Physiologic Monitoring

Journal Articles

1. Tinker JH, Dull DL, Caplan RA, Ward RJ, Cheney FW: Role of monitoring devices in prevention of anesthetic mishaps: A closed claims analysis. Anesthesiology 71:541-546, 1989. [Abstract, NLM PubMed Link].

   A review of 1,175 closed claims indicated that about one-third of the negative outcomes could have been prevented by application of additional monitors. The adverse outcomes judged preventable by additional monitoring (end tidal CO2 and pulse oximetry) are eleven times more costly than those mishaps not judged preventable.

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: Cardiovascular System; Equipment Problems. Order this article from: ASA Closed Claims Project.

   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. Robbertze R, Posner KL, Domino KB. Closed claims review of anesthesia for procedures outside the operating room. Current Opinion in Anesthesiology. 2006 19:436-442. [NLM PubMed Link]. See also: Monitoring - Physiologic, Respiratory System. Order this article from: Journal Website.

   Nonoperating-room anesthesia claims had a higher severity of injury and more substandard care than operating room claims. Inadequate oxygenation / ventilation was the most common mechanism of injury.

4. Cheney FW, Posner KL, Lee LA, Caplan RA, Domino KB. Trends in Anesthesia-related Death and Brain Damage: A Closed Claims Analysis. Anesthesiology. 2006 Dec;105(6):1081-1086. [Abstract, NLM PubMed Link] See also: Respiratory System, Malpractice System, Monitoring - Physiologic. Order this article from: Journal Website.
   
   The significant decrease in the proportion of claims for death or permanent brain damage from 1975 through 2000 seems to be unrelated to a marked increase in the proportion of claims where pulse oximetry and end-tidal carbon dioxide monitoring were used. After the introduction and use of these monitors, there was a significant reduction in the proportion of respiratory and an increase in the proportion of cardiovascular damaging events responsible for death or permanent brain damage.

Newsletter Articles

1. Zeitlin GL: Recovery room mishaps in the ASA Closed Claims Study. ASA Newsletter 53(7):28-30, 1989.  [Full Text] See also: Respiratory System.
   
2. Cheney FW: The ASA Closed Claims Study after the pulse oximeter: A preliminary look. ASA Newsletter 54(2):10-11, 1990. [Full Text].
   
3. Bowdle TA: Central line complications from the ASA Closed Claims Project. ASA Newsletter 60(6):22-25, 1996. [Full Text] See also: Cardiovascular System; Equipment Problems
   
4. Domino KB: Trends in anesthesia litigation in the 1990's: Monitored anesthesia care claims. ASA Newsletter 61(6):15-17, 1997. [Full Text] See also: Anesthesia - Regional / MAC; Malpractice System.
5. Cheney, FW: Changing Trends in Anesthesia-Related Death and Permanent Brain Damage ASA Newsletter 66(6): 6-8, 2002. [Full Text; PDF Version] See also: Respiratory System, Malpractice System
6. 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: Cardiovascular System; 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; Cardiovascular System