Expert: Ronald Levy, M.D. - 10/17/2007

Question
My 47 year old brother-in-law was rushed to the local ER last week at 7:00 p.m. after collapsing with severe thigh/groin pain.  Was determined that he had a large hernia which needed to be removed, however, was not thought to be causing the pain.  Surgeon was brought in about 10 p.m. and successful hernia removal was completed under epidural as my brother-in-law had sleep apnea.  Patient was placed in recovery for about 1 hour, his CPAP machine was brought from home and used by him during the night.  After recovery, patient was placed in regular room.  At 8:00 a.m the next morning, we were told he went into cardiac arrest.  We were told he was found unresponsive. I believe that given his condition of sleep apnea he was not properly monitored.

Answer
Of course I would have no way to say whether this is true or not but I should point out that if your brother-in-law was in a regular hospital bed (not a monitored ICU or step down unit) then nurses generally only check on their patients once a shift and then when they give out medicines, etc. Particularly at night, if there is no emergency, they try to let people sleep. The question could be raised "Should he have been in a monitored bed?" but again, the answer is likely "No". Without an autopsy, there is no way to determine why he died. We have many patients with sleep apnea and, unfortunately, we can't have continuous monitoring on all of them. I am sorry for your loss.

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMB-Galveston