions, past surgeries, and what prescription and over-the-counter medications are taken. Complete information enables the medical team to assess how the patient’s body will respond to drugs used. Before undergoing a minor medical procedure, PLEASE ASK QUESTIONS to elicit answers and enable you to properly understand the procedure you are to undergo, the possible risks, and only then weigh the risks and determine if it is necessary.
Importance of Monitoring
We like believe an 81-year-old woman with a history of heart arrhythmia will be carefully monitored during a routine medical procedure that involves sedatives that can cause respiratory distress or cardiac complications. Some have said the medical team failed to carefully monitor Joan Rivers during the endoscopy and got caught off guard and unprepared when she predictably went into cardiac arrest.
Failure to properly monitor patients accounts for thousands of medical injuries every year. Monitoring failures include not paying close attention to vital signs during a medical procedure. Like in the routine procedure on Joan Rivers, the common medical error of healthcare complacency can be deadly. Continuous electronic monitoring of oxygenation (i.e., the adequacy of oxygen in the blood) with pulse oximetry and ventilation (i.e., adequacy of breathing) with capnography (a monitor of carbon dioxide), combined with traditional nursing assessment, greatly reduces life-threatening complications of sedation, narcotics, or anesthesia.
Resources at Outpatient Clinics Are Less Than at a Hospital
If you schedule a medical procedure at an outpatient facility, be sure the facility has proper, state-of-the art monitoring and emergency equipment.
Hospitals, in contrast to outpatient centers, are staffed to deal with emergencies, from heart attacks to allergic reactions, while outpatient centers tend are focus narrowly with few other resources. If risk is high, such as for an 81-year-old woman with a significant medical history, insist the surgical team fully and properly inform you before a decision is made.
Outpatient surgery center safety statistics are truly frightening. A recent study in the American Journal of Surgery found of the nearly 4 million patients sent home after having a procedure at an outpatient facility, 1 out of every 31 (3.2%) were admitted to the hospital or visited an emergency room for surgical complications after being sent home. Consider insisting on having any surgical procedure at hospital, which has staffed and equipped for emergencies. Requirements for a safe surgery making sure there is proper clinical staff is in the operating room and emergency equipment is on standby if a complication occurs.
Perhaps you or a loved one recently underwent a routine medical procedure that caused a catastrophic injury or death. If poor monitoring, failure to be prepared for an emergency, or other error caused the devastating result, seek legal recourse immediately. Michigan law is unfair to people injured by medical professionals and any delay seeking legal help can mean losing your right to reimbursement. A medical malpractice lawsuit must, typically, be brought within 2 years after the medical error (e.g., surgery date) or be barred forever. In limited instances, a claim may be brought within six months after the patient discovers or should have discovered the error, but the lawsuit must be brought before six years after the error.
At Buchanan & Buchanan, our combined legal-medical team has decades of experience handling medical malpractice cases, including cases involving failure to monitor or failure to rescue/respond properly to emergency situations. We have medical professionals on staff to talk with you and immediately review your claim. Our team quickly and efficiently assess the medical facts and takes immediate action to protect your legal rights.