The Colorado Society of Anesthesiologists Responds to Colorado Court of Appeals Ruling Regarding the Delivery of Anesthesia Care


Newswise — DENVER – July 19, 2012 – Today the Colorado Court of Appeals released its long-awaited ruling on the lawsuit brought by the Colorado Medical Society and the Colorado Society of Anesthesiologists seeking to overturn the 2009 decision by then Governor Ritter that Colorado should not follow the long-standing Medicare rule requiring nurse anesthetists to be supervised by physicians when delivering anesthesia care. The Court upheld the District Court ruling that the opt-out from the federal supervision requirement was consistent with state law and that nurse anesthetists in Colorado may be considered completely independent of physician supervision.

“As the physician leaders in patient safety in the state, Colorado’s anesthesiologists are dismayed at the Court’s decision and fear for its impact on patients,” said Kristin Woodward, M.D., President of the Colorado Society of Anesthesiologists (CSA). “Contrary to the Court’s opinion, anesthesia care is more than just a medication. It is a complex and potentially life-threatening medical service. To abandon 150 years of physician supervision of this vital aspect of medical care unnecessarily lowers the standard of care in those hospitals affected by the governor’s order and increases the likelihood of patient harm during surgery and other procedures.”

In its challenge to the Ritter decision, CSA and the Medical Society called attention to those aspects of Colorado law that require physician supervision of advanced practice nurses while performing delegated medical functions such as the delivery of anesthesia care. In addition, Colorado law has long held the surgeon to be the “Captain of the Ship” in the operating room, placing responsibility on the surgeon to supervise all personnel in an operating room, including a nurse anesthetist. With the Court’s ruling, these operating physicians now have legal liability for the actions of practitioners that they do not control.

“For more than twenty years, CSA has fought for a rational approach to scope of practice issues in Colorado, always putting patient safety and quality of care as the highest priorities,” stated Randall M. Clark, M.D., Director for the American Society of Anesthesiologists. “Others, most notably leadership in the Colorado Hospital Association and a few rural hospital administrators, have placed expediency above patient safety, and unnecessarily so. In the absence of an anesthesiologist, the operating physician can and must provide the needed medical oversight of the anesthesia service and any complications that arise. The patients in the hospitals now subject to the governor’s action should be told that there may not be a physician supervising their anesthesia care so that they can decide for themselves whether or not to accept that risk. These hospitals must not impose that risk on patients without their knowledge,” Clark concluded.

“Despite the Court of Appeals ruling, the Colorado Society of Anesthesiologists will continue to fight on behalf of our patients,” added Dr. Woodward. “We may appeal to the Colorado Supreme Court or we may seek action in the state legislature to correct this flawed and pernicious setback for patient safety. Regardless of the next steps we take in the governmental arena, we will be tireless in our role as advocates and educators. We will continue to work to improve the quality and safety of anesthesia care in every corner of the state.”

The Colorado Society of AnesthesiologistsColorado Society of Anesthesiologist (CSA) is a non-profit educational association representing over 697 licensed physicians in the state of Colorado who are engaged in the practice of, or otherwise specifically interested in anesthesiology. CSA is a recognized component society of the American Society of Anesthesiologists and was incorporated in 1983.


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