Fact #1 - I never knew anything about Dr. Teich's legal problems but naively assumed if he was licensed that he had met certain legal requirements; i.e. not being a convicted felon. So it never occurred to me to ask him if he was one.
Fact #2 - I did not administer Paula Kane's oral medication, as you reported.
Around 1:30 pm, I was asked to provide IV sedation after Ms. Kane demanded to be put to sleep.
Fact #3 - Ms. Kane did not suffer a respiratory arrest, as plaintiff's attorney asserted at trial.
It was undisputed that Ms. Kane suffered a primary cardiac arrest with a nearly uniformly fatal condition called PEA or pulseless electrical activity.
While the commonest cause of PEA is lack of oxygen typically recognized by a decrease on pulse oximeter tone. There was no such decrease in Ms. Kane.
Low oxygen events have been prevented by the use of the pulse oximeter, a device I insisted Michael Stephens, Hoag Hospital administrator, acquire in 1983, 7 years before it was deemed a standard of care by the American Society of Anesthesiologists.
It is virtually impossible for a primary respiratory arrest to occur with a functioning pulse oximeter, as was the case until Kane's last heart beat.
After getting baseline vital signs and BIS readings, I administered the late Paula Kanes propofol sedation monitored by both pulse oximetry & brain activity monitors.
She did not die from propofol overmedication as you reported.
Her sentinel event was an abrupt loss of pulse oximeter signal, the vast majority of times is caused by the sensor falling off the fingertip.
Her probable cause of death was the extremely rare cause of air embolism that, after 3 days, would have been undetectable by the coroners autopsy.
Air embolism is not predictable in dental implant surgery but has been reported.
http://www.springerlink.com/content/x6602350v24vp388/
Air embolism in dental surgery is not preventable or treatable.
Fact #4 I have been a board certified anesthesiologist since 1980, licensed by the California Medical Board since 1976 & recognized as an expert reviewer for the Board since 2005.
Unlike my Dental License for general anesthesia, my medical license has both the original date of issue & the expiration date.
The Dental Board never provided any notification of the expiration of my permit for GA.
Fact #5 - I have not been sued for malpractice since 1991, settled for $5,000 to cover a Hoag OB patient's medical expenses. She had nothing bad to say about my care.
I have spent my entire career in anesthesia as a patient safety advocate, starting with my introduction of the non-invasive blood pressure monitor to Hoag Hospital in 1979.
In March 1992, I developed propofol ketamine IV sedation in response to the challenge of caring for patients involved in the office death in Newport Beach in 1990.
http://articles.latimes.com/keyword/edward-j-domanskis
I was his expert witness in both his malpractice trial & with the CA Medical Board.
In 1997, I was the first Orange County anesthesiologist to routinely monitor propofol anesthesia depth with a BIS brain monitor.
Following the 2004 death of Olivia Goldsmith, author of The First Wives Club, Cambridge University Press chose me first, among 40,000 US anesthesiologists, to write the first ever anesthesia textbook, Anesthesia in Cosmetic Surgery.
This book is the first anesthesia text with a brain monitor on the cover & first to define levels of sedation/anesthesia with numbers instead of words.
Also, in 2004, local US Congressman John Campbell presented Dr. Friedberg with a Congressional Recognition award for improving safety of wounded combat troops.
I thank you for taking time to read the facts.
Dr Barry Friedberg
