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  • Houston Press Uses Families Loss As Propaganda Tool for ASA



    The recent article in the Houston Press (found here:http://tinyurl.com/nuugybq ) was pretty insulting. This time as opposed to going through all the evidence i decided to simply point out their lies.

    Here was our reply.

    It is unfortunate that patients in this article had negative outcomes. I feel for their families but If i were them i would be quite angry that my loss was being exploited as a political propaganda piece designed to disparage another group.

    More like propaganda and fear mongering, honestly. Should I write an article about all the negative outcomes directly related to an individual Anesthesiologist care and then make a blanket statement about all anesthesiologists? Does not seem fair or honest right?

    One would think that a group of physicians would have more common sense.

    As a CRNA working independently for 7 years without any Anesthesiologists for 3 hours I can say definitively that my patients have no more risk than if there was one sitting in the lounge or one doing the anesthetic themselves. It is not just me who says that, its all the current research which proves it.

    What the real motive here is to try and disparage one profession in the interest of controlling them and making more money. If I was so inclined to lower myself to the authors level I too could write an article which suggested that because of a number of negative incidents by Anesthesiologists resulting in negative outcomes have happened that ALL Anesthesiologist are as incompetent or dangerous.

    The difference between CRNAs and Anesthesiologists is not a clinical one, it is an ethical one as evidenced by this propaganda article.
    Comments 7 Comments
    1. MarathonNurse's Avatar
      MarathonNurse -
      I'm not a SRNA yet (starting in January) but I was wondering if someone could explain a few things to me about the Houston Press article. First off, if the patient had long QT syndrome and was given Zofran by the MDA, why is the CRNA being attacked? Why is Memorial Hermann not being named in the suit, if supposedly the patient was covered in "columns of ants?"
    1. jwk's Avatar
      jwk -
      Quote Originally Posted by MarathonNurse View Post
      I'm not a SRNA yet (starting in January) but I was wondering if someone could explain a few things to me about the Houston Press article. First off, if the patient had long QT syndrome and was given Zofran by the MDA, why is the CRNA being attacked? Why is Memorial Hermann not being named in the suit, if supposedly the patient was covered in "columns of ants?"
      The Zofran had absolutely nothing to do with this patient's death. It sounds pretty much like a poorly managed airway crash all around. All the rest is BS fluff from the plaintiff's lawyer.
    1. bicycle Charlie's Avatar
      bicycle Charlie -
      I sent a message to the "reporter" at the Houston Press:

      Hello Diana,
      You have explored several surgical tragedies. You are not a medical professional, and you turned for explanation to experts in the field of anesthesiology.
      I believe you may have tried to balance your critique, and in small measure, you have. By including a rationale for doses and weight by an unbiased professional as opposed to presenting solely the opinion of a plaintiff attorney's expert witness, you preserved a semblance of objectivity. That is not the reason for my responding to your article.

      In your re-telling, several errors of "nuance" were concerning to me, for example: "Minutes later, Lambourn noticed Hunt wasn’t breathing."
      I say nuance errors not to minimize the importance of your errors. Much of the practice of anesthesiology hinges on minutia, or "nuance," if you will. One of your sources likens our practice to a chef...a "little" of this or that can make the difference.

      When a subscriber of the Houston Post reads in your article that "after several minutes..." the nurse "noticed" the patient was not breathing, that reader is predictably drawn to the conclusion that the anesthesia provider must have been absent/dim/inattentive to allow "minutes" to pass before "noticing" the patient wasn't breathing. Or, that reader might wonder if what you meant was that several minutes after the case started, the nurse was closely monitoring the patients breathing pattern, and "noted" apnea.

      Nuance, minutia, minutes...see what I mean? Because patients undergoing endoscopy very often do slow or stop breathing, usually briefly, during the most "uncomfortable" part of the procedure, the insertion of the scope (a few minutes after induction of anesthesia). So I don't know what you intended to have the reader believe: did it take minutes to notice, or did the apnea occur several minutes after the start of the case (which, as I indicated, is fairly common in conscious sedation/non-intubated general anesthesia)?
      Obviously, I don't know what happened, or if you meant to imply that it did in fact take minutes to "notice," but if an anesthesia provider, whether a nurse or MD, took "minutes" to notice if a patient wasn't breathing, that is prima facie evidence of malpractice.

      Here's my point: because of your nuanced error in writing this story, you bring the reader toward the conclusion of malpractice by the nurse anesthetist. Any anesthesia provider, MD or CRNA, would have been able to proof read your article and clarify with you what you intended to convey vs. what was implied. Again, I have no way of knowing what happened, and your article IMHO does not enlighten me as to important factual conclusions.

      What your article does imply, and it does this several times, is that nurse anesthetists are not as competent as anesthesiologists. You relate that: "...20 years ago with a study that found that cases in which anesthesiologists directly oversaw anesthesia had better outcomes than those in which anesthesiologists did not." Had you used all current data, you will find there is no research to corroborate differences in outcomes among any of the anesthesia practice models or provider mixes. Your readers would not be drawn to that conclusion after finishing your piece.
      I encourage you to spend a "few minutes" researching anesthesia outcomes vs. anesthesia provider models in the US. That may add some "nuance" to your viewpoint.
    1. tri21's Avatar
      tri21 -
      Quote Originally Posted by bicycle Charlie View Post
      I sent a message to the "reporter" at the Houston Press:

      Hello Diana,
      You have explored several surgical tragedies. You are not a medical professional, and you turned for explanation to experts in the field of anesthesiology.
      I believe you may have tried to balance your critique, and in small measure, you have. By including a rationale for doses and weight by an unbiased professional as opposed to presenting solely the opinion of a plaintiff attorney's expert witness, you preserved a semblance of objectivity. That is not the reason for my responding to your article.

