Anesthesia Student Survival Guide.pdf - Index of

QuAlity AssurAnce, PAtient And Provider sAfety ● 485
Table 30.1 ASA Closed Claims Study – most common adverse outcomes.
Adverse outcome (N = 7,740) % of claims Median payment ($) Range of payment ($)
death 29 338,000 353–17,934,000
nerve damage 19 92,650 394–10,716,000
Permanent brain damage 10 1,216,950 5,950–35,960,000
Airway trauma 7 72,000 34–2,115,000
eye damage 4 97,600 37–3,335,000
injury to newborn 3 667,069 3,966–15,822,000
stroke 3 301,250 7,050–24,966,195
Pneumothorax 3 62,900 465–13,950,000
Back pain 3 26,400 2,240–1,782,500
headache 3 18,300 884–874,500
Aspiration Pneumonitis 3 301,750 573–3,450,000
Myocardial infarction 2 218,000 7,600–1,810,500
Burn, thermal 2 49,995 5,025–844,800
skin reaction 2 21,788 488–727,500
Awareness 1 37,463 1,940–846,000
Meningitis 1 101,219 4,608–873,000
contributes to adverse outcomes, since outcomes are not confounded by disease
processes.
Table 30.1 shows the most common adverse outcomes listed in the ASA
Closed Claims Database with corresponding lists ranges of payments for the
claim. It is evident that adverse outcomes occur in groups in a small number of specific
categories. More than half of all adverse outcomes are found in three categories:
death, nerve damage, and brain damage. The significance of identifying these
large groups of injuries is that research and interventions can be more effectively
directed at a few large areas of clinical practice, potentially resulting in
substantial improvements in patient safety. In the past, this technique was used
successfully by the American Society of Anesthesiologists to focus attention
on monitoring standards and specific guidelines for high-frequency adverse
events, leading to the promulgation of the ASA Standards for Basic Anesthetic
Monitoring (see next page).