Patient Suffers Permanent Nerve Damage Due to Failed Anesthesiology Procedure

I routinely performed supraclavicular blocks while I was in private practice and never had a patient suffer a similar result. However, for the past 14-years I have been in an academic setting where our blocks are placed by our acute pain service. That said, a key point in this case would be what was disclosed in the informed consent for the block. There are particular risks in placing nerve blocks and those risks, including those that can potentially cause serious and long-term effects, must be covered prior to the block and certainly prior to sedation for the block. Only with this disclosure can a patient weigh those risks against the alternative anesthetic plans and then give informed consent for the procedure. In terms of actual placement of the block, we would need to look at the experience of the anesthesiologist and asses his placement of the block (e.g. ultrasound guided; nerve stimulator: injection pressures). I would also ask if the patient was awake during placement of the block. If so, did the patient complain of any pain during the procedure?