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The death of Joan Rivers: how safe are outpatient clinics?

The tragic death of the comedy legend Joan Rivers has left a lot of people wondering about the safety of outpatient surgery clinics. The Yorkville Endoscopy Clinic in New York City, where Rivers had her procedure and suffered respiratory arrest and cardiac arrest, is still open as of this writing. The American Association for Accreditation of Ambulatory Surgery Facilities sent representatives to the clinic, and subsequently sent a letter to it citing two deficiencies it found. The Association declared the clinic to be in “immediate jeopardy” and placed the clinic on “emergency suspension.” The Association advised the clinic to stop all procedures and surgeries “until accreditation questions are settled.” However, York clinic responded that it maintains its federal and state authorization to provide patient care–and evidently it intends to do so.

Your Denver medical malpractice attorney explains that outpatient ambulatory facilities that lack accreditation can still function as long as they remain licensed. Furthermore, the same regulations that apply to hospitals may not apply to outpatient facilities. For instance, some outpatient clinics may not require a thorough pre-op exam, which includes the evaluation of the health of a patient’s heart and lungs, any medication they may be taking, and a discussion with anesthesiology prior to the procedure or surgery. Another issue that can arise in the absence of adequate preparation for outpatient procedures is the lack of a clearly defined procedure:  what exactly does the procedure involve for which consent is given? This appears to be a critical part of the investigation into Rivers’ death; she consented to an endoscopy but not necessarily to a biopsy, the latter procedure being what allegedly led to respiratory failure and then cardiac arrest.

The biggest consideration in determining whether to have a procedure or surgery in a hospital or outpatient setting is the difference in the staffing and infrastructure between the two facilities; although procedures are now considered “routine,” when done in an outpatient setting there is neither the staffing nor the equipment in place to adequately deal with an adverse event.  The question then becomes: how likely is an adverse event?  

Your Denver medical malpractice attorney emphasizes that several factors must be assessed. Obviously, the health of the patient must be considered. Any chronic condition such as asthma, diabetes or high blood pressure will affect a body’s ability to handle the extra stress of surgery or a procedure. Similarly, the age of a person also affects the body’s ability to handle anesthesia, the surgery or procedure, the medications given, and any risk of infection. The type of anesthesia necessary–sedation or general–must also be factored into the assessment, since some types can be more stressful on the body and harder to recover from than others. If any of these factors indicate a risk for an adverse event is present, then having the surgery or procedure where such an event can be accommodated is a good idea.  

If you or a loved one has not received appropriate care in an outpatient clinic, contact Jordan Levine at Levine Law today to discuss your legal options.

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