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ANESTHESIA CLOSED CLAIMS PROJECT A BIBLIOGRAPHY OF PEER-REVIEWED JOURNAL ARTICLES PROJECT OFFICE Anesthesia Closed Claims Project Department of Anesthesiology and Pain Medicine University of Washington Box 356540 Seattle, WA 98195-6540 Voice: 206-616-2673 Fax: 206-543-2958 www.asaclosedclaims.org

PEER-REVIEWED JOURNAL ART ICLES Caplan RA, Ward RJ, Posner K, Cheney FW: Unexpected cardiac arrest during spinal anesthesia: A closed claims analysis of predisposing factors. Anesthesiology 68:5-11, 1988. Accompanied by an editorial by Keats AS: Anesthesia mortality A new mechanism. Anesthesiology 68:2-4, 1988. Caplan RA, Posner K, Ward RJ, Cheney FW: Peer reviewer agreement for major anesthetic mishaps. Quality Review Bulletin 14:363-8, 1988. Cheney FW, Posner K, Caplan RA, Ward RJ: Standard of care and anesthesia liability. JAMA 261:1599-1603, 1989. Accompanied by an editorial by Brunner EA: Monitoring anesthetic care: New directions. JAMA 261:1633, 1989. Tinker JH, Dull DL, Caplan RA, Ward RJ, Cheney FW: Role of monitoring devices in prevention of anesthetic mishaps: A closed claims analysis. Anesthesiology 71:541-6, 1989. Caplan RA, Posner KL, Ward RJ, Cheney FW: Adverse respiratory events in anesthesia: A closed claims analysis. Anesthesiology 72:828-33, 1990. Kroll DA, Caplan RA, Posner K, Ward RJ, Cheney FW: Nerve injury associated with anesthesia. Anesthesiology 73:202-7, 1990. Accompanied by an editorial by Keats AS: The Closed Claims Study. Anesthesiology 73:199-201, 1990. Posner KL, Sampson PD, Caplan RA, Ward RJ, Cheney FW: Measuring interrater reliability among multiple raters: An example of methods for nominal data. Statistics in Medicine 9:1103-15, 1990. Chadwick HS, Posner K, Caplan RA, Ward RJ, Cheney FW: A comparison of obstetric and nonobstetric anesthesia malpractice claims. Anesthesiology 74:242-9, 1991. Caplan RA, Posner K, Cheney FW: Effect of outcome on physician judgments of appropriateness of care. JAMA 265:1957-60, 1991. Accompanied by an editorial by Schroeder SA, Kabcenell AI: Do bad outcomes mean substandard care. JAMA 265:1995, 1991. Cheney FW, Posner KL, Caplan RA: Adverse respiratory events infrequently leading to malpractice suits. Anesthesiology 75:932-9, 1991. Gild WM, Posner KL, Caplan RA, Cheney FW: Eye injuries associated with anesthesia. Anesthesiology 76:204-8, 1992. Morray JP, Geiduschek JM, Caplan RA, Posner KL, Gild WM, Cheney FW: A comparison of pediatric and adult anesthesia closed malpractice claims. Anesthesiology 78:461-7, 1993. Sivarajan M, Posner KL, Caplan RA, Gild WM, Cheney FW: Substance abuse among anesthesiologists: I. [Letter to the Editor]. Anesthesiology 80:704, 1994. Cheney FW, Posner KL, Caplan RA, Gild WM: Burns from warming devices in anesthesia. Anesthesiology 80:806-10, 1994. Posner KL, Caplan RA, Cheney FW: Variation in expert opinion in medical malpractice review. Anesthesiology 85:1049-54, 1996. Caplan RA, Vistica MF, Posner KL, Cheney FW: Adverse anesthetic outcomes arising from gas delivery equipment: A closed claims analysis. Anesthesiology 87:741-8, 1997. Accompanied by an editorial by Eisenkraft JB: A commentary on anesthesia gas delivery equipment and adverse outcomes. Anesthesiology 87:731-3, 1997.

