Patient Suffers Permanent Injuries from Botched Intubation

This case involves a patient who suffered injuries when undergoing bariatric surgery. The patient presented to hospital and was seen by defendant to prepare for bariatric surgery. Close to a month later the defendants operated and during the surgery, the defendants made numerous attempts to intubate patient, all of which failed and resulted in a damaged larynx, vocal cords, throat and wind pipe. The surgery was ultimately aborted. Weeks later, the defendants initiated and attempted a second bariatric surgery on patient. The second surgery also involved several attempts to intubate patient, which ultimately included installing a permanent tracheostomy, and which during the course of, and as a result of, permanently damaged his larynx and caused disfigurement. A month later, patient underwent a third operation in which patient received yet another tracheostomy. It is alleged that the defendants did not follow the proper steps when conducting these procedures, and the multiple operations and intubation attempts, caused permanent damage to the patient.

Question(s) For Expert Witness

1. Do you have knowledge of the proper steps and protocols to follow when intubating a patient during bariatric surgery?

2. Have you ever had a patient suffer from these complications after intubation?

Expert Witness Response E-008133

This case details an odd sequence of events and practice that may not be standard of care and possibly a preventable outcome. In response to the questions ? yes, I have knowledge and experience of guidelines and safe practice for intubating patients during bariatric surgery. This is a part of my daily practice. I have not had a patient suffer such serious complications after intubation. I hope this is because of sound clinical judgment and contingency planning with regard to airway management. On a fairly routine basis, I have had to manage difficult airways in this patient population (both anticipated and unanticipated). My clinical experience has included cases where I initiated plans with ENT colleagues for an ?awake? tracheostomy technique for various reasons (anticipated difficult airway ; need for prolonged ventilation). It also includes knowledge and use of a variety of airway management adjuvants and techniques which includes video laryngoscopy and fiberoptic bronchoscopy.