Another death...

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It's very sad. We'll have to wait to see what occurred before we know if something could have prevented it. I think things like this will always continue to happen as surgery / anesthesia is not 100% safe. Will adding another provider help things? I'm not sure.

Reading comments below the article is frightening.... to think those opinionated degenerates could sit on a jury and decide your future is disheartening. What ever happened to a jury of peers?
 
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there will always be ass hat providers. having two ass hats in the room wont change anything except the fees collected since birds of a feather flock together. professional regulation and CE requirements are a joke. There was gauze in his airway (probably why he started coughing) and it was never cleared. sounds mismanaged but you never know for sure unless you were there.
 
Sad but we don't know if it was negligence yet.

http://www.ncbi.nlm.nih.gov/m/pubmed/19022119/

RESULTS: The frequency of office anesthetic complications occurring in 2004 were consistent with our previous studies. There was 1 office death, for a mortality rate of 1/1,733,055. The incidence of other specific anesthetic-related complications is documented.
 
supraopticus said:
there will always be ass hat providers. having two ass hats in the room wont change anything except the fees collected since birds of a feather flock together. professional regulation and CE requirements are a joke. There was gauze in his airway (probably why he started coughing) and it was never cleared. sounds mismanaged but you never know for sure unless you were there.
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Obviously we do not know the details, but before we all jump to conclusions, the gauze in the patient's airway could have been there as a throat screen to protect the patient from any broken tooth fragments, surgical burs, etc. It is common to place a throat screen (cotton gauze) especially when doing sedations. I remember when I was on my hospital rotation in school and pediatric dentistry residents were providing general anesthesia and packed gauze all the way back in the child's airway. And again, we don't know if the patient had any undiagnosed medical conditions, i.e. like hypertrophic cardiomyopathy or anything of that nature. Patient may also have experience a laryngospasm. Who knows. But I would wait to jump to conclusions. It may have been negligence, but it may not have been.
 
DCRedskinsRule said:
http://gma.yahoo.com/man-dies-wisdom-teeth-removed-201504759.html

Why so many? Any one think there's going to be a cultural paradigm shift because of stories like this OR more regulation requiring OS to only perform the case and have an anesthesiologist present for the sedation?

So sad. 👎
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OS's should NOT be performing their own anesthesia. It is a right that they have gained only through aggressive lobbying. This topic was brought up on the anesthesia forum and one of the anesthesiologists said that having an OS perform anesthesia is very dangerous. He also mentioned that, if he ever needed oral surgery, he would bring one of the CRNAs he works with and have that person run the anesthesia. I agree. Allowing OS's to run their own anesthesia is just a way for them to make more $$$. But it is dangerous. No other surgeon runs his/her own anesthesia.
 
Silent Cool said:
OS's should NOT be performing their own anesthesia.
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If the narrow anesthetic scope of OMFS isn't as broad as that of anesthesiologists and if their safety record is quite safe (<1 death/1,700,000 = 0.000000577) considering their length of training, why do OMFS need to use anesthesiologists? How much training is enough training before it becomes timely and economically unreasonable for the hospital, OMFS residents, practitioners, and patients? I think we need to look at this from the point of view of an actuary.

http://forums.studentdoctor.net/showthread.php?p=13887201

http://www.ncbi.nlm.nih.gov/pubmed/12966471

http://www.washingtonoralsurgeryassociates.com/outcomesofwisdomteethremoval.pdf
 
UCSFx2017 said:
If the narrow anesthetic scope of OMFS isn't as broad as that of anesthesiologists and if their safety record is quite safe (<1 death/1,700,000 = 0.000000577) considering their length of training, why do OMFS need to use anesthesiologists? How much training is enough training before it becomes timely and economically unreasonable for the hospital, OMFS residents, practitioners, and patients? I think we need to look at this from the point of view of an actuary.

http://forums.studentdoctor.net/showthread.php?p=13887201

http://www.ncbi.nlm.nih.gov/pubmed/12966471

http://www.washingtonoralsurgeryassociates.com/outcomesofwisdomteethremoval.pdf
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Having a CRNA perform the office-based anesthesia is a smart and economically viable solution. The anesthesia is generally simple, but it needs full attention in case the SHTF.
 
