Adverse Events During Cosmetic Surgery: A Thematic Analysis of Closed Claims

According to the American Society of Plastic Surgeons, there were approximately 1.8 million cosmetic and reconstructive surgeries performed in the United States in 2012. Very few anesthesia-related mortality statistics and detailed descriptions of adverse events during cosmetic/plastic surgery are found in existing literature. This article describes the use of thematic analysis, and subsequent findings, of a cosmetic closed-claim database generated by the American Association of Nurse Anesthetists (AANA) Foundation Closed Claim Research Team. From the most current dataset of 245 claim files provided by the insurance company (CNA), we isolated 25 claims regarding patients undergoing cosmetic and/or related plastic surgery procedures performed from 2003 to 2012. Three major themes emerged from the claims data: (1) normalization of deviance, (2) ineffective communication patterns, and (3) nonadherence to the AANA Standards for Nurse Anesthesia Practice. Detailed descriptions of the adverse events as they relate to the major themes are provided, and suggestions are offered for actions that may mitigate future adverse events in this subset of the population.