ANESTHESIA CLOSED CLAIMS BIBLIOGRAPHY www.asaclosedclaims.org Domino KB, Posner KL, Caplan RA, Cheney FW: Awareness during anesthesia: A closed claims analysis. Anesthesiology 90:1053-61, 1999. Featured in This Month in Anesthesiology. Cheney FW, Domino KB, Caplan RA, Posner KL: Nerve injury associated with anesthesia: A closed claims analysis. Anesthesiology 90:1062-9, 1999. Featured in This Month in Anesthesiology. Cheney FW: The American Society of Anesthesiologists Closed Claims Project: What have we learned, how has it affected practice, and how will it affect practice in the future? Anesthesiology 91:552-6, 1999. Domino KB, Posner KL, Caplan RA, Cheney FW: Airway injury during anesthesia. A closed claims analysis. Anesthesiology 91:1703-11, 1999. Morray JP, Geiduschek JM, Ramamoorthy C, Haberkern CM, Hackel A, Caplan RA, Domino KB, Posner K, Cheney FW: Anesthesia-related cardiac arrest in children: Initial findings of the POCA Registry. Anesthesiology 93:6-14, 2000. Accompanied by an editorial by Rothstein P: Bringing light to the dark side. Anesthesiology 93:1-3, 2000. Posner KL, Geiduschek J, Haberkern CM, Ramamoorthy C, Hackel A, Morray JP: Unexpected cardiac arrest among children during surgery, A North American registry to elucidate incidence and causes of anesthesia-related cardiac arrest. Qual Safe Health Care 11:252-7, 2002. Accompanied by commentary by Jones S, Raffles A: Pediatric Peri-Operative Cardiac Arrest (POCA) Registry. Qual Safe Health Care 11:210-1, 2002. Fitzgibbon DR, Posner KL, Domino KB, Caplan RA, Lee LA, Cheney FW: Chronic pain management: American Society of Anesthesiologists Closed Claims Project. Anesthesiology 100:98-105, 2004. Domino KB, Bowdle TA, Posner KL, Spitellie PH, Lee LA, Cheney FW: Injuries and liability related to central vascular catheters: A closed claims analysis. Anesthesiology 100:1411-8, 2004. Featured in This Month in Anesthesiology. Lee LA, Posner KL, Domino KB, Caplan RA, Cheney FW: Injuries associated with regional anesthesia in the 1980s and 1990s: A closed claims analysis. Anesthesiology 101:143-52, 2004. Peterson GN, Domino KB, Caplan RA, Posner KL, Lee LA, Cheney FW: Management of the difficult airway: A closed claims analysis. Anesthesiology 103:33-9, 2005. Featured in This Month In Anesthesiology. Lee LA, Domino KB: Complications associated with peripheral nerve blocks: Lessons from the ASA Closed Claims Project. Intl Anesthesiol Clin 43:111-8, 2005. Robbertze R, Posner KL, Domino KB: Closed claims review of anaesthesia for procedures outside the operating room. Curr Opin Anaesthesiology 19:436-42, 2006. Cheney FW, Posner KL, Lee LA, Caplan RA, Domino KB: Trends in anesthesia-related death and brain damage: A closed claims analysis. Anesthesiology 105:1081-6, 2006. Accompanied by an editorial by Lagasse RS: To see or not to see. Anesthesiology 105:1071-3, 2006. Bhananker SM, Posner KL, Cheney FW, Caplan RA, Lee LA, Domino KB: Injury and liability associated with monitored anesthesia care: A closed claims analysis. Anesthesiology 104:228-34, 2006. Accompanied by an editorial by Hug CC.: MAC should stand for maximum anesthesia caution, not minimal anesthesiology care. Anesthesiology 104:221-3, 2006. Selected for Anesthesiology CME program. 3