Silent Cool said:
Having a CRNA perform the office-based anesthesia is a smart and economically viable solution. The anesthesia is generally simple, but it needs full attention in case the SHTF.
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Dude, eat a dick, you have no idea what you're talking about. The only reason this sounds so outrageous is because the media loves to jump on any inflammatory story. Now the whole medical community can wag its finger at the dumb dentists for daring to use sedation techniques. Heres an idea, lets publish on national TV every time an Anesthesiologist has a death. Lets take an identical scenario, except we'll use your logic, where there must always be an anesthesiologist performing the complex propofol drip to yank some third molars. Please read.

http://www.baltimoresun.com/news/ma...o-olenick-settlement-20130403,0,3496441.story

This received no national attention, because apparently deaths are ok just so long as they're being delivered by an anesthesiologist. I don't know if you're an oral surgeon, anesthesiologist, or even a doctor, but lets get one thing straight: anesthesia is dangerous, no matter what. Thats why when you sign consent, "possible death" is on the form. The questions is, are the proper protocols being followed in the event of an unpredictable reaction. I have no idea if the oral surgeon in california's case was being negligent or not. In the same vein I have no idea if the anesthesiologist in the above story was being negligent or not. Maybe they were, if a court of law can prove they were then they should both lose their license. Regardless, OMFS has a long track record of providing safe, affordable anesthesia. Every specialty has accidents happen. Every specialty has negligent doctors. you don't make ******ed statements about taking procedures away from a profession because of anecdotal stories that serve your own purposes.

Of course this is a tragedy. but don't speak utter nonsense when theres people who could misinterpret your ill informed statements.
 
Gentledental1 said:
Dude, eat a dick, you have no idea what you're talking about. The only reason this sounds so outrageous is because the media loves to jump on any inflammatory story. Now the whole medical community can wag its finger at the dumb dentists for daring to use sedation techniques. Heres an idea, lets publish on national TV every time an Anesthesiologist has a death. Lets take an identical scenario, except we'll use your logic, where there must always be an anesthesiologist performing the complex propofol drip to yank some third molars. Please read.

http://www.baltimoresun.com/news/ma...o-olenick-settlement-20130403,0,3496441.story

This received no national attention, because apparently deaths are ok just so long as they're being delivered by an anesthesiologist. I don't know if you're an oral surgeon, anesthesiologist, or even a doctor, but lets get one thing straight: anesthesia is dangerous, no matter what. Thats why when you sign consent, "possible death" is on the form. The questions is, are the proper protocols being followed in the event of an unpredictable reaction. I have no idea if the oral surgeon in california's case was being negligent or not. In the same vein I have no idea if the anesthesiologist in the above story was being negligent or not. Maybe they were, if a court of law can prove they were then they should both lose their license. Regardless, OMFS has a long track record of providing safe, affordable anesthesia. Every specialty has accidents happen. Every specialty has negligent doctors. you don't make ******ed statements about taking procedures away from a profession because of anecdotal stories that serve your own purposes.

Of course this is a tragedy. but don't speak utter nonsense when theres people who could misinterpret your ill informed statements.
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Why don't you tell that to the people in the anesthesia forum. I'm sure they will have words for you. Jet Pro Pilot, would love to hear you chime in.
 
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Silent Cool said:
Why don't you tell that to the people in the anesthesia forum. I'm sure they will have words for you. Jet Pro Pilot, would love to hear you chime in.
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I could care less what anesthesiologists have to say. For them its just a turf battle. Every single specialty in medicine has their turf battles that they defend to the death. Heres another example, guess its too dangerous for CRNAs to provide anesthesia for GI cases, right?

http://www.outpatientsurgery.net/ne...ath-in-the-gi-suite-patients-family-sues-crna

I could roll these examples out all day. People die from anesthesia. just look at the track record.
 
