عدد الرسائل : 193
العمر : 47
تاريخ التسجيل : 27/07/2008
|موضوع: Case record Teething problems الجمعة فبراير 04, 2011 12:37 pm|| |
Mr A, a 48-year-old salesman, was admitted to hospital for an elective cholecystectomy. Dr B assessed him for anaesthesia on the night before his operation. He was noted to be in good general health. Dr B observed that Mr A had several crowns on his front teeth and noted this finding.
Mr A had had several anaesthetics in the past. He had experienced postoperative nausea and vomiting (PONV) after some of the operations. Mr A expressed concern about this and appeared somewhat anxious about his operation. Dr B made a note that he had explained the general anaesthetic procedure, the plan for postoperative pain relief, and what steps he would take to minimise the risk of him experiencing PONV.
There was no specific record of the risk of dental damage despite the presence of several crowns on the patient’s front teeth. Dr B prescribed a “premed” of an anxiolytic and an antiemetic. Dr B used a “total intravenous” type of anaesthetic technique. The record showed that he had intubated the trachea to secure the airway. There was no note of any difficulties with the airway nor laryngoscopy. The operation proceeded smoothly. Mr A was pleased that he had not experienced any PONV on this occasion. However, he did complain of dental pain.
Mr A visited his dentist a few weeks later. The dentist found a damaged crown and associated fracture of the underlying root. He concluded that this was consistent with an injury associated with instrumentation of the airway. Mr A required several appointments with the dentist and experienced discomfort for some time. Mr A made a claim against Dr B.
Scrutiny of the notes and anaesthetic records confirmed that Dr B had assessed the airway and noted the presence of the crowns. Crucially, there was no mention that he had warned Mr A of the risk of dental trauma. Furthermore, Mr A stated that he had not received any verbal warning at any time about the risk. The case was settled for a low sum to cover the costs of dental work and pain and suffering.