Lee LA, Roth S, Posner KL, Cheney FW, Caplan RA, Newman JJ, Domino KB: The American Society of Anesthesiologists Postoperative Visual Loss Registry: Analysis of 93 spine surgery cases with postoperative visual loss. Anesthesiology 105:652-9, 2006. Accompanied by an editorial by Warner MA: Postoperative visual loss: Experts, data, and practice Anesthesiology 105:641-2, 2006. Kent CD, Domino KB: Awareness: Practice, standards, and the law. Best Pract Res Clin Anaesthesiol 21:369-83, 2007. Jimenez N, Posner KL, Cheney FW, Caplan RA, Lee LA, Domino KB: An update on pediatric anesthesia liability: A closed claims analysis. Anesth Analg 104:147-53, 2007. Bhananker SM, Ramamoorthy C, Geiduschek JM, Posner KL, Domino KB, Haberkern CM, Campos JS, Morray JP: Anesthesia-related cardiac arrest in children: Update from the Pediatric Perioperative Cardiac Arrest Registry. Anesth Analg 105:344-50, 2007. Accompanied by an editorial by Davis PJ: When assessing what we know we don t know is not enough: Another perspective on pediatric outcomes. Anesth Analg 105:301-3, 2007. Lee LA, Posner KL, Cheney FW, Caplan RA, Domino KB: Complications associated with eye blocks and peripheral nerve blocks: An American Society of Anesthesiologists closed claims analysis. Reg Anesth Pain Med 33:416-22, 2008. Metzner J, Posner KL, Domino KB: The risk and safety of anesthesia at remote locations: The US closed claims analysis. Curr Opin Anaesthesiol 22:502-8, 2009. Davies JM, Posner KL, Lee LA, Cheney FW, Domino KB: Liability associated with obstetric anesthesia: A closed claims analysis. Anesthesiology 110:131-9, 2009. Accompanied by an editorial by Leighton BL: Why obstetric anesthesiologists get sued. Anesthesiology 110:8-9, 2009. Bhananker SM, Liau DW, Kooner PK, Posner KL, Caplan RA, Domino KB: Liability related to peripheral venous and arterial catheterization: A closed claims analysis. Anesth Analg 109:124-9, 2009. Fitzgibbon DR, Rathmell JP, Michna E, Stephens LS, Posner KL, Domino KB: Malpractice claims associated with medication management for chronic pain. Anesthesiology 112:948-56, 2010. Accompanied by an editorial by Jamison RN, Clark JD: Opioid medication management: Clinician beware! Anesthesiology 112:777-8, 2010. Cheney FW: The American Society of Anesthesiologists Closed Claims Project: The beginning. Anesthesiology 113:957-60, 2010. Ramamoorthy C, Haberkern CM, Bhananker SM, Domino KB, Posner KL, Campos JS, Morray JP: Anesthesia-related cardiac arrest in children with heart disease: Data from the Pediatric Perioperative Cardiac Arrest (POCA) Registry. Anesth Analg 110:1376-82, 2010. Accompanied by an editorial by Steven JM: Congenital heart disease and anesthesia-related cardiac arrest: Connecting the dots. Anesth Analg 110:1255-6, 2010. Rathmell JP, Michna E, Fitzgibbon DR, Stephens LS, Posner KL, Domino KB: Injury and liability associated with cervical procedures for chronic pain. Anesthesiology 114:918-26, 2011. Hindman BJ, Palecek JP, Posner KL, Traynelis VC, Lee LA, Sawin PD, Tredway TL, Todd MM, Domino KB: Cervical spinal cord, root, and bony spine injuries: A Closed Claim analysis. Anesthesiology 114:782-95, 2011. Accompanied by an editorial by Lanier WL, Warner MA: New perioperative cervical injury: Medical and legal implications for patients and anesthesia providers. Anesthesiology 114:729-31, 2011. Metzner J, Posner KL, Lam MS, Domino KB: Closed claims analysis. Best Pract Res Clin Anaesthesiol 25:263-76, 2011.

