In a malpractice lawsuit filed against an anesthesiology group, a patient's family argued that the provider on duty arrived too late to save the patient's life, a fatal error that might have been prevented if the provider had been carrying an emergency pager, which the group had agreed to use in order to respond to codes. The anesthesiology group responded that its physician arrived as soon as he was alerted and did more than any other staff member to save the patient, even though he was not responsible for responding to hospital codes.

After undergoing oral surgery at Seattle's Swedish Medical Center, 20-year-old Mikhail Manyak suffered an anaphylactic reaction to his medications. Airway swelling left him unable to breathe. A code was called, but the hospital's rapid response team failed to establish the airway.

The team attempted to contact a member of Physicians Anesthesia Service, the hospital's designated emergency airway service. The group's on-call provider, who had the pager, was in surgery and could not respond. Mel Crawford, an attorney for Mr. Manyak's familiy, says the pager should have been handed over to a backup provider. Since the backup anesthesiologist, James Burkman, MD, did not have the pager, he could not be contacted until the team messaged him via the public address system, which cost them precious minutes, says Mr. Crawford. When Dr. Burkman arrived, his efforts restored the patient's breathing, but it was too late to prevent severe brain damage. Mr. Manyak died a few days later.

Mr. Manyak's family filed a wrongful death lawsuit against the hospital and then added Dr. Burkman as a defendant, alleging he responded too slowly and his initial rescue efforts failed. Dr. Burkman was later switched out for the anesthesia practice as a whole, and another charge was added: The service should have instituted a policy requiring its available on-call physician to carry the pager and ensure that he could arrive at an emergency code within 2 minutes. An expert witness testifying for the patient's family insisted that was standard care for anesthesia groups.

The hospital settled the case for $750,000, but Physicians Anesthesia Service kept fighting. It disputed that Dr. Burkman was negligent, pointing out that he got the patient breathing after 3 other physicians on the scene failed to do so, says Mr. Fitzer. The defendants also argued that no other anesthesiology group in the state had such a policy.

A trial jury sided with the group, clearing Dr. Burkman of the allegations of negligence and the group of lacking proper procedures. "The jury concluded that my client acted heroically and did everything he could to save this young man's life," says Mr. Fitzer.

The patient's family was ordered to pay $634 in court costs, and was denied a new trial, a ruling it did not appeal.

Leigh Page