Court – He is accused of manslaughter for the tragic death of a forty-year-old – Victim forced to have a gastric band for health reasons
by Silvana Cortignani
Viterbo – Perplexed by yet another postponement, when they were hoping for the sentence. They are the family members of the obese patient who died in an operating room in Belcolle on 19 April 2017 during gastric banding surgery for health reasons. An anesthetist from the Viterbo hospital has been charged with manslaughter.
Yesterday’s hearing was postponed to the end of May when, barring unforeseen circumstances, after more than seven years, the discussion is scheduled. The victim’s family members became civil parties in the trial with the lawyer Marco Russo.
An operating room – Archive photo
In recent months, doctors and nurses have already testified that between midday and two in the afternoon on 19 April 2017 they found themselves, for various reasons, in the operating block room of the Belcolle hospital where the patient died. The victim was a forty-year-old, suffering from a serious form of obesity, who came specifically from Rome to undergo surgery in the excellence department of the Viterbo hospital.
Three intubation attempts failed. The drama began with three unsuccessful attempts to intubate the patient, carried out by the accused for about twenty minutes starting from midday. Given the impossibility of completing the operation, the anesthetist decided to wake up the patient, postponing the operation, which in any case was not urgent. At that point, around 12.30, the surgeon left the operating room. However, during the awakening procedures, the victim apparently demonstrated that he was not ventilating well and a laryngeal mask was placed on him. She appears to be due to glottis edema developed during three failed intubation attempts.
Crowd of doctors and nurses around the patient. The head of anesthesia and resuscitation would also arrive around 12.50. From that moment, according to what emerged during the hearing, the accused would no longer have any role. Around the patient, according to the testimony of an instrumentalist, there would have been a crowd of about ten people: a couple of nurses and many doctors, including anesthetists and surgeons. The surgeon who was supposed to operate on the patient also returned to the operating room, around 1.30 pm, alerted by message from the surgeon.
The only solution is tracheotomy. At a certain point, with the forty-year-old in cardiocirculatory arrest and an unsuccessful attempt to resuscitate her with cardiac massage, it would have become clear to everyone that the only way to save the patient’s life would have been a tracheotomy. While waiting for the ENT specialist, who was in the ward, the surgeon in charge of the team that was supposed to carry out the gastric banding and a general surgeon on duty in an adjacent operating room would have made the incision to expose the trachea, according to the testimony of the latter. At 1.46pm the ear doctor would take over, perfecting the tracheotomy, taking 9 minutes to complete the operation. But by then it was too late and the patient died.
“It should have been done in a minute.” “That emergency tracheotomy should have been carried out in one minute,” defense consultant Fabrizio, professor Fabrizio Fattorini, anesthetist and resuscitator, professor at Sapienza University and manager of around ten operating rooms, said during one of the previous hearings of the trial. . He underlined that for an anesthetist “not being able to intubate is a tragedy”. According to him, the accused was left alone, when he would have needed the help of colleagues. “There had been no predictive risk assessment, no condition that could suggest a difficult intubation. The three attempts made are according to the guidelines. As well as the mask to promote ventilation which was not good when I woke up,” he said.
“The tracheotomy is the responsibility of those who know how to do it”. According to Professor Fattorini, the head of anesthesia and resuscitation, who arrived in the operating room at 1.50 pm, should have immediately called the ENT doctor and had the surgeon intervene, underlining that ENT doctors and surgeons are responsible for carrying out the tracheotomy, but also adding: ” The surgeon acts between the anesthetist and the surgeon. But tracheotomy is the responsibility of those who know how to do it and if there is an emergency situation they must act.”
Silvana Cortignani
Articles: Obese patient dies in the operating room in Belcolle, two doctors defend the anesthetist – Obese patient dies in the operating room, no to the “immediate” acquittal of the anesthetist – Anesthesiologist on trial dies in the operating room during gastric banding
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