And in an English case, an anesthesiologist was convicted of manslaughter for the death of a patient undergoing surgery for a detached retina. During surgery, the patient’s ventilation was interrupted because of accidental disconnection of the endotracheal tube for 4 minutes. This led to a cardiac arrest. An alarm had apparently sounded but was not noticed. The injury would not have occurred had the doctor attended to the patient instead of being away from the operating room.
Medical boards are generally thought to be insufficiently vigilant over matters of professional misconduct. For one thing, there is an inexplicably wide variability in the rates of disciplinary actions. In 2007-2009, for example, Minnesota had the lowest rate of disciplinary actions per 1,000 physicians (1.07), whereas Alaska had the highest rate (7.89), some seven times higher. State rankings also change drastically from year to year without apparent good reason. For another, criminal convictions for insurance fraud and violation of controlled substances prescriptions frequently end up with only mild or modest discipline. All of this has led critics such as Public Citizen to bemoan that "Most states are not living up to their obligations to protect patients from doctors who are practicing medicine in a substandard manner."
Dr. Tan is a former professor of medicine and adjunct professor of law at the University of Hawaii, Honolulu. This article is meant to be educational and does not constitute medical, ethical, or legal advice. It is adapted from the author’s book, "Medical Malpractice: Understanding the Law, Managing the Risk" (2006). For additional information, readers may contact the author at siang@hawaii.edu.