Expert: Ronald Levy, M.D. - 6/1/2008

Question
QUESTION: Dear Ronald,
I thank you for this opportunity to ask you questions which have come about since my wife Haile Sandra Plafkin underwent a gall bladder operation on Dec. 5, 2007;she did not come out of the anesthesia for 12 hours or more, and from that time on, she has suffered from delirium, and we have been in and out of hospitals ever since.  She now has been diagnosed with Lewy Body Dementia;however before the operation, she did not experience the traumatic change in her total person that occurred after the operation.  She is now on Seroquel, Stalevo, Sinemet, Remeron, Klonopin.  Prior to the operation, she was on none of these.  My wife said to me before the operation that she was afraid, but that she would try to be brave.  I feel that I made a mistake by letting her go through with it, and that her primary physician gave us bad advice.  Then I feel that the surgeon and anesthesiologist did not bother to come down to the recovery room and check on my wife after just a few hours to find out what was wrong, and why was she not responding.  I would appreciate very much if you could be of some help to me, so that I might be of more help to my wife in leading a better quality of life.  

A Sincere Thanks For Your Time
Shalom

Roger Plafkin
Plafkin Farms(View on Photobucket.com and Webshots.com)
2150 Buttrick
Ada, Michigan
49301
1-616-676-0590
plafkin@juno.com

ANSWER: First of all you should not feel guilty letting her have the operation. Complications do happen and not having the surgery could have had more drastic consequences. As to what happened to her, I cannot say without reviewing the medical record and the anesthetic record. I don't know how I can be of help to you other than to tell you that it is not your fault, it is probably not the surgeon's or anesthesiologists' fault and that you wife was unfortunate to have suffered a complication. Many people believe that any time a patient has a complication that either malpractice has occured or they chose a bad surgeon or they shouldn't have had the surgery. None of this is true. Unfortunately a certain percentage of patients will have complications despite a perfect surgery.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston

---------- FOLLOW-UP ----------

QUESTION: Ronald,
Acknowledging, that a certain percentage of patients will have complications despite a perfect surgery, do you have anymore insight as to how we might remedy this problem.  In other words, are there advancements at the University of Texas Medical Branch that we do not have in our area, that might help my wife.  I would like you to ask yourself this question "Had this event occurred on my watch, what would I have done, and how would I have responded to this crisis after 2 1/2 or 3 hours had gone by.  I am not looking for retribution;I am looking for a light at the end of the tunnel so that perhaps we can proceed in a better direction.

Thank you again,
Shalom
Roger Plafkin


Answer
First of all, I don't know where you are so it is hard to answer that question. If, for example, you were at a small private community hospital, the anesthesiologist/surgeon might not have been able to come sooner if they were involved in another case. At UTMB, we are a teaching hospital so at any given time SOME anesthesiologist is available to see a patient in the PACU or to respond to s STAT call. This is one of the advantages of having surgery at a teaching hospital. On the downside, at a teaching hospital you are more likely to have residents managing your case (under supervision of the faculty). As to what I would have done, it depends on the information I was given at the time, whether I was involved in another case, etc. I agree that she shouldn't have been left alone for so many hours but by the same token, even if she was seen promptly doesn't mean that she would not have had the same problem.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston