Hospital Wasn't Negligent in Anesthesiology Resident's Propofol Suicide

IkeBoy18

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Im not sure why her estate would think that the hospital is at fault. I think they were really giving her an amazing opportunity to move past her issues.

http://www.outpatientsurgery.net/outpatient-surgery-news-and-trends/general-surgical-news-and-reports/hospital-wasn-t-negligent-in-anesthesiology-resident-s-propofol-suicide--12-19-13

Published: December 19, 2013

"She was an anesthesiology resident at New York Presbyterian Hospital with a propofol addiction. She spent 6 weeks in rehabilitation before returning to work. The day before she took her life by overdosing on propofol, she told her director she planned to resign. Was the hospital responsible for Janet Y. Christophel's death?

No, the hospital couldn't be held responsible for the propofol-overdose-related death of one of its residents, because the resident had signed a comprehensive release that indemnified the hospital from all "causes of action of any nature whatsoever," a court has ruled.

In dismissing the case against New York-Presbyterian Hospital, the Supreme Court of New York rejected arguments that the resident's signature was unwitnessed and possibly inauthentic, that the document was ambiguous and that refusing to hold the hospital responsible would go against public policy.

Dr. Christophel committed suicide with the drug in May 2011. In September 2010, she'd sought help from the program director of New York-Presbyterian's Weill Medical College of Cornell University. After completing a 6-week rehabilitation program, she was cleared to return to work.

A few months later she was given OR responsibilities, where she again gained easy access to propofol. Two months after that, on the day before she took her life, she told the director she planned to resign.

Her estate argued that the hospital had been negligent.

The signed release, which was executed when Dr. Christophel returned to work after her rehab stint, included 8 provisions. Along with indemnifying the hospital, it included agreements to abide by her treatment plan, not to use any inappropriate drugs and to submit to testing in the event that the hospital found appropriate cause.

Although the estate questioned the validity of her signature, it didn't present testimony from a handwriting expert, as the court noted. Further, said the court, there was no public policy issue because it was clearly in Dr. Christophel's interest to sign the release. She was being given the opportunity to get on with her professional life and there was every reason to believe she understood what she was signing, said the court."
 
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pgg

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Back to work in 6 weeks, back to the OR in a few months? Return to practice in less than a year is a risk factor for relapse. 2/3 relapse rate across the board, 1/4 of those being fatal. Diversion followed by return to work is a 'condition' with a 10% or so mortality rate, so it ought to be taken seriously.

Regardless - this was reported as a suicide, not an accidental OD. One could make the argument that an accidental OD could be the institution's fault if it didn't adhere to its policies or other standards in returning an at-risk person to a risky job, but a suicide? Ridiculous.


We had a CRNA diverting opiates a couple years ago. I testified in before the hospital credential committee as the anes dept head, recommending they not permit him to return to practice here, and they decided to suspend him for a minimum period of two years. He's elsewhere now, working, and even though he's now a couple years removed from the diversion and doing well, I still worry about him all the time.
 

Mman

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I'd think they'd have a bigger problem with the committee for physician health that approved her returning to work in the environment in such a short time frame.

In my state, you have to go through a rehab program and then complete an evaluation to determine if you can go back to medicine and if you can, then they go back and determine if you can go back into anesthesia. It's a length process (generally around 12-18 months I think) before it is completed.
 

FFP

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Im not sure why her estate would think that the hospital is at fault.
Because this is the United States of Attorneys.

There is way too much paternalism in our society. People want anybody else to be responsible for their own actions, but themselves. This should stop if we don't want to go the way of the Roman Empire. If you let a psych patient work and he kills himself, it's your fault. If you don't, you are discriminating blah-blah, and it's your fault again. How about some common sense here?

Where the heck was the concerned family that wants money now? Shame on them for not providing the needed support, and then having the nerve to sue.
 
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nap$ter

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Back to work in 6 weeks, back to the OR in a few months? Return to practice in less than a year is a risk factor for relapse. 2/3 relapse rate across the board, 1/4 of those being fatal. Diversion followed by return to work is a 'condition' with a 10% or so mortality rate, so it ought to be taken seriously.

Regardless - this was reported as a suicide, not an accidental OD. One could make the argument that an accidental OD could be the institution's fault if it didn't adhere to its policies or other standards in returning an at-risk person to a risky job, but a suicide? Ridiculous.


We had a CRNA diverting opiates a couple years ago. I testified in before the hospital credential committee as the anes dept head, recommending they not permit him to return to practice here, and they decided to suspend him for a minimum period of two years. He's elsewhere now, working, and even though he's now a couple years removed from the diversion and doing well, I still worry about him all the time.
where do you get those statistics?
 

pgg

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where do you get those statistics?
I've got them in my office. Will post the references on Monday. As I recall I pulled them from two studies, one mid-90s and one 2005ish. Think there was something in Anesthesiology around 2008 too.
 

nap$ter

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i thought those stats came from some reports with very small n's with very old school minimalistic treatment and super-lax post-return monitoring.

i think domino's report showed better numbers and more favorable outcomes.
 
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