Gentledental1 said:
I could care less what anesthesiologists have to say. For them its just a turf battle. Every single specialty in medicine has their turf battles that they defend to the death. Heres another example, guess its too dangerous for CRNAs to provide anesthesia for GI cases, right?

http://www.outpatientsurgery.net/ne...ath-in-the-gi-suite-patients-family-sues-crna

I could roll these examples out all day. People die from anesthesia. just look at the track record.
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I know anesthesia is not always safe. But one person shouldn't be handling the anesthesia and the surgery. No other surgeons do that. If you were going under, wouldn't you rather have a separate person monitoring your anesthesia? I would.
 
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Honestly, what do you know? Empirical evidence shows the opposite of what you're saying. A pt died in the OR last week under the care of an MD anesthesiologist at the hospital I work at. Bad outcomes happen all the time; it really sucks. Though, less bad outcomes for OMS when compared to hospital cases - OMS training is fine.

Silent Cool said:
OS's should NOT be performing their own anesthesia. It is a right that they have gained only through aggressive lobbying. This topic was brought up on the anesthesia forum and one of the anesthesiologists said that having an OS perform anesthesia is very dangerous. He also mentioned that, if he ever needed oral surgery, he would bring one of the CRNAs he works with and have that person run the anesthesia. I agree. Allowing OS's to run their own anesthesia is just a way for them to make more $$$. But it is dangerous. No other surgeon runs his/her own anesthesia.
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EDIT: ENT, EM, and GI do this all the time too.
 
yappy said:
Honestly, what do you know? Empirical evidence shows the opposite of what you're saying. A pt died in the OR last week under the care of an MD anesthesiologist at the hospital I work at. Bad outcomes happen all the time; it really sucks. Though, less bad outcomes for OMS when compared to hospital cases - OMS training is fine.



EDIT: ENT, EM, and GI do this all the time too.
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Right, which is why the anesthesia docs in the anesthesia forum totally agree with you
I saw the quote about other docs "managing" anesthesia, and the rebuttal from someone saying, 'actually, we have a lot of problems with GI running anesthesia.'

Post from JPP, an anesthesia veteran, #15 of this thread:

http://forums.studentdoctor.net/showthread.php?t=229460

"If I ever have to go to a dentist/oral surgery's office for a procedure that involves anesthesia, I'm bringing one of my CRNAs. Dentists/oral surgeons doing their own anesthesia is extremely dangerous IMHO."

Yup, pretty sure I'll stick with the experts on that one. I don't care if problems rarely happen. I'd feel better with a separate person monitoring the anesthesia, especially if it is done outside of a hospital.
 
Silent Cool said:
Right, which is why the anesthesia docs in the anesthesia forum totally agree with you
I saw the quote about other docs "managing" anesthesia, and the rebuttal from someone saying, 'actually, we have a lot of problems with GI running anesthesia.'

Post from JPP, an anesthesia veteran, #15 of this thread:

http://forums.studentdoctor.net/showthread.php?t=229460

"If I ever have to go to a dentist/oral surgery's office for a procedure that involves anesthesia, I'm bringing one of my CRNAs. Dentists/oral surgeons doing their own anesthesia is extremely dangerous IMHO."

Yup, pretty sure I'll stick with the experts on that one. I don't care if problems rarely happen. I'd feel better with a separate person monitoring the anesthesia, especially if it is done outside of a hospital.
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Why don't you throw in some of quotes from anesthesiologists who are proponents of OMFS administering anesthesia instead of only quoting points from one side of the argument?

We'd all like to 'feel' safer. I mean I'd like to have all the medical specialists (Anesthesiologists, Trauma Surgeon, Pathologist, Radiologist, GI, ENT, etc.) in the same room when I go to the emergency room. I bet I'd feel a lot 'safer'. This probably would reduce the rate of mortality in the current emergency medicine delivery system, which already has a good safety record. But is this economically feasible or objectively worth it? It's easy to be emotional even about one death but imagine the strain it would leave on the total health care system, especially after socializing it.
 
UCSFx2017 said:
Why don't you throw in some of quotes from anesthesiologists who are proponents of OMFS administering anesthesia instead of only quoting points from one side of the argument?

