A Dallas County, Texas jury returned a verdict of $21 million in favor of a 27-year-old patient who was injured by anesthesia care provided by a certified registered nurse anesthetist (CRNA) at Baylor University Medical Center.
What is a CRNA?
CRNAs are advanced practice registered nurses (APRNs), meaning they are registered nurses with graduate-level training in nursing anesthesia.
Are CRNAs supervised by a doctor?
Under Texas law, CRNAs must be medically directed or supervised by a physician.
Sometimes an anesthesiologist physician provides CRNA oversight, but other times that’s done by the surgeon who’s performing a procedure or surgery in an operating room.
US Anesthesia Partners (USAP) is the practice group that employed the CRNA, as well as the physician anesthesiologist who as responsible for supervising the CRNA’s care of the patient and plaintiff, Carlos Rojas.
This doctor was supervising 4 CRNAs at the same time
The evidence at trial showed that the USAP anesthesiologist physician was supervising three other CRNAs in three different operating rooms while also supervising the CRNA who was responsible for Carlos’s anesthesia care.
That one doctor was responsible for four CRNAs at the same time.
It’s easy to see how that can be a difficult situation. The doctor can only be in one operating room at the time. Think about what could happen if two emergencies happened at once, with both requiring the anesthesiologist’s physical presence and attention. Where would the anesthesiologist physician go? What would happen to the other patient who needs emergency care?
Lawsuit alleged poor CRNA care
Carlos had gone to the hospital for surgery to repair a shin fracture. After the nurse anesthetist put Carlos under general anesthesia, complications developed. The lawsuit alleged that the CRNA botched the emergency response, which left Carlos with a permanent brain injury and in a vegetative state.
Lawsuit alleged no informed consent
One of the most interesting aspects of this medical malpractice trial is the evidence presented to the jury about the informed consent process. According to the lawsuit:
• During the informed consent process, the anesthesiologist and CRNA didn’t explain “that there’s a difference between providers or their qualifications.”
This is a much-debated topic between physician anesthesiologists and CRNA professional groups who are advocating for completely independent, unsupervised practice. Some CRNA groups contend that nurse anesthetists offer equivalent or superior anesthesia care to that provided by physician anesthesiologists. Anesthesiologists vehemently disagree.
• Carlos was told that a CRNA would provide anesthesia, but wasn’t informed that “a more qualified anesthesiologist was available and an option for him.”
• He also wasn’t told that he had “the right to choose” whether to have an anesthesiologist or CRNA. The only way US Anesthesia Partners personnel would provide patients “the patient’s choice to have an anesthesiologist [was] if the patient knows enough to object to a CRNA and insists on an anesthesiologist.”
One of the plaintiff’s attorneys commented that it may be good for business to allow one anesthesiologist physician to supervise multiple nurse anesthetists (CRNA) at the same time, but that comes at the expense of patient safety. Based on the verdict, the jury seemed to agree.
If you or someone you care for is facing surgery or a procedure that will require anesthesia, don’t allow an operating room nurse or other personnel to rush you into signing informed consent paperwork. Under Texas law, obtaining informed consent is a non-delegable duty of a physician.
When providing patient consent for anesthesia care, it’s important to understand the education, training, and experience of the person who will be providing the bedside care. Anesthesia care is highly technical and when complications occur, there’s a race to secure the airway and keep oxygen getting to supply the brain and vital organs. Some people are comfortable with an experienced CRNA in the bedside anesthesia role, while others prefer a residency-trained anesthesiologist physician. Either way, it is the patient’s choice.
If you’ve been seriously injured because of bad anesthesia care in Texas, then contact a top-rated, experienced Texas medical malpractice attorney for a free strategy session about your potential case.