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Medical Malpractice Claims Related to Performance of Transesophageal Echocardiography by Anesthesiologists

John S McNeil1, Karen E Singh1, Paul D Gallo1

  • 1Department of Anesthesiology, University of Virginia Health, Charlottesville, VA.

Journal of Cardiothoracic and Vascular Anesthesia
|November 3, 2023
PubMed

Insights

Transesophageal echocardiography (TEE) complications during cardiac surgery are rare but can lead to lawsuits, primarily due to esophageal injury. Most anesthesiologist care in these cases was deemed appropriate.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Medical Malpractice

Background:

  • Over 300,000 adults undergo cardiac surgery annually in the US.
  • Intraoperative transesophageal echocardiography (TEE) is common in these procedures.
  • Patients are often elderly with comorbidities, increasing procedural risk.

Purpose of the Study:

  • To investigate the frequency and causes of malpractice lawsuits related to intraoperative transesophageal echocardiography (TEE).
  • To analyze the types of complications leading to litigation and assess the appropriateness of care.

Main Methods:

  • Review of a closed claims database of 2,564 cases.
  • Identification and analysis of 13 cases involving TEE complications.
  • Expert review of the medical care provided.

Main Results:

  • Esophageal injury was the most frequent cause of TEE-related malpractice suits.
  • Only two cases were associated with diagnostic errors.
  • The majority of anesthesiologist care was considered appropriate in expert reviews.

Conclusions:

  • While major complications from TEE are uncommon, they can result in litigation, predominantly due to esophageal injury.
  • Anesthesiologist performance in TEE-related malpractice cases is generally found to be appropriate.
  • Further attention to preventing esophageal injury during TEE may reduce malpractice claims.

Keywords:
cardiac anesthesiologycardiac surgeryesophageal perforationlawsuitmedical malpracticetransesophageal echocardiography (TEE)

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