The use of propofol by gastroenterologists: medico-legal issues

The increasing use of non-anesthesiologist-administered propofol for sedation during gastrointestinal endoscopy has both clinical and legal consequences. As medical practices develop, the law of clinical negligence will be applied in the context of such developments. While the law will recognize the desirability of advanced techniques and methods, in circumstances where an injury or adverse outcome occurs, the facts of a particular case will be scrutinized to determine whether or not the duty of care between patient and clinician has been breached. This paper considers a number of specific matters likely to arise in the context of a clinical negligence/malpractice claim resulting from the use of non-anesthesiologist-administered propofol, in particular the role and standard of care expected of gastroenterologist and/or anesthetic provider, the relevance of FDA labeling, the implementation and use of protocols, the importance of patient selection and informed consent.