$2,415,000: Anesthesiologist Runs Into Intubation Complications Resulting In Death Of Patient

CASE DESCRIPTION: Decedent was admitted into St. Jude Hospital in Fullerton for elective sinus surgery. Due to intubation complications and doctor negligence the patient died on the table. Decedent’s family brought suit for wrongful death due to the negligence of the doctor and the hospital.

RESULT: $2,415,476.70 total settlement On December 7, 2001, Decedent Thomas B. (age 52, and Vice President of an airplane part repair company) was admitted to St. Jude Hospital in Fullerton for elective sinus surgery. Defendant Dr.  Merlin N., the anesthesiologist, initially had some difficulty intubating Thomas  B., and after several failed attempts he was successful in placing a tube. The patient had been administered a long lasting paralytic so he could not breathe on his own. As is standard protocol, after intubating the patient, Dr. Merlin N. went to inflate the cuff (to create an airtight seal in the treachea) — which was leaking. Due to this leak the endotracheal tube needed to be changed before surgery could occur, but the patient was not at risk at this time because he had a patent airway.

At that time Dr. Merlin N. chose to simply remove the size 6.5 tube believing he could replace it with another tube. However, Dr. Merlin N. was unable to place a new tube due to inflammation and swelling caused by the initial difficult intubation effort. Suddenly, the patient was without an airway, because Dr. Merlin N. failed to use a “tube exchanger” device which would have allowed the tube to be changed with no risk to the patient. Dr. Zain K. (the ENT surgeon) then attempted to also intubate the patient, and was also unable to do it. The nursing staff sought help from any other anesthesiologist available (but failed to call a Code Blue — which would have yielded an emergency team sooner to save Thomas B’s life.)

As precious time passed, and with Thomas B. receiving no oxygen, Dr. Zain K. then attempted to do a tracheostomy to establish an airway. Unfortunately, Dr. K. failed to establish the tracheostomy airway. A staff anesthesiologist at St. Jude, was able to finally leave the patient he was attending to in a nearby operating room to come help. He immediately inserted an LMA (“Laryngeal Mask Airway”) in Thomas B’s airway and was immediately able to ventilate the patient. Unfortunately, it was too late. Thomas B’s monitor readings showed he was already unsalvageable — although efforts did continue to save him. Had the LMA been used earlier, Thomas B’s life would not have been lost.

It is noted also that the anesthesiologist, Dr. Merlin N., was not board certified and was known by other staff anesthesiologists at St. Jude Hospital to lack knowledge and training in difficult airways. As such, Plaintiff’s alleged hospital liability under the Elam case, for allowing a physician to practice on staff who was known to be substandard in his skill and learning.

Plaintiffs contend that Defendant Dr. Merlin N. failed to use proper procedure and equipment to attempt to re-intubate Thomas B. without a tube exchanger. Plaintiffs also contend had the LMA been used earlier, Thomas B’s life would not have been lost.

Also, Plaintiffs contend Dr. Zain K. should have performed a successful tracheostomy which would have saved Thomas B’s life, and failed to do so when he “froze” under pressure. Plaintiffs also contended that the hospital negligently allowed Defendant Merlin N. to remain on staff without proctoring or additional training despite hospital staff knowledge that Dr. Merlin N. had substandard difficult airway training and skills.

TYPE OF CASE: Medical Malpractice; Wrongful Death

INJURIES: This incident resulted in the death of Thomas B.

DATE & LOCATION OF INCIDENT: On 12/7/01 at St. Jude’s Hospital, in the City of Fullerton, CA.

PLAINTIFF’S AGE: Decedent – 52 at time of the incident.

OCCUPATION: Decedent was the Vice President of an airplane parts repair company.

Richard A. Cohn
For Plaintiff – Christine, Mark, Adam & Matthew B.

David Weiss
For Defendant – Merlin N, M.D.
Richard Madory
For Defendant – St. Jude Medical Center
Marshall Silberberg
For Defendant – Zain K., M.D.