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Medico-legal issues in obstetric anesthesia: what does an obstetrician need to know?

  • Review Article
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Obstetric anesthesia has become a recognized subspecialty of anesthesiology and an integral part of practice of most anesthesiologists. Perhaps no other subspecialty of anesthesiology provides more personal gratification and clinical challenges than the practice of obstetric anesthesia. However, in addition to clinical challenges obstetric anesthesia is laden with medico-legal liability.

Objective

This review article attempts to highlight the influence of the current medico-legal climate on the practice of obstetric anesthesia.

Methods

All articles relevant to the subject of this investigation were retrieved from a Medline search.

Results

Obstetric anesthesiologists are frequently named (besides obstetricians) in claims involving bad neonatal outcomes. Obstetric anesthesia is also the most common subspecialty of practice to be ceased due to medico-legal concerns.

Conclusions

Good perioperative evaluation of all patients, detailed review of patient’s medical records, and constant vigilance can decrease the incidence of complications and subsequently medico-legal issues.

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Notes

  1. The database does not contain claims on all adverse anesthetic events, nor does it have any denominator data on how many anesthetics are performed per year. Consequently, estimates of risk for specific regional anesthesia procedures or populations cannot be made. Other limitations include the nonrandom, retrospective collection of data provided partially by direct participants instead of impartial observers; the bias toward substandard care designations for poor outcomes; and changing anesthetic practice and standards during the 20-year time span for this data. Despite these limitations, the ASA Closed Claims database provides useful information on large numbers of rare adverse events that are not amenable to prospective study from single centers.

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Authors and Affiliations

  1. Department of Anesthesiology, UCSD Medical Center, 200 W. Arbor Drive, San Diego, CA, 92103-8770, USA

    Krzysztof M. Kuczkowski

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  1. Krzysztof M. Kuczkowski
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Correspondence to Krzysztof M. Kuczkowski.

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Kuczkowski, K.M. Medico-legal issues in obstetric anesthesia: what does an obstetrician need to know?. Arch Gynecol Obstet 278, 503–505 (2008). https://doi.org/10.1007/s00404-008-0697-1

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  • DOI: https://doi.org/10.1007/s00404-008-0697-1

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