Injury Due to Incorrect Intubation: Can You Claim?

Injury due to incorrect intubation can be severe. When it is the result of medical malpractice, it may be possible to claim compensation in South Africa.

What is intubation

Medical intubation is a procedure that involves a healthcare worker inserting a tube into a patient’s mouth (or nose) and into the windpipe (trachea). The tube is connected to a ventilator, which delivers a steady stream of oxygen and removes carbon dioxide.

Intubation is administered when a patient is struggling to breathe or undergoing a surgical procedure. Medically, the procedure is called endotracheal tube intubation (ETI).

The situation in South Africa

Unfortunately, in South Africa intubation errors are common. A high proportion of intubations in public hospitals are performed by interns and supervised by junior doctors – including community service doctors – who have little experience with intubation.

Intubation is also commonly performed by non-physicians/paramedics prior to arrival in hospital.

One study looking at intubation errors in South Africa found that, “Difficult or failed intubation accounted for half the deaths associated with general anaesthesia.

“It also featured as a direct cause of mortality in deaths associated with spinal anaesthesia in the last report into maternal deaths in South Africa.”

The study found that, despite training, unfamiliarity with “airway, equipment or process” frequently led to unsuccessful intubation.

Injuries caused by incorrect intubation

Intubation is relatively common. Usually, what can be a life-saving procedure is safe. However, incorrect intubation can cause serious injury, even death. Common injuries include:

• traumatic brain injury
• internal bleeding from cuts, scrapes or punctures
• nerve damage from cuts, scrapes or punctures
• damage to the lungs, throat, oesophagus or trachea
• irregular heartbeat
• vocal cord paralysis
• teeth and mouth injuries
• stroke
• infections
• coma.

In a US-based study of legal claims following incorrect intubation, common injuries included permanent deficits (89.2%), death (50.5%), and anoxic brain injury (37.4%).

Types of intubation mistakes

The most common examples of intubation mistakes and omissions include:

• cutting, scraping, or puncturing soft tissue in the mouth, throat or airway
• improper positioning of the tube in the airway
• dislodged or disconnected tubes
• placing the tube in the oesophagus (not the trachea)
• bent or kinked tubes
• overinflated tubes
• failure to monitor patient oxygenation or other vital signs
• failure to intubate.

What constitutes medical malpractice or negligence?

Medical malpractice or negligence occurs when doctors or healthcare professions deviate from the accepted standard of care when intubating, or by failing to intubate, a patient.

When a patient suffers serious injuries, or death, because of an intubation error that could have been avoided there may be grounds for compensation.

Claims for injury due to incorrect intubation

Serious injury as a result of incorrect intubation can lead to a substantial compensation pay-out.

In one South African case, a self-made businessman and company director, J. Nel, was awarded R1,642,774 for loss of income and earning capacity, R42,366 for future medical and hospital expenses, and R200,000 for general damages by the Pretoria High Court following a failed intubation ahead of back surgery.

The patient sued anaesthetist, Dr R. Raath, following the failed intubation. The patient ended up in intensive care for a month and bedridden at home after his discharge. The formerly “dynamic” businessman had to learn to walk again and suffered severe depression.

Claiming compensation for injury due to incorrect intubation: first steps

If you have suffered an injury due to incorrect intubation, the first step is to seek legal advice from an attorney who specialises in this type of personal injury case.

The attorney will hear your story, assess your case and explain how a compensation claim works.

A medical malpractice claim typically takes several years to conclude. The claims process involves:

• collecting and evaluating medical records
• obtaining expert medical opinions
• issuing a summons with particulars of the claim
• waiting for the defendant’s plea
• applying and waiting for a trial date
• proving the alleged negligence in court.

A settlement may be offered at any point in the claims process. However, it’s important to have sound legal advice so you don’t accept a settlement offer that’s unreasonably low.