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Clinical Negligence Case Involving Anaesthetic Awareness

10 May 2019

Our Clinical Negligence Solicitors acted for a client who suffered a period of anaesthetic awareness (where a patient awakens during surgery) whilst having a laparoscopy (keyhole surgery).

The purpose of general anaesthesia is to cause a state of controlled unconsciousness, prevent movement and relieve pain. It will be administered by an anaesthetist either as a liquid injected into your veins through a cannula (a thin, plastic tube that feeds into a vein, usually on the back of your hand) or as gas that you breathe in through a mask. An anaesthetist is a doctor who has had specialist training in anaesthesia, in the treatment of pain, and in the care of patients in the intensive care unit. Care of the unconscious patient during surgery is the responsibility of the full multi-disciplinary surgical team, however, it is the anaesthetist’s duty to providing anaesthesia during surgery. There are some mistakes that are so serious they are termed ‘Never Events’ (serious, largely preventable patient safety incidents that should not occur if relevant preventive measures have been put in place) such administering a nerve block at the wrong site or administering the wrong gas.If the anaesthetist does not provide a suitable level of the drug to cause unconsciousness then the patient can wake up, become aware of the surgery and even feel pain, yet be unable to move or communicate what’s happening to the medical team. This can be an incredibly frightening experience. The amount of anaesthetic should be continuously monitored to help ensure this doesn't happen.

Unfortunately, our client was not suitably anaesthetised for her operation and has vivid recollections of being cut open whilst in the operating theatre. She felt the surgical incision and the sensation of gas insufflation. She also heard the consultant surgeon discussing what he was going to do. She attempted to speak and alert the medical staff that she was aware of what was happening, but she was unable to move. She found the event traumatic and frightening. It would appear that it took around 20 minutes for our client’s blood pressure to settle which is the likely period of awareness.

When the anaesthetic had worn off sufficiently, our client advised the nurse in the recovery room that she had felt a searing pain when the cut was made and that she could hear the surgeon telling everyone what he was doing. The nurse told our client that she had been dreaming. The impression given to our client was that this could not have happened and that she must have got it wrong. When our client was transferred to the ward, she repeated what happened to the nurses. She again felt like she wasn’t taken seriously and so called her daughter and her partner, who telephoned the hospital that afternoon. This prompted an investigation and when the blood pressure charts were reviewed, the hospital admitted there had been an error.

Our client was extremely distressed by the incident. She had difficulty sleeping and her GP prescribed medication to help restore her sleep pattern. She continued to struggle following the incident and her GP suggested that she was suffering from PTSD and recommended counselling. Our client required trauma focused cognitive behavioural therapy with a private psychologist. Following her treatment, her nightmares became less frequent but have not stopped. She was diagnosed with PTSD and will require further sessions of trauma focused cognitive behavioural therapy and/or eye movement desensitisation and reprocessing therapy.

Whilst liability was never admitted, a suitable settlement was reached and our client received compensation intended to cover the costs of her future treatment and for the pain and distress of the incident.

"Natalie Hirst was excellent in my case, keeping me updated and informed every step of the way and was always happy to talk to me about any queries I had. Nothing ever seemed too much for her to help me with through the process. I would recommend her to friends and family.”

For further advice on Clinical Negligence, please call us on 01483 543210 or alternatively email nataliehirst@barlowrobbins.com

By Natalie Hirst