Judgment notwithstanding the verdict: the anesthesiologist's duty to monitor head position in the perioperative period

Abstract

In early 2000, Dr F, a neurosurgeon, was treating patient SB, an obese woman, for pain from cervical disc protrusions. Dr F suggested that a cervical hemilaminotomy and foraminotomy at C3-4 and C4-5 would be an effective strategy to address SB's pain. SB agreed to the surgery, and SB was admitted to Hospital at 8 am. The surgery began at 10:15 am, with Dr L as the anesthesiologist and nurse anesthetist JS assisting. Dr L, with the assistance of JS, attached several monitors. After these monitors were attached, JS placed an oxygen mask on SB's face and began administering oxygen. General anesthesia was induced and an endotracheal tube was inserted and fixed into place. After Dr L and JS completed this initial work, Dr F and his surgical nurse placed SB on the operating room (OR) table in a seated position, with SB's head flexed toward her chest. They then taped her head to a horseshoe-shaped headrest to prevent movement during surgery. After positioning SB and taping her head in place, Dr F left the OR to prepare for surgery. During Dr F's absence, the anesthesia team padded various pressure points to prevent