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Medical Malpractice and the Liability of the Loss of Airway: The Otolaryngology Perspective

Objectives: Analyze malpractice litigation trends to better understand the causes and outcomes of suits involving loss of airway to prevent future litigation and improve physician education. Methods: Jury verdict reviews involving otolaryngologists and loss of airway were obtained from a computerized legal database, WESTLAW from 2001-2011. Data were compiled on the demographics of the defendant, plaintiff, nature of injury, legal allegations, verdicts, and judgments. Results: Fourteen cases were identified and selected for review. Ten cases resulted in mortality, three cases in anoxic brain injury, and one case involved subglottic stenosis. Four cases were found in favor of the defendant, while ten cases resulted in plaintiff verdicts or settlements with an average award of $1,580,172. Seven cases involved loss of airway due to failed intubations. The most common procedures involved in the loss of airway were oropharyngeal procedures (29%). There were no cases involving a planned surgical airway. The most common legal allegation was delay in procedures (64%). No cases involved failure of informed consent. Conclusions: In cases of loss of airway, there is significant liability consigned to otolaryngologists. They are held accountable for recognizing an emergent airway, promptly and successfully securing the airway, and ensuring a protected airway throughout the patient’s disposition. Thus, close oversight, prompt action, and unequivocal communication in emergent airways is imperative.