According to the American Association of Nurse Anesthetists1 mortality rates for conditions studied were from 0.11% to 1.2%. While these percentages may seem small when one considers the hundreds of thousands of surgical cases performed annually under anesthesia an ominous picture emerges. The average for all patients is 0.38%. This means that out of every 1000 cases, 38 patients die. The mortality rate adjusted by operation does reveal certain patterns. Mortality rates were lower, 10 times lower for mastectomies and hysterectomies than they were for cholecystectomies. In a more recent risk-adjusted study of 117,440 surgical cases in Pennsylvania, Silber, et al.2, observed an increase of 2.5 deaths per 1000 patients when an anesthesiologist was not involved in the case. This statistic is alarming in light of the Institute of Medicine’s Review which concluded: “Today anesthesia mortality rates are about one death per 200,000 to 300,000 anesthetics administered.”
Nevertheless the Institute of Medicine in a study more broadly considering anesthesia practices throughout the United States does not confirm a difference in overall anesthesia-related mortality based on whether an anesthesiologist or a nurse anesthetist was present.3 Though the above-cited materials focus on whether there is a different risk and whether an anesthesiologist or nurse anesthetist is present, what gives one greater pause and concern is the fact that the risk for anesthesia-associated deaths is so high. Even stranger is the ten-fold increase in anesthesia mortality when a cholecystectomy is done as opposed to a mastectomy or hysterectomy. All are major operations.
In any event, mortality from anesthesia should be so infrequent that its occurrence always justifies a proper investigation and explanation.
This law firm has investigated countless anesthesia-related cases and has therefore considerable experience in assisting survivors and family members as well as injured patients in learning whether a suspected anesthesia complication was unnecessary or not.
[1]April 2003; 71:109-106
[2]Silber, J.H., Kennedy, S.K., Even-Shoshan, O., et al., Anesthesiologist Direction in Patient Outcomes, Anesthesiology 2000:93:152-163.
[3]Institute of Medicine, To Err is Human Building a Safer Health System, Washington, D.C. National Academy Press, 1999:27