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https://www.medpagetoday.com/special-reports/exclusives/9243...
Patient Awake for 13 Minutes of Surgery
— Paralytic initiated, but sevoflurane never turned on

Caswell charges that he's suffering from post-traumatic stress disorder and panic attacks because of the experience.

He's suing anesthesiologist Bruce Weber, MD, and nurse anesthetist Kathleen O'Leary, CRNA, as well as their employer, Washington University in St. Louis.


Mr Caswell & his lawyer will eventually have a large cash inflow.
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from the article...

Last summer, Matthew Caswell went into Progress West Hospital in O'Fallon, Missouri, for hernia repair and removal of a lipoma on the back of his neck.

</snip>

He said the story he's gathered so far is that Caswell was brought into the operating room and given the paralytic agent. Either the anesthesiologist or nurse anesthetist put the mask for the inhalational anesthetic on him, but then the surgeon asked to see the lipoma before starting.

The mask was taken off and Caswell was turned over so the surgeon could see the lipoma. He was then returned to supine positioning, and the mask was put back on, but the sevoflurane was never turned on, Vuylsteke said.

</snip>


There's your problem. Trying to do two things at once. Would have been a lot safer to do this as two separate surgical procedures.

I wonder who decided to double up? You're "managed care provider"?

intercst
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Dear goodness, terrible.

I remember years ago, some scandal of the doctor either using the meds on himself or selling it, and people were awake enough to feel EVERYTHING - but too asleep to react.

Ugh I can't talk about it anymore.
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OK a little humour on a Friday afternoon in serious lock down as the variants and a few selfish people have made a mess of our former COVID-19 success story.

I received a letter this morning from our MSI - Health Card people with a form to fill out and mail back for the once every five year replacement card. Other than add my cell number and tick off the optional tissue donation section nothing had changed ... other than the envelope they sent didn't have the prepaid thingy so I had to use a stamp! At least I didn't have to lick the stamp but so much for 'FREE Healthcare' I commented to wife.

She displayed absolutely zero sympathy!

Tim
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tim443,

I received a letter this morning from our MSI - Health Card people with a form to fill out and mail back for the once every five year replacement card. Other than add my cell number and tick off the optional tissue donation section nothing had changed ... other than the envelope they sent didn't have the prepaid thingy so I had to use a stamp! At least I didn't have to lick the stamp but so much for 'FREE Healthcare' I commented to wife.

She displayed absolutely zero sympathy!

</snip>


Reminds me of that scene in Michael Moore's "Sicko" where he was walking around an NHS hospital in London looking for the office where you paid your bill. He spied an office marked 'Cashier', walked up to the window, and learned that this was where they dispensed cab fare home for patients that need it.

Video clip:
https://youtu.be/V2sFT7T0mCs

intercst
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Reminds me of that scene in Michael Moore's "Sicko" where he was walking around an NHS hospital in London looking for the office where you paid your bill. He spied an office marked 'Cashier', walked up to the window, and learned that this was where they dispensed cab fare home for patients that need it.

While I thought Michael Moore was a bit of a hambone, I must confess I enjoyed watching his shows.

Of course we know our system is not really "Free" it is sometimes hard to explain that to people who don't pay taxes to CRA. Of course everyone pays Federal Sales Tax and only Albertans and the three Northern Territories don't collect Provincial Sales Taxes.

Generally the system is really many systems as each province runs their own with financial assistance from the feds to ensure they meet certain standards.

A quirk of the Nova Scotia system was that calling an ambulance was not included and could be fairly expensive (it is included in my private insurance). Just days ago there was a report of two people dying at home of COVID-19 and that it might have been because they were afraid of having to pay the ambulance bill. Our premier immediately announced that the fee would be waved during COVID.

Hmm been years since I checked but it used to be over $800! So they changed it in 2018. Of course our Premier at the time was a Medical Doctor.

$146.55
Most Nova Scotians pay $146.55 for an ambulance trip to the hospital. This is only a portion of the real cost of the service. The provincial government covers the other 80 per cent.


Best thing about Single Payer ... no bill collectors involved and the Medical people always get paid.

Thus ends the lesson for today!

Good luck with the Chinese Rocket due to arrive tomorrow hmmm? Perhaps it's really a fiendish plot to attack!!!

Tim
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So my personal take being a now retired anesthesiologist....

During that time, Caswell's vital signs surged...

Unfortunately the article doesn't mention the use of a BIS monitor. Essentially an compressed EEG to help gauge a patient's "awareness". When I first started, you only had heart rate and blood pressure to go by, and they could be affected by so many things other than a patient being aware. So definitely a bit of art of pure science. When BIS monitors came out, a little bit of a game changer. Still an art to gauging awareness but now more science.

FWIW, had a vaporizer (used to deliver anesthetic gases not to make someone disappear) malfunction. It was turned on but no gas coming out. Only reason I knew it, exhaled gas analyzer was reading 0%. Anesthesia is full of redundant backup systems these days.

This is also one of the reasons you give Versed (liquid valium) pre-operatively. People won't remember/recall anything. Gives you some wiggle room if things go badly.

As far as questioning doing 2 procedures at the same time, it is common place. The only fault in that part of the story, the surgeon should have seen the patient in pre-op holding and marked the area of the lipoma as well as initialed the side/site of the hernia they intended to operate on. All before any Versed or other meds given. That is now standard procedure.

Mr Caswell & his lawyer will eventually have a large cash inflow.

Yes and no. Depends on the state. Several states have caps on "pain and suffering". But don't be mislead by the cap thinking it is unfair. Places with caps usually have another category of "making the patient whole/well/correcting the problem". That part is unlimited. Why do tort lawyers hate pain and suffering caps? That is where they get their 30% cut. They get 0% from making the patient whole payout.

JLC
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