After a four-day trial and deliberations for forty-five minutes, the jury returns a defense verdict.
On April 11, 2012, plaintiff, a 68-year-old retired female, presented to an outpatient surgery center for a bunionectomy. The plaintiff underwent a preoperative anesthesia evaluation by an anesthesiologist who documented that her airway was within normal limits. However, he then transitioned her care to a second anesthesiologist, the defendant in the case. The defendant anesthesiologist selected a size four laryngeal mask airway (LMA) for protection of the plaintiff’s airway while she was under general anesthesia and documented that he placed it atraumatically. In the days following her surgery, the patient complained of significant voice changes, and she was ultimately diagnosed with a left recurrent laryngeal nerve injury, which in turn paralyzed her left vocal cord and caused significant dysphonia and swallowing problems.
Plaintiff filed suit in Fairfax County Circuit Court alleging the defendant anesthesiologist and his practice breached the standard of care by negligently selecting the size four LMA for use during her bunionectomy. Plaintiff alleged that the defendant anesthesiologist should have instead selected a size three LMA due to her abnormally small airway for a woman her size. Defendants denied the allegations and the case was tried starting on February 29, 2016.
Plaintiff’s liability expert was an anesthesiologist from New Orleans, LA. Plaintiff’s expert testified that the defendant breached the standard of care by failing to conduct a preoperative examination and by incorrectly selecting a size four LMA for the plaintiff. Plaintiff’s expert testified that he personally examined the plaintiff on three separate occasions and identified that a size four LMA would not fit in her airway. Plaintiff’s expert also testified for the plaintiff on causation, asserting that use of a size four LMA caused excessive force and pressure on the plaintiff’s left recurrent laryngeal nerve during LMA placement and the surgery. Plaintiff also called a voice specialist and Professor of Otolaryngology, and a general practice otolaryngologist. Plaintiffs’ experts agreed that use of the LMA caused the injury to plaintiff’s left recurrent laryngeal nerve and her resulting voice problems.
Defense liability experts, anesthesiologists from Richmond, VA, testified that the defendant anesthesiologist met the standard of care by reasonably relying on the preoperative examination performed by the original anesthesiologist, by looking in the patient’s mouth as he inserted the size four LMA, and by placing the LMA atraumatically. Defense experts concluded that the defendant anesthesiologist’s selection of the size four LMA was reasonable because it conformed to sizing recommendations provided by the manufacturer and contained in the medical literature and because there was no evidence in the medical records that the plaintiff actually had an abnormally small mouth or airway. Defense liability expert, a voice specialist, testified for the defense on causation, contending that although there was no doubt that the LMA itself caused the injury, there was insufficient evidence to conclude that the defendant’s selection of a size four LMA was a cause of plaintiff’s unfortunate outcome. Moreover, Plaintiff’s liability experts agreed that plaintiff has a 90-95% chance of recovering a near-normal conversational voice if she elects to undergo curative surgery.