Endotracheal intubation is the placement of a flexible plastic tube into a patient’s trachea in order to maintain an open airway or to serve as a conduit through which to administer certain drugs. The procedure can be a lifesaving measure but, when improperly done, it can create serious, even deadly consequences.
In this article we’ll discuss the procedure and the tragic results that follow when mistakes are made during intubation. We will help you understand how you can prove damages caused by procedure if you take such a case into a Georgia courtroom in search of justice. We will also give you an idea how these cases are presented in a court of law.
In early 1980, a 20-year-old man was involved in a serious car crash. When the paramedics arrived on the scene, it was apparent that this young man was in respiratory distress. The paramedic in charge decided to perform an intubation to allow the victim to breathe as he was taken to a nearby hospital.
Upon arrival, the ER doctor saw that the tracheal tube inserted at the scene was improperly positioned. Instead of providing oxygen to the man’s lungs, the tube had been inserted into his esophagus. The error was corrected, but the man had been without sufficient oxygen to his brain for many critical minutes. He suffered severe brain damage as a result.
This sad story is a long one. The victim was comatose for 8 days and, during that time, his condition deteriorated. Pneumonia set in. The doctors told the family that if he survived the young man’s life would likely be vegetative. The doctors advised the family to unplug him from life support. It was not a decision the family was prepared to make.
In time, the young victim did regain consciousness and the pneumonia was successfully treated. Unfortunately, the brain damage caused from the improper intubation was such that he would spend the remainder of his life in a nursing home.
Because he was a physically fit young man at the time of the accident medical professionals knew he would be a difficult patient to handle. His physical condition would have allowed him to stand and walk and to move around, but his diminished mental capacity would cause him to be frustrated and agitated by his limitations. For all the days of his life after the accident he was given high dosages of lithium and other mood stabilizers to keep him docile and curb the aggressive behaviors that sometimes developed.
This young man died in the spring of 2018 at the age of 58, when he succumbed to widespread sepsis, (another nursing home nightmare). At the time of his death he was still a nursing home resident. He had never been able to regain any real part of his life and while family members visited him regularly, his life was a sadly wasted one.
The young man’s family did not understand the rights afforded him under the law. They thought that since he had been speeding at the time of the accident, they had no right to “blame” anyone for his condition.
This tragic story is not that unusual. It turns out that as many as 40 percent of pre-hospital endotracheal intubations performed by paramedics are failures. Failures include misplacement of airway tubes, punctures and injuries to surrounding tissues that may or may not be noticed or treated in a timely way that can lead to complications such as in our case.
To this very day, discussions among medical professionals often become animated over the wisdom of allowing emergency service technicians to perform esophageal intubations. According to the US national Library of Medicine and the National Institutes of Health, the benefits of pre-hospital endotracheal intubation performed without physician oversight remain in question. They conclude in a 2015 Annual Update in Intensive Care and Emergency Medicine that the “…unique environmental conditions and challenges of the out-of-hospital setting, inappropriate and overzealous ventilation can still result in detrimental outcomes.” The medical community recognizes that when this procedure is dangerous, yet it is still allowed to continue in the field.
Some the harms caused by improper intubation can be seen immediately when a patient is examined by a qualified physician. In some cases, swift intervention can mitigate the overall effect. Too often, though, the damage is already done.
Because this event most often happens among medical professionals, ambulance and hospital records are critical in proving intubation error and the consequences. Later, notes to the victim’s chart made by nursing staff and other medical professionals regarding the patient’s progress or lack thereof will also be useful.
The trickier damages to prove are the other, more subjective ones. The degree to which the victim suffers must be documented in clear written or recorded verbal examples complete with dates and times when the observations are made. Documentation is everything in these cases.
A young man with brain damage may struggle to remember where he lives, or even his sister’s name. He is shown a pencil, but he cannot name it nor verbalize the uses of the instrument. He knows he should know, but he simply cannot recall. This can trigger sometimes violent outbursts or deepening depression. The victim’s inability to control his emotions can also be a very serious and debilitating effect of the procedure’s misapplication. Sadly, this lack of control is often the reason victims of brain damage end up in nursing facilities away from home and the people they love.
The victim’s inability to enjoy normal communication is compromised by brain damage. This complicates interpersonal relationships and can result in the victim’s withdrawal from society – further isolation; whether self-inflicted or imposed upon him by others can precipitate a downward health spiral. Eventually, some victims simply stop interacting with others at all.
As an observer, you may not understand the importance of the daily evidence of the changes in the victim’s life. That’s why each and every incident family members observe should be written down. Keep a notebook in his room and leave it where family members and visitors can jot down notes. (Visitors may someday be called as witnesses.) The evidence of such notes are critically important as your personal injury lawyer paints a picture for the jury of what your loved-one has lost.
How much is a young man’s life worth? What might our young man might have become – what would his children have become if he’d been able to marry and become a father – if his life not been so devastated? What, precisely is it worth to suffer daily with the confusion, frustration and eventual isolation severe brain damage causes?
Of course, there is no way of knowing exactly whether or not this young man would have been the CEO of a mighty corporation or the author of the great American novel. Nevertheless, we have the guidelines established by other cases to answer some of these questions.
When medical professionals fail to adhere to the standard of care that’s expected of them there are three kinds of damages that can be considered. They are:
- Compensatory Damages – Awards for compensatory damages cover the losses and expenses you suffer as a result of your injuries. Most often these take the shape of medical bills, lost wages, and travel expense. This also includes the cost of future care – in some cases, a lifetime of care.
- Non-economic Damages – These are the damages meant to cover the pain and suffering and other intangible losses like the inability to enjoy the progression of a ‘normal’ life.
- Punitive Damages – In order to collect punitive damages, there must be evidence of reckless or willful misconduct or fraud. For these to come into play, you must prove that the person who presided over the cause of the damage intentionally meant to harm the victim, or simply didn’t care if the victim would be forever changed.
Your legal team will consider each of these categories and ask the insurance companies. In some cases, through negotiation, both sides may find a settlement solution together. If necessary, a court and Jury Trial may be necessary to compensate the victim for the applicable damages.
Medical malpractice is a very technical and complicated segment of law. Because medicine is a science, scientific evidence and expert witnesses will be necessary. What will also be critical is the expertise provided by a well-seasoned personal injury lawyer. In cases such as these a lawyer who knows how to present the evidence is essential. Medical facilities and practitioners have access to powerful, well-paid malpractice attorneys who are very experienced at defending malpractice claims. Going to court in a medical malpractice case without a personal injury attorney is not recommended.
Our firm offers a free case analysis to each potential client. We will review the facts in your case and help you decide how to proceed. There is no obligation, just good advice at no cost. The more thorough your understanding of the law as it applies to your victim, the better off he or she will be in the end. Call The Millar Law Firm today for a free case review. There is no legal fee unless money is recovered for you.