As an acute care and trauma surgeon, patients die much more often on my operating table than they do for surgeons who deal with carefully selected elective surgeries. My patients are often at the brink of death when I lay steel on them to try to fix what is wrong. As a consequence, over an almost 20 year career, I’ve had my share of patients who have died on the table or soon thereafter. Usually, if I know I’ve done my best and they succumbed solely because of their disease process or injury, I am at peace with a patient passing away; it is their disease or injury that caused them to die and I was there to do my best to alter the outcome. Sometimes, if for whatever reason, I think that I could have done something differently or better, like diagnosed a condition earlier, done the procedure differently, etc., and I think that this may possibly have contributed to the patient’s death, then I might beat myself up for a while. But, then, I get my head back in the game, take that introspection to heart and if I see an opportunity to improve for the next time I face that situation, it sticks with me, and again, I can be at peace with it. In order to remain in a field where patients are more likely to die no matter what you do for them, you cannot internalize their deaths and allow it to consume you, otherwise you’re no good for the subsequent patients.
In terms of “what happens”, I’’m not sure if the above is what you were looking for or maybe you were asking are there any institutional, licensure, governmental, or liability consequences for a surgeon who has a patient die on his/her table. In general, most unexpected operative deaths are reviewed by hospital peer groups and a judgment is rendered as to whether the death was non preventable, potentially preventable or completely preventable (i.e., it should not have happened). These groups are empowered to recommend consequences to the medical staff leadership, comprising a spectrum of actions: no action necessary, physician education, trend the physician, monitor the physician’s subsequent patient care, restrict the physician’s privileges, require the surgeon to acquire additional training, report the physician to the state Medical Board, removal from staff, etc. I practice in the state of California in Los Angeles County, and all operative deaths, and deaths 24 hours following operation are reviewed in some shape or form by the the County Coroner’s office. This can be as simple as the coroner reviewing the chart and determining that the death was not unexpected and closing the case, up to formal autopsy and determining that there was a surgical misadventure that caused the patient’s death. The more drastic cases can lead to the surgeon being reported to the board and, in rare cases, recommendation that the surgeon be formally investigated for criminal charges (this is extremely rare). Other consequences of an operative death can be found in civil actions. The family always has the right to file malpractice and wrongful death suits against the surgeon. This can happen even if peer review, coroners, and medical boards determine that the surgeon rendered adequate care. (Especially since, in most states, peer review proceedings are not legally discoverable).
Most surgeons take operative death very seriously and we strive to make sure that we give our most skillful care in the OR. Often, because of the nature of the disease or injury, our efforts are not successful. This is part of being a surgeon and part of being a successful surgeon is learning to live with the death of your patients and using their deaths to help you become a better surgeon to help the next patient.
Hope this helped!
Read other answers by Bryan Hubbard on Quora:
- As a surgeon did you ever have a "Oh man this is just nasty!" moment during an operation?
- Doctors: How do surgeons hold out on surgeries more than 6 hours long? Do they rest during the operation?
- Who is highest paid doctor among the following, an Orthopedic (bone) Surgeon or a Cardiac (heart) Surgeon?
from Quora http://ift.tt/2f3PzLS
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