Home E-Weekly March 14, 2017

Wisconsin 'Black Box' Law Would Require Cameras in Every OR

Published: March 13, 2017

EYE IN THE SKY Video cameras installed in ORs would help investigators determine why adverse events happen.

Wisconsin may become the first state in U.S. that requires surgical facilities to have video and audio recording capability. The "black box" proposal would give patients the right to insist that any surgery that involves anesthesia be captured on video.

Wade Ayer intends to work with Wisconsin lawmakers to reintroduce legislation inspired by the death of his sister, Julie Ayer Rubenzer, 38, a Wisconsin native who died of a massive amount of propofol during a breast enhancement surgery performed at a Florida cosmetic surgery center in September 2003. She slipped into a coma and died months later. Oral surgeon Kurt Dangl, MD, the physician who performed the surgery despite not being certified for the procedure, lost his medical license, but was not criminally charged. Dr. Dangl also operated without having an anesthesiologist or nurse present.

In 2015, Mr. Ayer worked with Wisconsin State Representative Christine Sinicki to introduce the "Julie Ayer Rubenzer Bill," which would have required all surgical facilities in the state to place video cameras in ORs to capture time- and date-stamped recordings of procedures. Mr. Ayer says hospital and surgery center lobbyists helped kill the bill before it was brought up for vote in the state assembly.

"There are many wonderful surgeons, nurses and staff members who care about patient safety, but there needs to be more oversight of what they do in the OR," says Mr. Ayer.

The planned renewal of the legislation in Wisconsin is part of a growing interest in using black box technology to protect patients first introduced by Teodor Grantcharov, MD, PhD, who created a platforms that mimics what flight data recorders document during mid-air disasters. Dr. Grantcharov's platform captures video from the surgeon's imaging equipment and from a wall-mounted camera in the OR. It also captures audio recordings of the procedure, the patient's vital signs, data from the anesthesia machine and how many times the room's door is opened during a case.

Dr. Grantcharov believes black box technology can be used to analyze adverse events or assess new procedures, technology and techniques.

"If it's done well and used constructively, the potential to enhance patient safety is significant," says Dr. Grantcharov. "This is not about the surgeon or the surgical team. Everything that's going on in the OR is about the patient."

Daniel Cook

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