Medicolegal Risks and Outcomes of Sedation

Most children who receive sedation outside the operating room have good outcomes and benefit from efforts to reduce pain and anxiety during a procedure. However, administration of sedative and analgesic agents to children in the outpatient setting always carries some risk to the patient. If a child has an adverse outcome after sedation, and there is evidence of substandard care then there is the potential for a professional liability (“malpractice”) claim against the providers and/or the facility. It is difficult to track with any reliability the actual results of all such claims throughout the USA, in part because there is no uniform national system to report jury verdicts and judgments in state courts that are not appealed. Further, if a malpractice case is settled prior to a jury verdict, the details of those settlements are often kept confidential by the agreement of parties, typically at the request of the medical providers or their insurance carriers. A review of publicly available reports has identified several pediatric sedation claims of alleged negligence. In each of these malpractice cases, the allegations were that the care provided by the professionals (and/or institution) was below an established standard of care, that there was a breach of that standard and that the breach caused injury to the patient. Standard of care is defined as that care which a reasonable physician in a particular specialty would have given to a similar patient, under similar circumstances. Because most clinicians have similar access to information and knowledge, they are usually held to a national standard of care regardless of how remotely the individual may practice.