Joan River’s Death Spotlights Dangers of Outpatient Surgery Centers

Medical Malpractice

By Kay Van Wey, Board Certified in Personal Injury Trial Law by the Texas Board of Legal Specialization.

Same day surgery centers, more formally known as ambulatory surgery centers (ASCs) have become quite popular these days. They’re convenient for patients, profitable for physicians, and they allow insurance companies to save money. This is great, until tragedy strikes…

When Something Goes Terribly Wrong

It is unfortunate that it takes the death of a high profile celebrity to draw our attention to the dangers associated with some out patient surgery centers. Joan Rivers went in for  a simple procedure which ended up costing her life, but why? 

 According to the New York Times, “Joan Rivers died as a result of a predictable complication of medical therapy.”

As her vocal cords swelled during surgery, her oxygen supply was cut off, leading to cardiac arrest, brain damage, and ultimately death. One of the basic tenets of medicine is to always protect the airway. Meaning, physicians have many ways to deliver oxygen to patients when their airway becomes compromised. So, why was  a tracheotomy not performed to allow oxygen to maintain Joan River's heart? Why there were no attempts to revive Joan Rivers by performing basic CPR?

Obviously, something went very wrong in this clinic. As more and more ambulatory surgeries are performed in outpatient clinics every day, we must stop and think about how safe outpatient clinics really areWould Joan Rivers still be alive if her surgery had been performed in a hospital?

Clinics Not Equipped for Emergencies

First and foremost, if you are facing ambulatory surgery in an outpatient clinic, understand many of them do not have immediate access to emergency services. They are not all staffed to handle a crisis, either.

Hospitals are equipped with personnel who are trained to handle a crisis, while outpatient centers often need to transfer a patient in crisis to a hospital or call 9-1-1 for help. Older patients may be especially vulnerable  because they can deteriorate more rapidly when a crisis occurs. There may not be time for a transfer to a  facility which can provide a higher level of care.

Secondly, many outpatient surgery centers do not have the wide span of staff expertise that hospitals possess. Hospitals are equipped to manage a wide range of emergencies that could occur during surgery. Hospitals who maintain competent, well trained and equipped staff are knowledgeable in advanced life support techniques. That may not be the case at an out-patient surgery center. 

So Much Can Go Wrong

Many ambulatory surgical centers do not have specific, detailed procedures in place to  avoid medical errors. Some do not ensure that their staff is properly trained, or that they are following these procedures carefully. When policies do not exist, or are not adhered to, risks abound and they can include the following:

  • Discharging patients too early

  • Failing to recognize post operative complications that can imperil the patient's life

  • Failing to appropriately respond to medical emergencies

  • Medication errors or overdoses

  • Falls resulting in serious injury

  • Surgical fires

  • Wrong site surgery

Any of these can transform a simple surgery that should be “no big deal” into a serious injury, or even death, as in Joan River’s case. Every surgery is serious and carries risks, regardless of where it is performed.  Ambulatory Surgery Centers need to be held to the same standards as hospitals to ensure patient safety.  If a patient is badly injured or hurt in an outpatient clinic, and an investigation reveals negligence, a lawsuit may be necessary to protect the patient's rights, to recover for the harm that was caused and to prevent similar injuries from occurring in the future.

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