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Jury awards $12 million in esophageal intubation case

Surgical patient was left with a permanent brain injury requiring round-the-clock care

Medical and health professionals often use intubation to secure the patient’s airway. This involves inserting a flexible endotracheal tube down the patient’s throat into the trachea, or airway.

In some situations, and anesthesiologist or certified registered nurse anesthetist (CRNA) will intubate a patient as part of administration of general anesthesia for surgery. This is typically done in a planned, controlled environment. 

In these circumstances, the standard of care requires a pre-anesthesia assessment, which includes planning for proper management of patients with difficult airways. There are a number of factors that anesthesiologists consider including, for example, patients with a thick neck, obstructive sleep apnea, or prior complications under general anesthesia. 

In other situations, patients need intubated when they crash, code, or have respiratory distress or an obstruction.

In both settings, the stakes of an ineffective intubation are high. They can result in a patient going without oxygen for a time long enough to cause permanent brain damage. 

One of the dreaded complications of a botched intubation attempt is esophageal intubation. To understand what esophageal intubation means, we should briefly discuss a little anatomy. 

As you know, you can breathe through your mouth, but also eat and drink through your mouth. When breathing through your mouth, air flows through the trachea, or breathing tube, into the lungs. In contrast, food and water go through the esophagus, a muscular structure that’s located posterior to or behind the trachea, on the way to the stomach.

When performing an intubation, it’s important for the anesthesiologist, CRNA, physician, or other personnel to properly visualize the anatomical structures to ensure that the endotracheal tube is inserted into the trachea, rather than the esophagus. One of the classic ways that clinicians can verify proper intubation is to make sure they can see the endotracheal tube passing between the vocal cords.

Esophageal intubation is more common with difficult or emergency innovations, but can still happen with pre-operative intubations. In fact, that’s what led to a California case that was recently resolved through settlement illustrates the terrible injuries that can occur when an esophageal intubation occurs and isn’t immediately recognized and corrected.

A woman discovered a lump in her breast and was taken to a hospital operating room for breast cancer surgery. She was intubated as part of that procedure. Instead of inserting the endotracheal tube into the trachea, as required by the standard of care, it was placed in her esophagus. As result, the lawsuit alleged that she went without oxygen to her brain and now requires full-time nursing care.

Because of the brain injury and significant health care expenses that this woman faces for the rest of her life, it will take significant financial resources to take care of her. In April 2022, that case settled for $12 million.

If you’ve been seriously injured because of poor medical, nursing, or anesthesia care in Texas, then contact a top-rated experienced Texas medical malpractice lawyer for free consultation about your potential case.

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him by calling 281-580-8800 or emailing him right now.


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