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People have anaesthesia in order to manage pain during surgery or related procedure. It is able to control the flow of blood, the heart rate, the heart rhythm and blood pressure. The purpose is to provide:
- Relaxation during surgery.
- Blockage of pain fibers.
- Helping you forget the procedure.
- Making you sleepy.
- Making it so that youíre unconscious during the surgery.
What are the types?
- Local, which involves injecting a medication through the skin or on the skin in order to block the pain in a small area of the body.
- Regional, which blocks a nerve proximal to the surgical site so that a larger area is numb for surgery. You can have a peripheral nerve block that blocks specific peripheral areas. You can also have a spinal or epidural nerve block that involves putting an anesthetic in the spinal area to block everything beneath the blocked area.
- General, which involves injecting the medication so that the brain is affected and you become unconscious. Someone has to breathe for you during the procedure.
How do you know which type to use? The type to be considered depends on your past and current health. If you have had problems with other surgeries, this should be considered. If you have heart disease or diabetes you are at greater risk. If family members have a known allergy, you might have the same allergy.
Certain surgeries require general anaesthesia and others can get by with regional or local surgery. If the EKG is questionable, the anesthesiologist may make a call against anesthesiology.
This procedure can have complications even though it is generally considered safe. Local, carries the least risk and general, carries the most risk. Allergic reactions to the medication can be very dangerous and can happen with any type. Most people donít know they have an allergy.
Complications of regional anaesthesia include weakness and paralysis at the site of the affected nerves. You can get a headache after spinal or epidural procedures. It can be associated with dizziness, nausea, vomiting, stiff neck and light sensitivity. Low blood pressure is possible as is the inability to urinate so that a catheter needs to be inserted. A backache is definitely possible. It is possible for you to get an infection from spinal or regional anaesthesia. Nerve damage and permanent paralysis can occur following the procedure and isnít noticed until the medication has worn off.
General anaesthesia carries the greatest risks, complications and side effects. There is a risk of death with this type so anaesthesiologists need to take care before using this on patients. A history and brief physical examination are necessary before surgery.
In general anaesthesia, the body and mind are affected. Side effects, if the patient is well supported after surgery, usually clear up after about twenty four hours. There is also the possibility of 'unaesthetic awareness' which is also known as 'unaesthetia awareness' in which case the patient is conscious and aware whilst not being able to move or communicate whilst the surgical procedure is carried out which can be caused as a result of medical negligence by the doctor. The other complications include:
- Having a sore throat from the ET tube used to manage the airway during the surgery.
- Drowsiness or fatigue after the surgery.
- Headache that can last for at least twenty four hours.
- Vision difficulties.
Serious complications are possible after general anaesthesia. Your risk increases with age, allergies and poor overall health. Gender plays a role in who has a bad reaction. If you have underlying health problems, use tobacco, use alcohol, or drugs, your risk goes up considerably. The major serious complications include:
- An intra-operative stroke.
- A heart attack while in surgery.
- Brain damage from loss of oxygen.
Anaesthetic Error Medical Overview
Anaesthesia is divided into local, regional and general anesthesia. All types of anesthesia work to numb or anesthetize the body in parts or in whole so that surgery can be done without pain or discomfort for the person having surgery to the body. Each type of anaesthesia carries its own risks, which fortunately are rare.
Regional and local anaesthesia carry similar risks. Regional anaesthesia involves injecting a major proximal nerve that sends anaesthetic signals to a wide range of the body, such as the entire lower arm or leg for foot and hand surgery. The major side effects can involve injection of the xylocaine (anaesthetic) into an artery or vein sending it into the body's blood stream unnecessarily and damage to the nerve being numbed, which can be permanent or semi-permanent. The same is true on a smaller scale with local anaesthesia. Local anaesthesia also uses xylocaine as a local anaesthetic injected directly into the area of the injury. You can get systemic anaesthesia toxicity if the anaesthetic gets injected into the bloodstream.
Regional anaesthesia also constitutes epidural and spinal anaesthesia. Systemic toxicity is possible with these types of anesthesia. You can also get heart complications, lung complications, infection, local swelling, and bruising at the site of injection. A headache is a common complication of spinal anaesthesia because the spinal anaesthetic creates a hole in the dura such that cerebrospinal fluid leaks up and causes a lack of CSF around the brain and resultant headache. The treatment is to put a blood patch on the leak to stop the leakage and allow the dura to heal.
General anaesthesia involves the use of anaesthetic injectable medications along with inhaled anaesthetic gases. There are more complications from this type of anaesthesia than with local or regional anaesthesia. The risks you face depend on your age, your health and your personal response to anaesthesia. Some medical conditions, such as heart disease, circulatory disease or nervous system disease will increase your risk of getting complications of general anaesthesia. Certain medications you take can increase the risk of getting complications of general anaesthesia. Make sure your doctor knows everything you are taking. Even smoking, alcohol consumption or the use of illicit drugs can contribute to side effects from anaesthesia.
General anaesthesia can cause you to have a lack of a gag reflux so that, until a tracheostomy tube is placed in the airway, you can aspirate secretions or vomitus. This can result in a chemical or bacterial pneumonia. Aspiration is uncommon but can happen with deadly consequences. This is why people are asked not to eat or drink prior to surgery for several hours before surgery. Anaesthesiologists use special techniques in intubation to block the chances of aspiration.
Coughing, muscle spasms in the voice box and gagging can happen during removal or insertion of the endotracheal tube. Laryngospasm or bronchospasm can occur in response to the airway so that the person can't get enough airflow through the airway. Blood pressure and heart rate can increase during the insertion of the airway and teeth and lips can be damaged. Teeth can be broken and you can have a sore throat or hoarseness for a number of days.
General anaesthesia can lead to rhythm problems of the heart, stroke, or to damage to the heart in the form of a heart attack. About one in 200,000 people actually die from general anaesthesia, even if they were healthy before the anaesthesia-related death.
There is a rare but life threatening condition associated with general anaesthesia called malignant hyperthermia. This is usually associated with the inhaled anaesthetics and with succinylcholine-a muscle relaxant. It results in a severe rise in temperature in the operating room which can fry the brain and do the ultimate damage in the form of death to body tissues and the entire body.
HELPLINE: ☎ 1800 633 634
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here