To the Editor
I read with interest the letter by Dr. Metz in the Winter 2001-2002 APSF Newsletter1 regarding the possible medicolegal liabilities of automated records. Unfortunately, he raises yet again the specter of artifactual values being recorded and subsequently misinterpreted by plaintiff’s attorneys.
This issue is as old as the technology, and it was well addressed in numerous reviews in the late 1980s.2-4 The argument of recorded artifacts leading to litigation is more than balanced by the improved “professional appearance” of the record, the capture of QA data for monitoring and performance improvement, and the removal of the subjectivity and potential dishonesty in recording the intrinsic variability of data. Perhaps Dr. Metz is aware of a case where the automated record has indicted the anesthesiologist? Even after the dire predictions of the past (and present), there seems to be no confirmation in reality.
I agree with the APSF that the promise of increased safety through analysis of event records free of subjective bias outweighs any unproven concern over potential litigation. As always, the best defense against liability claims is good medicine combined with good communication.
James M. Berry, MD
- Metz S. Legal implications of automated records. APSF Newsletter 2001;16(4):59.
- Morris C. Legal aspects of monitoring. In: Gravenstein JS, ed. The Automated Anesthesia Record and Alarm Systems. Boston: Butterworths, 1987:269-75.
- Whitcher C. Advantages of automated record keeping. In: Gravenstein JS, Holzer JF, eds. Safety and Cost Containment in Anesthesia. Boston: Butterworths, 1988:207-21.
- Eichhorn JH. Disadvantages of automated anesthesia records. In: Gravenstein JS, Holzer JF, eds. Safety and Cost Containment in Anesthesia. Boston: Butterworths, 1988:223-32.