Physicians Duties to Diagnose and Treat Obstructive Sleep Apnea

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Upon establishment of the physician-patient relationship, a physician owes his patient the duty of reasonable care present in the community when treating his patient (31). A 1993 Louisiana case found a hospital and its physicians liable for the death of patient William Cornett as a result of the defendants' failure to treat the decedent's OSA (6). Mr. Cornett suffered from acromegaly, a generally nonmalig-nant pituitary tumor causing excessive secretion of growth hormones and the resulting enlargement of facial features, limbs, and soft tissues of the body (46). The condition may cause OSA, from which Mr. Cornett also suffered (46).

In March 1986, a family practice resident at the defendant hospital examined Mr. Cornett, who complained of chest pains and sleep apnea. The resident referred the patient to the hospital's endocrinology clinic for acromegaly. The hospital failed to schedule the appointment (46).

Seven months later, Mr. Cornett presented at the hospital's emergency room believing he was in a diabetic coma. He again explained his four- to five-year history of sleep apnea, and Mr. Cornett fell asleep during his diabetes testing, which proved negative. Concerned about Mr. Cornett's somnolence, the emergency room physician ordered arterial blood gas testing, which indicated elevated carbon dioxide levels and low oxygen levels. The emergency room physician testified at trial that Mr. Cornett requested treatment for sleep apnea because he had fallen asleep while driving. The doctor diagnosed acromegaly and sleep apnea. To confirm the diagnosis of acromegaly, the physician ordered diagnostic tests at the hospital's endocrinology clinic. These tests confirmed the diagnosis of the pituitary condition (47).

Mr. Cornett presented at the endocrinology clinic two weeks later when a different hospital physician confirmed a diagnosis of acromegaly and central hypoxia. This physician ordered pulmonary function testing at the hospital's chest clinic, but Mr. Cornett died before his scheduled appointment date. The cause of death was documented as cardiopulmonary arrest as a consequence of pituitary tumor (47).

Expert testimony at trial indicated that Mr. Cornett's death was more likely caused by sleep apnea and, had the hospital and its physicians provided appropriate medical treatment for OSA, Mr. Cornett would have survived. The last two hospital physicians who examined Mr. Cornett acknowledged that OSA is a potentially fatal condition. Each also testified that they failed to inform Mr. Cornett of the risk of death presented by untreated sleep apnea. The hospital's own medical expert acknowledged that sleep apnea may lead to life-threatening cardio-respiratory events and that the disease is a recognized emergency. The appellate court affirmed the trial court's holding the hospital and the physicians liable for professional negligence (48).

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Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

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