Committees  |   August 2014
The Changing Environment of Legal Liability: The Loss of Chance Doctrine and What It Could Mean for Anesthesiologists
Author Affiliations
  • Christopher M. Burkle, M.D., J.D.
    Committee on Professional Liability
Article Information
Cardiovascular Anesthesia / Critical Care / Ethics / Medicolegal Issues / Quality Improvement / Committees
Committees   |   August 2014
The Changing Environment of Legal Liability: The Loss of Chance Doctrine and What It Could Mean for Anesthesiologists
ASA Monitor 08 2014, Vol.78, 48-49.
ASA Monitor 08 2014, Vol.78, 48-49.
Imagine bringing an unstable patient emergently to the O.R. after blunt abdominal trauma and a positive focused abdominal sonography for trauma (FAST). The patient becomes pulseless en route and resuscitation is begun promptly. In the crisis, you administer ephedrine rather than epinephrine during one medication cycle, deviating from the advanced cardiac life support (ACLS) algorithm for pulseless electrical activity. Recognizing the error, you later resume appropriate medications according to the algorithm. Despite care, the patient expires from his injuries. You are later named in a lawsuit claiming that your error makes you liable for the patient’s loss of chance.
Traditional standards of negligence in medical malpractice cases require a claimant to establish that the physician deviated from the medically accepted standard of care and that this breach was a proximate cause of the injury. When there is more than one possible cause of injury, the plaintiff must prove that the physician’s deviation from the standard of care was a substantial factor in causing the injury described. In addition, each element above must be met with a preponderance of evidence (greater than 50 percent likely).
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