Same Day Surgery Centers – Ambulatory Surgery Centers
Everybody loves “same day” surgery centers: patients for the convenience, doctors for the ease and extra profit of owning their own surgical facility, insurance companies for the money they save. Except when disaster strikes: A patient is badly hurt or killed, and a medical malpractice investigation shows the surgery center did not follow basic standards that any hospital would have.
Then the lesson is learned all over again: Surgery is serious business wherever it is undertaken, and same day surgery centers – known more formally as Ambulatory Surgery Centers (ASCs) – need to follow the same rigorous safety standards that hospitals follow to keep their patients safe and healthy. When they don’t, and someone is hurt, a malpractice lawsuit may be appropriate.
In our law firm’s work on cases involving surgery at these same-day facilities, or in doctor’s offices, we are often amazed at how surgeons in outpatient surgery centers skirt the safety rules, especially with anesthesia. They often get away with breaking the rules, until it’s too late and a patient gets hurt.
Three examples from our own malpractice case files
- At a posh-looking same day surgery center in Montgomery County, Maryland a few years ago, a client of Patrick Malone & Associates went into cardiac arrest and suffered severe brain damage before her heart could be restarted, in a liposuction procedure. Her heart stopped because too much lidocaine was injected too quickly into her body fat. We brought a successful malpractice lawsuit for her against the plastic surgeon and the nurse anesthetist, but nothing could restore her health. She remains in a persistent vegetative state – an awake coma.
- At an abortion clinic in Prince George’s County, Maryland, strong sedative drugs were routinely injected into patients with no supervision by any anesthesiologist or even a nurse anesthetist, and no monitoring equipment whatsoever to check vital signs. Our client Susanne Logan stopped breathing sometime during the procedure, and by the time the gynecologist noticed, she had suffered severe brain damage. The case was featured on CBS’ “60 Minutes” as an example of poor care at an unlicensed facility. Read the 60 Minutes transcript here.
- In a surgeon’s office in Alexandria, Virginia, a middle-aged man underwent a cosmetic nose reduction surgery. He stopped breathing sometime after the surgery, due to the heavy dose of sedative drugs he had received, and the nurse who was supposed to be watching him didn’t notice anything was amiss until his body was already cool to the touch. A pulse oximeter monitor that should have been tracking his heartbeat and blood oxygen level had a broken part, and the surgeon had decided to go ahead with the surgery anyway despite not having any functional monitor.
These malpractice cases all had in common the lack of any accreditation by an outside body for the surgery center. There actually are three groups that inspect and accredit such facilities. The three main accreditors of ASCs are American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), Accreditation Association for Ambulatory Health Care (Accreditation Association or AAAHC) and The Joint Commission.
Often the problem with these surgery centers is a “systems error” – a failure to think through in advance the basic safety steps that must be followed to protect patients, and then to implement them.
Other errors that can easily lead to malpractice and patient injuries in same day surgery centers include:
- Failure to sterilize equipment;
- Discharging a patient too soon before they’re really ready to go home;
- Poor documentation of safety procedures;
- Poor staff oversight.
A recent advice article for surgeons on Medscape.com is eye-opening because it shows how surgeons need to be advised about safety steps that we lay people assume they would have already undertaken. The Medscape author wrote that failure to have detailed, specific procedures can lead to errors and injuries and then lawsuits. He identified common everyday failings such as:
- failure to sterilize equipment,
- discharging a patient too soon,
- failing to provide good supervision of staff, and
- failing to obtain proper informed consent for surgeries.
Another example the author gives: “… making sure that the battery on a portable defibrillator is replaced regularly. If you need to reach for the defibrillator, and it does not have a charge, you have a real problem. You should create a schedule for checking or changing batteries, and note that in your manual.”
This article shows how fear of malpractice lawsuits can be a good thing: motivating doctors to take safety steps to protect themselves from liability, and to protect patients in the process of doing that.
Patients need to find out their surgery center’s license and certification status. These are requirements that enforce standards of care essential for patient safety. Just because the surgery center looks clean and professional doesn’t mean it meets professional standards. State health agencies keep a list of licenses for these same day surgery centers. Read more…
Consult with an Experienced Malpractice Attorney
If you believe you or a family member has been seriously injured from medical malpractice, medical error, or neglect by a doctor, hospital, nurse, clinic, nursing home or other health care provider, you may want to click here to contact an experienced medical malpractice attorney for a free evaluation of your case. You can also email us at firstname.lastname@example.org or call us at 202-742-1500 or 888-625-6635 toll-free. We will respond within 24 hours. There is no charge for our initial consultation.