According to the American Academy of Otolaryngology & Head and Neck Surgery (AAO-HNS), removal of the tonsils, or a tonsillectomy, an effective and less costly treatment when compared with the risks of prolonged or repeated throat infections. It is considered a routine procedure, with relatively low risk. But for a Marysville, Ohio, family it turned out to be anything but routine.
On April 18, 2006, A. J. and Joshua Legge died from complications related to recent tonsillectomies and adenoidectomies (T&As). On August 10, 2010, over four years later, a Union County Common Pleas Court jury awarded the Legges $2 million in their medical malpractice lawsuit against their twin’s otolaryngologist.
Protocol for Tonsillectomies
In June 2010, the AAO-HNS reported that over half-a-million outpatient tonsillectomies are performed on pediatric patients each year. As such, this outpatient procedure is one of the most common and costly pediatric surgeries. Even though the standard procedure takes about 30-45 minutes to perform, patients remain in the clinic or hospital for a few hours of observation. Typically, pediatric patients are sent home to recuperate. In special cases, depending on a patient’s age and at a physician’s discretion, overnight stays can be authorized.
While several unforeseen events took place in the course of the Legge boys’ care, one of the crucial factors to the jury was that there is a standard protocol to admit and observe patients, age three and under, for tonsillectomies. In the case of the Legge twins, who were three years old, the family reported that their boys had a history of snoring and breathing trouble while sleeping. The doctor testified that the family told him about the twins’ breathing problems, but he did not believe them to be dangerous.
Medical evidence confirmed that the boys ultimately died from cerebral edema (fluid on the brain); pain medication prescribed post-surgery caused them to stop breathing. The jury found that had the physician listened to the family’s concerns about the twin’s medical history and followed prescribed protocol for an overnight stay, these little boys might be alive today.
Standards of Patient Care
While there can be unpreventable complications with many surgical procedures, concerns remain focused on standards of patient care to avoid those complications that are preventable and avoidable with reasonable care. President Obama’s call for healthcare reform has even addressed the need, especially in pediatric cases, for doctors to look at patient needs, histories and medical evidence instead of fee schedules and reimbursement systems.
While the AAO-HNS irons out medical evidence based on guidelines for tonsillectomies, one fact remains. Doctors need to meet their obligations to make decisions based on confirmed medical history, adhere to safety protocols and better educate patients and their families about post-surgical care and complications.