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Drug Mixup Leads to Tragic Consequences

Anesthesiologist mistakenly administered lidocaine instead of Hespan during spine surgery.

Published: April 15, 2015

The family of a Connecticut man who died after allegedly being administered lidocaine instead of Hespan, during a spinal procedure, has filed a wide-ranging malpractice lawsuit.

Michael A. Palmer Sr., 53, was undergoing a double-level anterior discectomy and fusion at the Surgery Center of Fairfield County (Conn.), according to the suit, when a surgical assistant "pressed against the blood pressure cuff" and caused his blood pressure reading to drop. In response, says the suit, anesthesiologist Sandra Joyce Congdon, MD, intended to administer Hespan, a synthetic plasma expander, but gave the patient a bolus of 4% lidocaine instead.

The patient went into cardiac arrest and died after being taken by ambulance to St. Vincent's Hospital in Bridegeport, Conn.

The patient's family alleges, among other things, that

  • the patient had wanted to have the surgery done at the hospital but was told by Gerard J. Girasole, MD, a part-owner of the surgery center, that insurance wouldn't cover the procedure at the hospital;
  • the procedure typically requires an overnight stay and had not been approved or authorized to be performed at the surgery center by its governing body;
  • the center failed to regulate conflict-of-interest issues regarding surgeons with ownership stakes in the facility; and
  • the center negligently failed to stock Intralipid, which could have reversed the effects of the lidocaine.

The surgery center was "cited by the [Conn.] Department of Health for doing an unapproved procedure," says Michael Koskoff, the family's lawyer. "And it's not on the list of procedures they represent doing on their website. I've consulted 2 spinal surgeons who say it's not a 1-day procedure, that you must keep the patient for at least 24 hours to observe for neck swelling. So it would have been malpractice to do it on an outpatient basis. But [the patient] was reassured that it was a 1-day procedure, that everything would be perfectly fine and there was nothing to worry about."

Mr. Koskoff says he's still trying to determine whether the patient was misled when he was allegedly told his insurance wouldn't cover the procedure in the hospital. "I assume it was a false statement," he says, "but I don't have the information from the insurance carrier yet."

Along with Drs. Congdon and Girasole, the suit names Surgical Care Affiliates, LLC, which operates 185 surgical facilities nationwide, the Surgery Center of Fairfield County, Fairfield Anesthesia Associates, the Orthopaedic & Sports Medicine Center of Trumbull, Conn., and Abraham Mintz, MD, another part-owner of the surgery center, who, according to the suit, performed the neurosurgical portion of the procedure.

The plaintiffs are seeking unspecified financial damages.

The surgery center did not respond to a request for comment by Outpatient Surgery Magazine.

Surgical Care Affiliates tells WFSB-TV in Hartford, Conn., "HIPAA laws prevent us from disclosing any information about patients. Our facility is a licensed and Medicare-accredited surgery center dedicated to providing high-quality healthcare service."

Jim Burger


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