Of the claims with an anticipated difficulty, help was either not called for or was unavailable in just one claim. In all of these closed claims involving a difficult airway, an extubation strategy was preformulated where appropriate for over half of the cases. The intent is to continue to analyze these data as they exist both before and after the acceptance of the guidelines. It is hoped that the advent of the difficult airway algorithm will serve to decrease the incidence of adverse outcomes and malpractice claims by improving the assessment and management of difficult airways when they arise. Claims involving airway management comprise an important aspect of the ASA Closed Claims Project database.
Difficult intubation is the second most common damaging event leading to malpractice claims.
It is somewhat disconcerting that the anesthesia care provider reported no anticipation of difficulty surrounding the airway management in nearly half of all claims reviewed here. This may reflect the fact that methods of predicting a difficult airway are not particularly sensitive. Closed claims analysis cannot yet evaluate the effect of new airway management tools such as the LMA on anesthesia liability arising from airway management problems. Perhaps with the acceptance of the ASA algorithm and its emphasis on preoperative assessment and management techniques, fewer injuries arising from management of the difficult airway will occur. A report by the American Society of Anesthesiologists task force on management of the difficult airway.