Was your anaesthesia complication preventable — and does that make it someone’s fault?
This article will help you understand what anaesthetists are required to do, where errors most commonly occur, and what the records will show if something went wrong.
What an anaesthetist is required to do
Anaesthesia is not passive. The anaesthetist carries active, continuous responsibility — before the procedure begins, throughout it, and into recovery. Australian law requires that an anaesthetist assess the patient’s risk profile, plan the anaesthetic accordingly, monitor the patient’s vital signs throughout, and respond immediately when those signs change. That obligation does not pause.
A patient undergoing elective surgery disclosed a history of sleep apnoea during pre-operative assessment. The anaesthetist did not adjust the sedation plan or arrange post-operative monitoring in a high-dependency setting. In recovery, the patient’s oxygen levels dropped. The nursing staff did not recognise the deterioration quickly enough. The patient sustained a hypoxic brain injury. The pre-operative notes recorded the sleep apnoea. No one acted on it.
Where the anaesthetist failed to assess the patient properly
Before any anaesthetic, the anaesthetist must review the patient’s full medical history — medications, allergies, prior anaesthetic reactions, cardiac and respiratory conditions, body weight, and airway anatomy. This is not a formality. It determines every decision that follows.
When an anaesthetist skips or rushes this assessment, the consequences emerge on the table. A patient with an unrecognised difficult airway cannot be intubated safely. A patient on blood thinners faces different risks than one who is not. The anaesthetist who failed to ask the right questions before the procedure caused the harm — not the procedure itself.
Where the anaesthetist gave the wrong dose or the wrong drug
Dosing errors are among the most common — and most preventable — anaesthetic failures. The anaesthetist must calculate the correct dose based on the patient’s weight, age, renal function, and the specific drugs already in the patient’s system. Getting this wrong is not a matter of bad luck.
Too much anaesthetic agent causes cardiovascular collapse or prolonged unconsciousness. Too little causes awareness under anaesthesia — the patient remains conscious but paralysed, unable to signal distress. Both outcomes are serious. Both are traceable in the records. The anaesthetic chart records every drug given, every dose, and the timing. That chart is the starting point for any examination of what went wrong.
Where the monitoring failed during the procedure
An anaesthetist does not administer the drugs and step back. Continuous monitoring of oxygen saturation, blood pressure, heart rate, end-tidal carbon dioxide, and depth of anaesthesia is mandatory throughout the procedure. When a patient’s condition changes, the anaesthetist must respond — immediately and correctly.
A patient whose oxygen saturation dropped and whose anaesthetist did not act for several minutes sustained harm that the monitoring system was specifically designed to prevent. The monitor alarmed. The anaesthetist was present. The response was delayed. That delay is the failure — and the records will show it.
- You told the team about a prior anaesthetic reaction, an allergy, or a medical condition — and something went wrong that relates directly to it.
- You experienced awareness under anaesthesia — you were conscious during the procedure but could not move or speak.
- You woke up with a brain injury, nerve damage, or organ damage that was not present before the procedure.
- You were told the complication was a “known risk” but were never warned about it before you agreed to the procedure.
- The team’s response to your deterioration felt slow — or you were told later that your condition was not noticed quickly enough.
- You received a different anaesthetic than the one discussed with you, or the anaesthetist who attended was not the one you met pre-operatively.
The records — not anyone’s memory of what happened — will answer these questions. Many people wait months or years before looking into this. The time limit for bringing a claim in NSW is fixed, and it does not pause while you are still trying to make sense of what happened.
What happens when you look into it
A legal examination of an anaesthesia complication starts with the records: the pre-operative assessment notes, the anaesthetic chart, the monitoring printouts, the recovery room observations, and the discharge summary. Those documents tell a factual story. They show what the anaesthetist knew, what they did, and when they did it.
The goal is an honest answer — not to assign blame for its own sake. If the records show that what happened was a known and unavoidable risk of the procedure, that is the answer. If they show that a clinician failed to meet the standard required of them, that matters too.
Not sure whether what happened during your anaesthesia was avoidable?
Dr Rosemary Listing reviews the records and gives you a straight answer. No obligation, no pressure — just clarity.
For more on how medical negligence claims work, see Reframe Legal — Medical Negligence.
Dr Rosemary Listing is a lawyer and medical negligence specialist with a PhD in medical negligence. She practises throughPeter Evans & Associates, based in NSW.
Dr Listing’s work is focused on giving people an honest answer about whether what happened to them was avoidable. Many people wait a long time before looking into it. She understands why — and she does not judge the waiting.
References
- Civil Liability Act 2002 (NSW), ss 5B, 5D, 5O — standard of care, causation, and the peer professional opinion defence.
- Rogers v Whitaker (1992) 175 CLR 479 — High Court of Australia; the standard of care owed by medical practitioners, including the duty to warn of material risks.
- Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 — English standard of care test (considered but not adopted in Australian law following Rogers v Whitaker).
- Australian and New Zealand College of Anaesthetists (ANZCA), PS18 — Recommendations on Monitoring During Anaesthesia (current edition).
- ANZCA, PS07 — Recommendations on the Pre-Anaesthesia Consultation (current edition).
- ANZCA, PS51 — Guidelines for the Safe Administration of Injectable Drugs in Anaesthesia (current edition).
- Limitation Act 1969 (NSW), s 14 — three-year limitation period for personal injury claims, subject to extensions under s 60C in cases of latent injury or delayed discovery.
- Donoghue v Stevenson [1932] AC 562 — foundational authority on the duty of care in negligence.
- Naxakis v Western General Hospital (1999) 197 CLR 269 — High Court; causation in medical negligence, the “but for” test and its application to clinical failures.
- Australian Commission on Safety and Quality in Health Care, Anaesthesia Safety — national data on anaesthetic adverse events and near-misses (current edition).
This article contains general legal information only. It does not constitute legal advice, and reading it does not create a lawyer–client relationship. The law discussed applies to New South Wales, Australia. Each person’s circumstances differ. Time limits apply to legal claims in NSW. Seek independent legal advice about your specific situation.