      In your re-telling, several errors of "nuance" were concerning to me, for example: "Minutes later, Lambourn noticed Hunt wasn’t breathing."
      I say nuance errors not to minimize the importance of your errors. Much of the practice of anesthesiology hinges on minutia, or "nuance," if you will. One of your sources likens our practice to a chef...a "little" of this or that can make the difference.

      When a subscriber of the Houston Post reads in your article that "after several minutes..." the nurse "noticed" the patient was not breathing, that reader is predictably drawn to the conclusion that the anesthesia provider must have been absent/dim/inattentive to allow "minutes" to pass before "noticing" the patient wasn't breathing. Or, that reader might wonder if what you meant was that several minutes after the case started, the nurse was closely monitoring the patients breathing pattern, and "noted" apnea.

      Nuance, minutia, minutes...see what I mean? Because patients undergoing endoscopy very often do slow or stop breathing, usually briefly, during the most "uncomfortable" part of the procedure, the insertion of the scope (a few minutes after induction of anesthesia). So I don't know what you intended to have the reader believe: did it take minutes to notice, or did the apnea occur several minutes after the start of the case (which, as I indicated, is fairly common in conscious sedation/non-intubated general anesthesia)?
      Obviously, I don't know what happened, or if you meant to imply that it did in fact take minutes to "notice," but if an anesthesia provider, whether a nurse or MD, took "minutes" to notice if a patient wasn't breathing, that is prima facie evidence of malpractice.

      Here's my point: because of your nuanced error in writing this story, you bring the reader toward the conclusion of malpractice by the nurse anesthetist. Any anesthesia provider, MD or CRNA, would have been able to proof read your article and clarify with you what you intended to convey vs. what was implied. Again, I have no way of knowing what happened, and your article IMHO does not enlighten me as to important factual conclusions.

      What your article does imply, and it does this several times, is that nurse anesthetists are not as competent as anesthesiologists. You relate that: "...20 years ago with a study that found that cases in which anesthesiologists directly oversaw anesthesia had better outcomes than those in which anesthesiologists did not." Had you used all current data, you will find there is no research to corroborate differences in outcomes among any of the anesthesia practice models or provider mixes. Your readers would not be drawn to that conclusion after finishing your piece.
      I encourage you to spend a "few minutes" researching anesthesia outcomes vs. anesthesia provider models in the US. That may add some "nuance" to your viewpoint.
      Bicycle Charlie, Thank you for sending that response to Diana! Very well said. I don't want to place judgment on the CRNA as there is no way of knowing the circumstance. God knows that the CRNA is devastated. I feel for the family who lost someone tragically. I want to know is this reporter being funded by the ASA?
    1. jwk's Avatar
      jwk -
      Quote Originally Posted by tri21 View Post
      Bicycle Charlie, Thank you for sending that response to Diana! Very well said. I don't want to place judgment on the CRNA as there is no way of knowing the circumstance. God knows that the CRNA is devastated. I feel for the family who lost someone tragically. I want to know is this reporter being funded by the ASA?
      Is every article that casts anesthesiologists unfavorably funded by the AANA?
    1. yankeern's Avatar
      yankeern -
      Jwk. You most likely will not article funded by the aana to push propaganda against the safety of MDAs. We take the high road. ASA doesn't know how to do anything else but to use scare tactics and lie to the public regarding CRNA safety. You will always support MDAs and the ASA because without them you don't exist.


      Sent from my iPhone using Tapatalk
    1. Syd's Avatar
      Syd -
      This should reflect that no procedure is minor. Having done my share of Endo. it is not approached lightly. Hydration,self medication,quick H+P, patient's unknown issues, patients failure to report, NPO status compliance; the list goes on. How about this…the tech. staff trying to instruct on how we preform your job, where you can stand ! Endo rms. that are little more the an after thought by hospital CEO's.. Limited space,drugs, supplies, and of coarse JACHO requirements; no predawn syringes, gloves,alcohol swabs, nothing on top of your chart,carts must be locked at all times unless immediate use. Then turn over time,…no premeds till time out in room, then slam dunk and get the he.. out so they can clean and bring in the next, and don't forget the anesthesia provider is required to clean down their equipment as they go, give report and "hook up" monitors in PACU before trotting over to assess,review explain and get consent signed on the next patient; and don't take more then five minutes before you are back in the room. Physican H+P 's mostly inadequate when they are found. And yes poor outcomes are directed at CRNA, even a perforation is your fault because, No one wants poor outcomes on their sheet; again since Gov. will tie this to reimbursement futures. So anesthesia is the fall guy for everything from poor IV access to gas pains. And Yes, they are devastated when things happen, they have the least power to effect change, an easy target, responsible for the patient and oversight of everyone else during that 5 minute preop, 30 min procedure,and post op comfort. If anyone has a way to improve our lives…lets get writing. Where are the research studies?