We'd all like to 'feel' safer. I mean I'd like to have all the medical specialists (Anesthesiologists, Trauma Surgeon, Pathologist, Radiologist, GI, ENT, etc.) in the same room when I go to the emergency room. I bet I'd feel a lot 'safer'. This probably would reduce the rate of mortality in the current emergency medicine delivery system, which already has a good safety record. But is this economically feasible or objectively worth it? It's easy to be emotional even about one death but imagine the strain it would leave on the total health care system, especially after socializing it.
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Actually, those fields you mentioned are often consulted by ER docs to solve the problem correctly.
 
Silent Cool said:
Actually, those fields you mentioned are often consulted by ER docs to solve the problem correctly.
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Only after the fact. The patient is only charged for the services of these specialists if and when they are needed. The point is that OMFS do not need, use, or charge the patient for these specialists' services.
 
Silent Cool said:
Right, which is why the anesthesia docs in the anesthesia forum totally agree with you
I saw the quote about other docs "managing" anesthesia, and the rebuttal from someone saying, 'actually, we have a lot of problems with GI running anesthesia.'

Post from JPP, an anesthesia veteran, #15 of this thread:

http://forums.studentdoctor.net/showthread.php?t=229460

"If I ever have to go to a dentist/oral surgery's office for a procedure that involves anesthesia, I'm bringing one of my CRNAs. Dentists/oral surgeons doing their own anesthesia is extremely dangerous IMHO."

Yup, pretty sure I'll stick with the experts on that one. I don't care if problems rarely happen. I'd feel better with a separate person monitoring the anesthesia, especially if it is done outside of a hospital.
Click to expand...

Please, for the love of god, enlighten me to what you are. Medical student? You so clearly don't understand the politics involved here its painful. So this anesthesiologist is willing in this instance to trust his crna, even though in a seconds notice he'll be saying they're under qualified too. You see, you don't know the history. Dentists invented anesthesia and have used it safely ever since. After a few years catch up, surgeons pulled their heads out of their ass and realized there was something to this whole anesthesia thing and it might be useful. But the work was below them, nurses became medicines providers of anesthesia. And so it went for many years. Well, as they are want to do, finally MDs decided to create a specialty out of thin air and tried to call it only theirs. Unfortunately they only control other MDs, so while they have been able to make it so no other MD can use the techniques of anesthesia, CRNAs and dentists are free to do as they please, because they have their own governing bodies and they came up with the practice (please tell me you understand CRNAs don't have to work for an anesthesiologist, they can practice by themselves). Quite frankly, anesthesia is a dying medical specialty because CRNAs are produced in such greater numbers, are cheaper, and do the exact same job. The only people who know these truths are Anesthesiologists, CRNAs, and OMS because we are the only three that actually carry general anesthesia permits. This is all about politics, plain and simple. Anesthesiologists are only the "experts" in their own world. They don't govern his, they merely make recommendations. OMS governs itself and has a damn good record of safety. You're a fool to not see that.
 
Gentledental1 said:
Please, for the love of god, enlighten me to what you are. Medical student? You so clearly don't understand the politics involved here its painful. So this anesthesiologist is willing in this instance to trust his crna, even though in a seconds notice he'll be saying they're under qualified too. You see, you don't know the history. Dentists invented anesthesia and have used it safely ever since. After a few years catch up, surgeons pulled their heads out of their ass and realized there was something to this whole anesthesia thing and it might be useful. But the work was below them, nurses became medicines providers of anesthesia. And so it went for many years. Well, as they are want to do, finally MDs decided to create a specialty out of thin air and tried to call it only theirs. Unfortunately they only control other MDs, so while they have been able to make it so no other MD can use the techniques of anesthesia, CRNAs and dentists are free to do as they please, because they have their own governing bodies and they came up with the practice (please tell me you understand CRNAs don't have to work for an anesthesiologist, they can practice by themselves). Quite frankly, anesthesia is a dying medical specialty because CRNAs are produced in such greater numbers, are cheaper, and do the exact same job. The only people who know these truths are Anesthesiologists, CRNAs, and OMS because we are the only three that actually carry general anesthesia permits. This is all about politics, plain and simple. Anesthesiologists are only the "experts" in their own world. They don't govern his, they merely make recommendations. OMS governs itself and has a damn good record of safety. You're a fool to not see that.
Click to expand...

