Improper Intubation Leads to Brain Damage

This case involves a 76-year-old female patient underwent routine hip surgery. Alleged improper intubation prevented proper ventilation and oxygen delivery to brain tissue for between 3 – 6 minutes. The patient had difficulty being aroused postoperatively and now displays neurological deficits that resemble severe stroke like complications. The patient was completely independent in activities of daily living but now requires 24 hr nursing home care and may be placed in a senior living facility.

Question(s) For Expert Witness

1. What involves the proper placement of a breathing tube and what steps are taken to avoid complications?

Expert Witness Response

Placement of a tube into the trachea is used to maintain airway patency and allow mechanical ventilation on patients who are unable to breathe independently. Some complications may involve accidental intubation of the right mainstem bronchus which is relatively common. This is rectified by withdrawing the tube slightly until breath sounds are heard bilaterally. Proper placement of the tube can be monitored by using end tidal CO2 meters. Other complications may be dental injury or placing the tube in the esophagus.