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Cardiovascular System Damaging Events

Journal Articles

  1. Caplan RA, Ward RJ, Posner K, Cheney FW: Unexpected cardiac arrest during spinal anesthesia: A closed claims analysis of predisposing factors. Anesthesiology 68:5-11, 1988. [Abstract, NLM PubMed Link]] See also: Anesthesia - Regional / MAC
    1. This is an in-depth review of 14 cases of unexpected cardiac arrest in healthy patients which were identified in the first 900 claims reviewed in the ASA Closed Claims Project. A major factor in the poor outcome (six deaths, eight permanent brain damage) seemed to be inadequate appreciation of the need for early treatment of cardiac arrest with alpha agonists in order to counteract sympathetic blockade.
  2. Domino KB, Bowdle TA, Posner KL, Spitellie PH, Lee LA, Cheney FW. Injuries and Liability Related to Central Vascular Catheters: A Closed Claims Analysis. Anesthesiology. 2004 Jun;100(6):1411-1418. [Abstract, NLM PubMed Link] See also: Monitoring - Physiologic; Equipment Problems. Order this article from: ASA Closed Claims Project
    1. Claims for injuries related to central vascular catheters had a greater proportion of death than other claims in the Closed Claims database. The most common central vascular catheter complications causing patient injury were wire/catheter embolus, cardiac tamponade, carotid artery puncture/cannulation, hemothorax, and pneumothorax. Patient safety may be improved by pressure waveform monitoring, use of ultrasound guidance for difficult catheterization, and checking and acting on a chest radiograph after vascular catheter insertion.
  3. Bhananker SM, Liau DW, Kooner PK, Posner KL, Caplan RA, Domino KB. Liability related to peripheral venous and arterial catheterization: a closed claims analysis. Anesth Analg. 2009 Jul;109(1):124-9. [NLM PubMed Link]. See also: Monitoring - Physiologic; Equipment Problems
    1. This analysis of claims arising from complications after peripheral IV and arterial vascular cannulation found that IV catheters were an important source of liability for anesthesiologists. IV claims involved a larger proportion of cardiac surgery procedures during which arms were tucked. Approximately half of IV claims resulted from extravasation of drugs or fluids. Claims related to radial arterial catheterization were uncommon.

Newsletter Articles

  1. Morray JP: Pediatric Perioperative Cardiac Arrest Registry. ASA Newsletter 59(6):13, 1995. [Full Text] See also: Pediatrics
  2. Bowdle TA: Central line complications from the ASA Closed Claims Project. ASA Newsletter 60(6):22-25, 1996. [Full Text] See also: Monitoring - Physiologic
  3. Morray JP: Pediatric perioperative cardiac arrest registry: An update. ASA Newsletter 60(6):26-28, 1996. [Full Text] See also: Pediatrics
  4. Bowdle, TA: Central Line Complications From the ASA Closed Claims Project: An Update. ASA Newsletter 66(6): 11-12 & 25, 2002. [Full Text; PDF Version] See also: Monitoring - Physiologic; Equipment Problems

Conference Presentations and ASA Abstracts

  1. Spitellie PH, Bowdle TA, Posner KL, Cheney FW, Domino KB: Injuries from Central Lines: A Closed Claims Analysis. Anesthesiology, 96: A1124, 2002. [Full Text] See also: Equipment Problems; Monitoring - Physiologic