You are so misinformed I won't get into it with you. I'd like JPP, BladeMDA, Sevo, and PGG to come over here and rip you a new one.
 
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Gentledental1 said:
Please, for the love of god, enlighten me to what you are. Medical student? You so clearly don't understand the politics involved here its painful. So this anesthesiologist is willing in this instance to trust his crna, even though in a seconds notice he'll be saying they're under qualified too. You see, you don't know the history. Dentists invented anesthesia and have used it safely ever since. After a few years catch up, surgeons pulled their heads out of their ass and realized there was something to this whole anesthesia thing and it might be useful. But the work was below them, nurses became medicines providers of anesthesia. And so it went for many years. Well, as they are want to do, finally MDs decided to create a specialty out of thin air and tried to call it only theirs. Unfortunately they only control other MDs, so while they have been able to make it so no other MD can use the techniques of anesthesia, CRNAs and dentists are free to do as they please, because they have their own governing bodies and they came up with the practice (please tell me you understand CRNAs don't have to work for an anesthesiologist, they can practice by themselves). Quite frankly, anesthesia is a dying medical specialty because CRNAs are produced in such greater numbers, are cheaper, and do the exact same job. The only people who know these truths are Anesthesiologists, CRNAs, and OMS because we are the only three that actually carry general anesthesia permits. This is all about politics, plain and simple. Anesthesiologists are only the "experts" in their own world. They don't govern his, they merely make recommendations. OMS governs itself and has a damn good record of safety. You're a fool to not see that.
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Amen.

General anesthesia is inherently dangerous. Everytime I see something like this I wonder if more 3rds could be extracted with just nitrous and local. I know people just want to be put under but how necessary is it really?
 
Bravo bravo.

Mr. Cool,

It seems through a review of your previous posts that you are a man of many interests in many fields. We appreciate your input in this matter and assure you that we all agree that a patients death is always tragic. I would like to thank you for the reminder to our community. Please return to trolling other hot topics in this vast World Wide Web.

Sincerely,
 
Noble6:

You will soon be credentialed to extract wisdom teeth and i encourage you to do so under local and will applaud your effort.
 
Noble6 said:
Amen.

General anesthesia is inherently dangerous. Everytime I see something like this I wonder if more 3rds could be extracted with just nitrous and local. I know people just want to be put under but how necessary is it really?
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I was more thinking along these lines when I posted this. Somehow this became a bizarre pissing contest where general anesthesia in an OR became the same as outpatient sedation during a thirds case...

But I'm wondering if you think that the negative publicity, fair or not, and warranted or not, will lead to greater pressure on OMSers to use sedations that aren't as deep - maybe banning propofol or remi or something without additional supervision. Basically, does anyone think that reports like this will lead to increased scrutiny and stricter regulations or will it be dismissed as additional evidence that "anesthesia is inherently dangerous"
 
Silent Cool said:
You are so misinformed I won't get into it with you. I'd like JPP, BladeMDA, Sevo, and PGG to come over here and rip you a new one.
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Whoa, hold on. 🙂

I did post my thoughts in this anesthesia forum thread about this, but I very specifically chose not to do so in this forum. If y'all are interested in my opinion 🙂 it's in that thread.


I'd like to ask that if any regulars from the anesthesia forum happen upon this thread, to post with some reservation and deference to the locals. They are professionals with an impressive safety record, despite rare complications like this one. We don't have to endorse their methods, but this is first and foremost their (dentist) forum and it's kinda rude to drop in and start ****.
 
CayleStanley said:
Noble6:

You will soon be credentialed to extract wisdom teeth and i encourage you to do so under local and will applaud your effort.
Click to expand...

