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January 24, 2012

Sleep Apnea Surgery Malpractice Lawsuit

In November 2009, a patient underwent multi-level surgery to treat her mild-moderate obstructive sleep apnea by a Houston, TX otolaryngologist.

The surgery included:

Uvulopalatopharyngoplasty (UPPP)
Tonsillectomy (typically considered part of UPPP)
Adenoidectomy
• Hyoid Myotomy
• Genioglossus Advancement

She unfortunately experienced some unspecified complications stemming from this surgery which apparently has not helped with her obstructive sleep apnea either. A malpractice lawsuit commenced and final judgement is still pending.

Let's take a closer look at the incomplete information provided.

The patient suffered from mild-moderate obstructive sleep apnea which typically means a AHI score of around 15 (< 5 is normal).

For this level of severity, simultaneous multi-level surgery is not typically performed. Rather such extensive surgery is reserved for severe obstructive sleep apnea.


Also unclear is whether any objective studies were performed prior to surgery to try and localize the levels of obstruction that required correction. Such preoperative studies include a sedated endoscopy as well as trial of CPAP usage.

Assuming patient tried and failed to use CPAP and had objective evidence for multi-level obstruction, what did each of the surgical procedures do?

UPPP, tonsillectomy, adenoidectomy address mouth-level obstruction.

Hyoid myotomy and genioglossus advancement address tongue-level obstruction (the tongue can fall backward while sleeping causing obstruction).

Complications can occur for each of these procedures mainly dealing with bleeding, hematoma, infection, or abscess formation. Swallowing problems can also occur with the hyoid myotomy and genioglossus advancement.

Read more information on obstructive sleep apnea.

Source:
Sleep apnea surgery leads to malpractice lawsuit. Southeast Texas Record. 1/23/12


Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

2 comments:

  1. From the predicate article:

    Sleep apnea surgery leads to malpractice lawsuit
    1/23/2012 4:31 PM By John Suayan, Galveston Bureau

    GALVESTON - A Santa Fe woman has filed suit against a Houston otolaryngologist, claiming a procedure in late 2009 caused her to suffer "multiple severe and persisting complications."

    A lawsuit filed Jan. 5 in Galveston County District Court says Dr. Raza Pasha misdiagnosed and improperly treated Rincey R. Wick's mild-to-moderate obstructive sleep apnea.

    The original petition shows Wick sought treatment from Raza and Texas Otolaryngology Partners LP for snoring and fatigue on Oct. 1, 2009. Wick was admitted to Methodist Hospital for planned surgery a month later.

    She underwent a uvulopharyngopalatoplasty,​ tonsillectomy, adenoidectomy, hyoid myotemy and geniouglossus advancement on Nov. 2, 2009, and was discharged two days later.

    The operation, however, proved to be unsuccessful, according to the suit.

    Wick sought additional treatment in January and April 2010 and went under three additional surgeries to correct Raza's actions, the suit states.

    "All three of the plaintiff's ENT surgeons, speech language pathologists and the plaintiff's original surgeon have uniformly concluded that the plaintiff suffers from ongoing multiple and chronic complications as a direct result of the extensive simultaneous multilevel surgery on Nov. 2, 2009," the suit says.

    Consequently, Wick seeks unspecified monetary damages and a jury trial.

    She is represented by Bettison Doyle Apffel & Guarino PC.

    Case No. 12-cv-0015

    http://​www.setexasrecord.com/news/​241198-sleep-apnea-surgery-​leads-to-malpractice-lawsu​it

    ReplyDelete
  2. Took a little digging, but here is the actual court case filing:

    http://public1.co.galveston.tx.us/CaseDetail.aspx?CaseID=334468

    ReplyDelete

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