ANESTHESIA CLOSED CLAIMS BIBLIOGRAPHY www.asaclosedclaims.org Lee LA, Posner KL, Kent CD, Domino KB: Complications associated with peripheral nerve blocks: Lessons from the ASA Closed Claims Project. Intl Anesthesiol Clin 49:56-67, 2011. Lee LA, Stephens LS, Fligner CL, Posner KL, Cheney FW, Caplan RA, Domino KB: Autopsy utilization in medicolegal defense of anesthesiologists. Anesthesiology 115:713-15, 2011. Accompanied by an editorial by McLemore JL, Garvin AJ: Autopsy and malpractice considerations. Anesthesiology 115: 685-6, 2011. Postoperative Visual Loss Study Group: Risk factors associated with ischemic optic neuropathy after spinal fusion surgery. Anesthesiology 116:15-24, 2012. Accompanied by an editorial by Warner MA: Cracking open the door on perioperative visual loss. Anesthesiology 116:1-2, 2012. Oliver H, Sharar SR, Stephens LS, Posner KL, Domino KB: Similar liability for trauma and non-trauma surgical anesthesia: A closed claims analysis. Anesth Analg. 115:1196-203, 2012. Kent CD, Mashour GA, Metzger NA, Posner KL, Domino KB: Psychological impact of unexpected explicit recall of events occurring during surgery performed under sedation, regional anaesthesia, and general anaesthesia: Data from the Anesthesia Awareness Registry. Br. J. Anaesth. 110:381-7, 2013. Editor s Choice selected for Br. J. Anaesth CME program. Mehta SP, Bhananker SM, Posner KL, Domino KB: Operating room fires: A closed claims analysis. Anesthesiology 118:113-39, 2013. Mehta SP, Eisenkraft JB, Posner KL, Domino KB: Patient injury from gas delivery equipment: A closed claims update. Anesthesiology 119:778-95, 2013. Cote CJ, Posner KL, Domino KB: Death or neurologic injury after tonsillectomy in children with a focus on obstructive sleep apnea: Houston, we have a problem! Anesth & Analg 118:1276-83, 2014. Accompanied by an editorial by Brown KA, Brouillette RT: The elephant in the room: Lethal apnea at home after adenotonsillectomy. Anesth & Analg 118:1157-59, 2014. Dutton RP, Lee LA, Stephens LS, Posner KL, Davies JM, Domino KB: Massive Hemorrhage: A report from the Anesthesia Closed Claims Project. Anesthesiology 121:450-8, 2014. Accompanied by an editorial by Scavone BM, Tung A: The transfusion dilemma: More, less, or more organized? Anesthesiology 121:439-41, 2014. Maxwell BG, Posner KL, Wong JK, Oakes DA, Kelly NE, Domino KB, Ramamoorthy C: Factors Contributing to Adverse Perioperative Events in Adults with Congenital Heart Disease: A structured analysis of cases from the Closed Claims Project. Congenit Heart Dis. 10:21-9, 2015. Lee LA, Caplan RA, Stephens LS, Posner, KL, Terman GW, Voepel-Lewis T, Domino KB: Postoperative opioid-induced respiratory depression: A closed claims analysis. Anesthesiology 122:659-65, 2015. Accompanied by an editorial by Sessler DI: Preventing respiratory depression. Anesthesiology 122:484-5, 2015. Kent CD, Posner KL, Mashour GA, Mincer SL, Bruchas RR, Harvey AE, Domino KB: Patient perspectives on intraoperative awareness with explicit recall: Report from a North American anaesthesia awareness registry. Br J Anaesth 115(Suppl 1):i114-i121, 2015. Pollack KA, Stephens LS, Posner KL, Rathmell JP, Fitzgibbon DR, Dutton RP, Michna E, Domino KB: Trends in pain management liability. Anesthesiology 123:1133-41, 2015. 5

Fitzgibbon DR, Stephens LS, Posner KL, Michna E, Rathmell JP, Pollak KA, Domino KB. Injury and liability associated with implantable devices for chronic pain. Anesthesiology 124:1384-93, 2016. 5-25-16