Aspects of law in respiratory care

¶ … legal issue and that pertains to respiratory care. As part of this article review, the author will give the purpose of the article, will answer as to why it is important to investigate the subject of the article, how the author(s) of the article carried out the task, the findings the article came, whether those findings were clearly stated and how much of article applied to the profession in which the author of this report works. While the author of this report has not been in any legal predicaments related to the field of respiratory care, it is indeed the field in which the author works.

The article that will be basis of this article review was published in 2001 and was found by the author of this report via an EBSCO search. As was requested and required by the assignment, the subject of the report is indeed one that is legal in nature and that pertains to respiratory incidents. To be specific, the article is about preventable adverse patient outcomes that are respiratory in nature. Of course, the legal ramifications of such incidents would be obvious. Just a few of the potential or expectable implications would be medical malpractice lawsuits and/or an investigation of what happened, what went wrong and who precisely was to blame in terms of their actions and inactions (Larson & Jordan, 2001).

The purpose of the article was to conduct a "closed claims analysis" of adverse incidents related to anesthesia being misused and misapplied in a way that involved a respiratory incident. The analysis was initiated through the AANA Foundation in 1995 and the information was provided by the Certified Registered Nurses Anesthetists (CRNA's). There was a research team of eight CRNA's using an instrument that involved a total of more than one-hundred fifty variables. To be precise, the documents related to the respiratory/anesthesia incidents were combed through using certain research methods, tools and analysis. The group was actually not just looking at respiratory-related cases but it was found that thirty-eight percent (fifty-eight out of one hundred fifty-one) involved a respiratory incident. Further, the study generally found that "respiratory incidents were more likely to result in death or permanent injury as compared to non-respiratory incidents" (Larson & Jordan, 2001). Beyond that, the study found that a higher percentage of respiratory incidents occurred in emergency cases (75% versus 34%) and in cases involving general anesthesia (44% versus 17%). One of the more common catalysts for these negative events seems to have been lack of proper monitoring of patients or, as the authors phrased it, "vigilance" (Larson & Jordan, 2001). The authors contend that this is an entirely preventable condition and event because, as they state in their abstract, "adverse respiratory incidents are largely preventable and frequently results in serious patient morbidity and mortality" (Larson & Jordan, 2001). The authors also break down the different categories of respiratory claims that they found. Those categories were endo-bronchial/espophageal intubpation, premature extubation, difficult tracheal intubation, aspiration, respiratory arrest and "other" (Larson & Jordan, 2001).

Regarding whether the methods and comments made were "adequate" and "appropriate" given what was being researched, the answer to this question would generally be a "yes." Indeed, all of the research in question is secondary in nature but that would be true to some degree no matter what. The veracity of the outcomes in this study would be dependent on the research care and quality exhibited and used by the research that was completed prior. As such, the selection of the studies used would matter just as much as how those studies were looked at. This subject is an important one because there should absolutely be a thorough investigation, whether it be at the level of a single incident or for a group of them, as to why adverse events keep happening in hospital and other clinical settings. Indeed, the celebrity Joan Rivers was not getting a "major medical procedure" in a hospital when she died. However, her death was absolutely respiratory and ostensibly preventable in nature. Regardless, she died nonetheless and the doctors and other professionals involved have been left to account for and explain their actions. Further, experts in the field say that the negative event with Rivers was a "predictable complication" of the procedure that was being conducted. The complication ended up causing oxygen not getting to Rivers' brain and it ended up killing her due to the amount of time her brain was deprived (Arnowitz, 2014). The authors of journal article reviewed for this report were presumably looking at the matter in the first place because any preventable patient death should be looked into at whatever level of detail possible so as to help prevent recurrence (or at least as much recurrence) in the future.

For so many preventable deaths to be occurring and for so many of them to be related to respiratory failures and issues is a bit disconcerting to the author of this report on a number of levels. First of all, the author of this report (as noted in the introduction) works in the field and is thus all the more concerned about what could happen to patients in or around the author's locus of control and care. Second, for people to die so unnecessarily due to lack of proper care and "vigilance" is disheartening and saddening to the author of this report. Doctors, nurses and other medical professionals need to exhibit the utmost professionalism and adeptness when they are taking care of a patient. Absolutely any procedure that could end up in breathing problems and/or other respiratory issues should be done very carefully. Even as something as simple as an allergy (e.g. To a drug) or lack of proper sanitation and purification of instruments can literally kill someone. Indeed, the overall chances of such complications are small when it comes to any average event or example. However, the chances are always there and patients (or their families) will not react well if they know (or think) something was done wrong when something negative happens to the patient involved.