Analysis of deaths related to anesthesia in the period 1996-2004 from closed claims registered by the Danish Patient Insurance Association.
BACKGROUND
Anesthesia is associated with complications, and some of them may be fatal. The authors investigated the circumstances under which deaths were associated with anesthesia. In Denmark, the specialty anesthesiology encompasses emergency medicine, chronic and acute pain medicine, anesthetic procedures, perioperative care medicine, and intensive care medicine.


METHODS
The authors retrospectively investigated anesthesia related deaths registered by the Danish Patient Insurance Association.


RESULTS
From 1996 to 2004, 27,971 claims were made by the Danish Patient Insurance Association covering all medical specialties, of which 1,256 files (4.5%) were related to anesthesia. In 24 cases, the patient's death was considered to result from the anesthetic procedure: 4 deaths were related to airway management, 2 to ventilation management, 4 to central venous catheter placement, 4 as a result of medication errors, 4 from infusion pump problems, and 4 after complications from regional blockades. Severe hemorrhage caused 1 death, and in 1 case the cause was uncertain.


CONCLUSIONS
Several of the 24 deaths could potentially have been avoided by more extended use of airway algorithm, thorough preoperative evaluation, training, education, and use of protocols for diagnosis and treatment.
Hove
Lars Dahlgaard
LD
Department of Anesthesiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. larshove@dadlnet.dk
Steinmetz
Jacob
J
Christoffersen
Jens Krogh
JK
Møller
Ann
A
Nielsen
Jacob
J
Schmidt
Henrik
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects / Q000401:mortality*; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002423:Cause of Death; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012449:Safety; D013997:Time Factors