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Chatham Orthopaedic ASC complaint alleges elective cervical surgery proceeded despite hypertensive emergency

The complaint alleges that Chatham Orthopaedics, Chatham Orthopaedic ASC, related surgery-center entities, an orthopaedic surgeon, a medical director, and an anesthesiologist approved and performed elective outpatient ACDF surgery on a patient with morbid obesity, sleep apnea, renal disease indicators, elevated blood pressure, and a day-of-surgery blood pressure the complaint characterizes as a hypertensive emergency. The complaint further alleges that after surgery the patient self-extubated, developed pulmonary edema and hypoxia, was transferred to Memorial Health University Medical Center, and later died, with the complaint citing an autopsy that identified pulmonary embolism as the immediate cause of death.

System
Chatham Orthopaedics
Facility
Chatham Orthopaedic ASC, LLC
Providers involved
Chatham Orthopaedic Associates, P.A. / Chatham Orthopaedic ASC, LLC / Surgical Care Affiliates, LLC / Sentry Anesthesia Management, LLC d/b/a Northstar Anesthesia / Dmitri Sofianos, M.D. / Robert Hoffman, M.D. / Stephen Miller, M.D.
Pattern
Alleged outpatient cervical surgery clearance despite hypertensive emergency and high-risk comorbidities
Harm
Alleged postoperative airway and ventilation complications followed by death from pulmonary embolism

Overview

This page concerns a public complaint alleging that elective outpatient anterior cervical discectomy and fusion proceeded at Chatham Orthopaedic ASC despite high-risk comorbidities and a blood pressure reading the complaint characterizes as a hypertensive emergency.

Chronology

  1. The complaint alleges that the patient was treated by Chatham Orthopaedics in 2022 for neck pain, back pain, cervical radiculopathy, and lumbar radiculopathy.
  2. According to the complaint, pre-operative review documented morbid obesity, treatment-noncompliant sleep apnea, renal-disease concerns, untreated elevated blood pressure, and a history of post-anesthesia complications.
  3. The complaint alleges that on January 24, 2023, the patient arrived for surgery with a blood pressure of 188/134 and that the non-emergent outpatient ACDF procedure proceeded.
  4. The complaint alleges that shortly after surgery the patient became combative, self-extubated, developed pulmonary edema and hypoxia, and required emergent transfer to Memorial Health University Medical Center.
  5. According to the complaint, post-transfer imaging showed the endotracheal tube positioned in the right mainstem bronchus, and the complaint later cited an autopsy identifying pulmonary embolism as the immediate cause of death.

Alleged failures

  • The complaint alleges that the medical director approved the patient for elective outpatient surgery despite comorbidities and risk factors that allegedly counseled against proceeding.
  • The complaint alleges that the orthopaedic surgeon proceeded with elective cervical surgery despite the patient’s day-of-surgery blood pressure and other risk factors.
  • The complaint alleges that the anesthesiologist approved surgery and allowed the procedure to proceed despite alleged hypertensive emergency and comorbidity concerns.
  • The complaint alleges inadequate post-operative airway and ventilation management after the patient self-extubated and developed pulmonary edema and hypoxia.

Entities and tags

Chatham Orthopaedic ASC, LLCChatham Orthopaedic Associates, P.A.Surgical Care Affiliates, LLCNorthstar AnesthesiaDmitri Sofianos, M.D.Robert Hoffman, M.D.Stephen Miller, M.D.ACDFHypertensive emergencyPulmonary embolismHigh-risk surgical clearanceFailure to optimize before surgeryPost-operative airway complicationOrthopaedic surgeryAnesthesiologyAmbulatory surgeryPost-operative airway management

Questions this example answers

What does the Chatham Orthopaedic ASC cervical surgery complaint allege?

The complaint alleges that Chatham Orthopaedics, Chatham Orthopaedic ASC, related surgery-center entities, an orthopaedic surgeon, a medical director, and an anesthesiologist approved and performed elective outpatient ACDF surgery on a patient with morbid obesity, sleep apnea, renal disease indicators, elevated blood pressure, and a day-of-surgery blood pressure the complaint characterizes as a hypertensive emergency. The complaint further alleges that after surgery the patient self-extubated, developed pulmonary edema and hypoxia, was transferred to Memorial Health University Medical Center, and later died, with the complaint citing an autopsy that identified pulmonary embolism as the immediate cause of death.

Who is identified in this public case example?

This public case example identifies Chatham Orthopaedic Associates, P.A., Chatham Orthopaedic ASC, LLC, Surgical Care Affiliates, LLC, Sentry Anesthesia Management, LLC d/b/a Northstar Anesthesia, Dmitri Sofianos, M.D., Robert Hoffman, M.D., and Stephen Miller, M.D. It also tags the source-supported entities Chatham Orthopaedic ASC, LLC, Chatham Orthopaedic Associates, P.A., Surgical Care Affiliates, LLC, Northstar Anesthesia, and Dmitri Sofianos, M.D.

What alleged failures are summarized here?

The complaint alleges that the medical director approved the patient for elective outpatient surgery despite comorbidities and risk factors that allegedly counseled against proceeding. The complaint alleges that the orthopaedic surgeon proceeded with elective cervical surgery despite the patient’s day-of-surgery blood pressure and other risk factors. The complaint alleges that the anesthesiologist approved surgery and allowed the procedure to proceed despite alleged hypertensive emergency and comorbidity concerns.