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Infographics in Anesthesiology  |   September 2014
Massive Hemorrhage and Malpractice Claims
Author Affiliations & Notes
  • Jonathan P. Wanderer
    Vanderbilt University School of Medicine
  • James P. Rathmell
    Massachusetts General Hospital/Harvard Medical School
Article Information
Infographics in Anesthesiology / Ethics / Medicolegal Issues
Infographics in Anesthesiology   |   September 2014
Massive Hemorrhage and Malpractice Claims
Anesthesiology 09 2014, Vol.121, A21. doi:10.1097/01.anes.0000452345.99889.fc
Anesthesiology 09 2014, Vol.121, A21. doi:10.1097/01.anes.0000452345.99889.fc
Complex Information for Anesthesiologists Presented Quickly and Clearly
Case categories for malpractice claims from massive hemorrhage were extracted directly from a recent analysis,1 using categories as specified by the authors and representing the proportion of cases by using relative size of the text. To demonstrate the disparity between the types of cases requiring massive transfusion and those leading to malpractice claims, we queried Vanderbilt University’s Perioperative Data Warehouse with institutional review board approval to identify procedures associated with transfusion over the past decade. Massive transfusion was defined as intraoperative administration of 10 or more units of erythrocytes along with any quantity of fresh frozen plasma. There were 1,255 such cases identified of the 599,908 analyzed, and they were categorized according to primary procedure using the authors’ categories.1 The relative proportions of each category were visualized using R (The R Foundation for Statistical Computing, Vienna, Austria, package treemap); the size of each block in the bottom diagram represents the relative proportion of massive transfusion cases for each case type. Although trauma and liver resection often require massive transfusion, there are few related malpractice claims. In contrast, spine surgery and obstetric (OB) cases seldom require massive transfusion, yet are overrepresented among malpractice claims.
Infographic created by Jonathan P. Wanderer, Vanderbilt University School of Medicine, and James P. Rathmell, Massachusetts General Hospital/Harvard Medical School. Address correspondence to Dr. Wanderer: jon.wanderer@vanderbilt.edu. Illustration by Annemarie Johnson, Vivo Visuals.
Reference
Reference
Dutton, RP, Lee, LA, Stephens, LS, Posner, KL, Davies, JM, Domino, KB Massive hemorrhage: A report from the Anesthesia Closed Claims Project.. Anesthesiology. (2014). 121 450–8 [Article] [PubMed]