How many guys in PP go ahead w/ the case using a conventional tube?
Since you asked, my thoughts align with some others regarding the elective nature of the case and the lack of ideal equipment.
Should things go south, the plaintiff's attorney will likely ask along the lines of:
1) Was this an elective case? Does elective mean it can wait?
2) Are there airway devices that would lessen the risk for this patient of having an airway fire? By the way, what is the usual type of tube one would use in these sorts of cases? Have you had occasion to use such a tube? Why would you not use such a tube then? Would you say a laser tube is the standard for these sorts of cases?
3) Since this case could wait, were there inquiries made into obtaining these types of "better" "safer" airway devices either through ordering from your hospital supplier or obtaining from another local hospital (hospitals often swap/provide equipment/drugs to each other when one runs short)? Is it often your practice to proceed with surgery lacking the proper equipment? If not, then why did you do so in this case? If the hospital lacks the required equipment for the case, do you believe these cases should be performed? Is it safe to do these cases? (As you can see, some of these questions can't be answered, they are just there to convince a jury you're a terrible physician. You can't say it's safe, because clearly it wasn't in this patient's case; If you answer no, you've just said it's not safe yet you proceeded anyways You'll look like an idiot.)
4) So, what percentage risk, are we talking about, Dr., for airway fire when you don't use one of these tubes? You don't know?
Again, the list goes on, and it's all about jury perception. If they think you're a careless, sub-standard practicing physician who put this already sick patient at greater risk, then you're done. A typical jury will have little to no idea about anything you're doing. They'll simply hear you say you didn't choose what was the safest or best option, and the plaintiff's attorney will get expert witnesses who literally wrote the book to say the same thing.
On a final note, however, I'll say this thread was very educational, as I'd never even have considered an LMA. It sounds reasonable to me, because I'm an educated anesthesiologist, but again to a layperson, it'll all typically boil down to one thing.