Lol, i'll leave bony impacted 3rds to OMS. But I have seen them extracted under nitrous and local. It's doable. Certainly not for everyone but I think it should be presented to patients with a history of good response to nitrous with little overall dental anxiety.
 
DCRedskinsRule said:
I was more thinking along these lines when I posted this. Somehow this became a bizarre pissing contest where general anesthesia in an OR became the same as outpatient sedation during a thirds case...

But I'm wondering if you think that the negative publicity, fair or not, and warranted or not, will lead to greater pressure on OMSers to use sedations that aren't as deep - maybe banning propofol or remi or something without additional supervision. Basically, does anyone think that reports like this will lead to increased scrutiny and stricter regulations or will it be dismissed as additional evidence that "anesthesia is inherently dangerous"
Click to expand...

Nothing will change.

Oral surgeons are extremely entitled to general anesthesia and they need it to practice effectively. They're also politically organized, have more money (as an organization) than most people on this forum realize, and know how to use it.

One tragic mistake made by an individual isn't enough to make a sweeping change come about.
 
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DCRedskinsRule said:
Why so many?
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Have there been a lot of deaths due to anesthesia administered by OMFS lately? This article only refers to one. Also, the one in Baltimore, as has been stated, was under the care of an anesthesiologist.
 
pgg said:
Whoa, hold on. 🙂

I did post my thoughts in this anesthesia forum thread about this, but I very specifically chose not to do so in this forum. If y'all are interested in my opinion 🙂 it's in that thread.


I'd like to ask that if any regulars from the anesthesia forum happen upon this thread, to post with some reservation and deference to the locals. They are professionals with an impressive safety record, despite rare complications like this one. We don't have to endorse their methods, but this is first and foremost their (dentist) forum and it's kinda rude to drop in and start ****.
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You, sir, are a gentleman. I appreciate that. 👍

Sublimazing said:
Nothing will change.

Oral surgeons are extremely entitled to general anesthesia and they need it to practice effectively. They're also politically organized, have more money (as an organization) than most people on this forum realize, and know how to use it.

One tragic mistake made by an individual isn't enough to make a sweeping change come about.
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True. The unfortunate reality is that these do tarnish image though...


To others: to compare the death rate of an OMFS patient to that of an anesthesiologist patient is completely false. They deal with trauma patients, severely compromised patients etc. OMFS typically will not work on a compromised patient. Essentially, anesthesiologists do not choose who they work on, whereas the OMFS has the luxury to choose. This will greatly bias these stats. All said and done, OMFS can provide very safe sedation on the type of patient they are comfortable with. If the patient is compromised, they will be usually sent to the hospital. Just my $0.02 🙂
 
Silent Cool said:
OS's should NOT be performing their own anesthesia.
Click to expand...

That's a pretty serious statement. I'm wondering what you do and what you know to make that kind of statement?

Silent Cool said:
It is a right that they have gained only through aggressive lobbying.
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Is that what it is? For some silly reason I was under the impression that anesthesia in this country began with dentistry. Something about the Ether Dome. And that OMFS, since it's inception, has always had full anesthesia privileges.

Silent Cool said:
This topic was brought up on the anesthesia forum and one of the anesthesiologists said that having an OS perform anesthesia is very dangerous.
Click to expand...

Well then, we have all the proof we need!
 
CMistry said:
That's a pretty serious statement. I'm wondering what you do and what you know to make that kind of statement?



Is that what it is? For some silly reason I was under the impression that anesthesia in this country began with dentistry. Something about the Ether Dome. And that OMFS, since it's inception, has always had full anesthesia privileges.



Well then, we have all the proof we need!
Click to expand...

C, how DARE you use sarcasm to battle such brilliant assertions???!? haha
 
Sublimazing said:
Nothing will change.

Oral surgeons are extremely entitled to general anesthesia and they need it to practice effectively. They're also politically organized, have more money (as an organization) than most people on this forum realize, and know how to use it.

One tragic mistake made by an individual isn't enough to make a sweeping change come about.
Click to expand...

Sounds like an aggravated, dental anesthesiologist in despair talking.... A specialty that should not even exist
 
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