Lawsuit: Wide-Awake Surgery Led to Death

Tuesday, April 10, 2007

By TOM BREEN, Associated Press Writer

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CHARLESTON, W.Va. —

Family members say the 73-year-old Baptist minister was driven to kill himself by the traumatic experience of being awake during surgery but unable to move or cry out in pain.

Sizemore's death has drawn attention to a little-discussed phenomenon called anesthesia awareness that some experts say may happen to 20,000 to 40,000 patients a year in this country. Typically they feel pain, pressure or other discomfort during surgery because they are not adequately anesthetized.

The causes can include doctor errors, faulty equipment or medical conditions so severe that the patient cannot be safely put under deep anesthesia.

"It's the first time I know of anyone succeeding in taking their own lives because of this, but suicidal thoughts are not all that uncommon" among such patients, said Carol Weihrer, president of the Virginia-based Anesthesia Awareness Campaign, which she founded after her own experience with anesthesia awareness.

Sizemore, a clergyman and former coal miner from the town of Beckley, was admitted to Raleigh General Hospital on Jan. 19, 2006, for exploratory surgery to diagnose the cause of abdominal pain, according to a lawsuit filed March 13.

An anesthesiologist and nurse anesthetist who worked for Raleigh Anesthesia Associates gave Sizemore paralyzing drugs to prevent his muscles from jerking and twitching during the surgery, the complaint alleges. But it says they failed to give him general anesthesia to render him unconscious until 16 minutes after the first cut into his abdomen. The family says he suffered excruciating pain.

Moreover, the lawsuit says, Sizemore was never told that he hadn't been properly anesthetized, and was tormented by doubts about whether his memories were real.

The lawsuit, filed against Raleigh Anesthesia Associates by two of his daughters, goes on to say that in the two weeks after his surgery, Sizemore couldn't sleep, refused to be left alone, suffered nightmares and complained people were trying to bury him alive.

On Feb. 2, 2006, Sizemore shot himself to death. His family says he had no history of psychological distress before his surgery. The abdominal pains were apparently related to gall bladder problems, according to the family.

"Being helpless and being in that situation can obviously be tough on people's psychological well-being," said Tony O'Dell, a lawyer for the family.

The lawsuit seeks unspecified damages.

Calls to Raleigh Anesthesia Associates were referred to a lawyer who had no comment Monday.

The Joint Commission on Accreditation of Healthcare Organizations, which accredits hospitals, says studies show that anesthesia awareness may happen in 0.1 percent to 0.2 percent of operations involving general anesthesia in this country.

Half of all such patients also report mental distress after the surgery, including post-traumatic stress disorder.

In 2005, the American Society of Anesthesiologists adopted guidelines calling for doctors to follow a checklist to make sure anesthesia is delivered properly. The ASA stopped short of endorsing brain-monitoring machines as standard equipment, saying doctors should decide on a case-by-case basis whether such devices are necessary.

"It could be that someday everybody who gets anesthesia will have a brain-wave monitor," said Dr. Robert Johnstone, a professor of anesthesiology at the West Virginia University School of Medicine.

Johnstone said such monitors are used at WVU, but in conjunction with other equipment anesthesiologists use to measure such things as blood pressure and body temperature. When such monitors and tests are used properly, he said, the chances of someone being awake are slim.

It was not clear whether Raleigh General uses such monitors. Calls to the hospital were not immediately returned.

Weihrer said that recognition of the experience and psychological counseling are often the only thing patients want.

"The reason people sue is because they want to be acknowledged," said Weihrer, who received a settlement after her anesthesia failed during a five-hour eye operation in 1998. "They don't want to be told, `You weren't awake; it was a dream.'"

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