A medical malpractice anoxic episode case resulting in brain injury: Velasquez v. U.S.A.

Disposition: (Settlement/Arbitration/Trial)	Settlement
Date:	9/1/1997
Type of Case:	Medical Malpractice
Allegation(s):	Intubation During Hip Surgery
Result:	$500,000
Case Name:	Velasquez v. U.S.A.
Facts:
Plaintiff, a 53-year-old, was admitted to the VA Medical Center in La Jolla to undergo a left hip replacement. He was examined by nursing and anesthesia staff and graded as an ASA 2 (low risk). On the morning of June 20, 1995, he was taken to the operating room. At 12:45 an epidural was given and general induction began. At 1:00 p.m., the anesthesiologist observed and documented easy mask ventilation. At 1:05 p.m., the plaintiff was intubated. The doctor, however, observed that plaintiff was unable to breathe through the endotracheal tube. Multiple attempts were made to intubate him and establish respiration. No ventilation was achieved until 1:20 p.m. when mask ventilation was resumed. During the time he was without respiration, the plaintiff suffered bradycardia. He experienced complete cardiopulmonary arrest. He was without any effective oxygenation for several minutes. Arterial blood gases taken at 1:18 p.m. indicated he was in a state of respiratory acidosis. A note written following the inspection of the machine alleged that the expiratory valve on the anesthesia circuit was stuck in the closed position while ventilation was attempted. There was another note which indicated the machine was last inspected at 7:00 a.m. that day. The plaintiff gradually awoke from this episode, but for some time he was unable to speak or communicate. He was assessed by VA medical staff as having sustained ischemic brain damage when he was without effective oxygenation. He has deficits to this day.
Injury/Injuries:
Ischemic brain injury. Treatment: psychological care. Residuals: Suicidal depression, difficulty doing simple math, mnemonic difficulty, inability to follow directions, inability to help around the house, irritability, noncommunicative, and unable to handle stress. Loss of household services and emotional distress damages.
Contentions:
Defendants failed to inspect the anesthesia equipment immediately before it was connected to plaintiff's respiratory system. Therefore, no one detected that it was not functional. Medical residents were in charge of the anesthesia. No one was skilled in the delivery of anesthesia managed plaintiff's care. Had the machine been inspected immediately prior to the plaintiff's induction, the closed valve would have been detected. The anoxic episode would never have happened. Had someone skilled in airway management intubated him, the esophageal intubations would not have happened. Had someone manually ventilated, rather than using the machine, this anoxic episode would have been minimized.
Special Notes:
The defendants argued that plaintiff suffered no significant brain injury. < back to Medical Malpractice Case Histories from the Law Offices of Robert Vaage and www.vaagelaw.com