INTRODUCTION

From a pricing standpoint, malpractice carriers do not routinely rate anesthesiologists who work in plastic surgery offices any differently from those who work in hospital operating rooms, but the claims they generate often do have issues that are unique to the plastic surgery population or to an office environment. An anesthesiologist working in an office is often the only one there who is skilled in airway and fluid management, and any additional help required, in terms of personnel or equipment, may be located some distance away. Office operating rooms are regulated by state requirements that vary widely, and anesthesia equipment typically runs the gamut from state of the art to frankly antique.

Despite all these considerations, from a legal standpoint, the standard of care—which is defined as what a similarly trained, competent physician might have chosen to do given the same circumstances—does not vary between office and hospital operating rooms. An anesthesiologist working in a small plastic surgery suite OR is held to the same standard of care as if the case were done in the operating room of a large metropolitan hospital a few miles away. This practice also includes the handling of any and all unforeseen complications that might occur.

Complications resulting in malpractice litigation against anesthesiologists can stem from problems in any stage of the process, from the patient preoperative evaluation through discharge.