Why some patients are consenting to their own mutilation, and why it might just land their physicians in seriously hot water.

, UK. May 1st, 2018


Tracheostomies. A quick search on google describes it as “Tracheotomy, or tracheostomy, is a surgical procedure which consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea.

You need help breathing, be it for the long, or short term. Have a tracheostomy.

How simple it sounds. But it is potentially deadly. And it will often ruin any chance of a good quality of life.

Patients are consenting to this procedure in their thousands across North America. The truth is, rarely is the procedure explained to them in the detail it should be. Neither are potential alternative options which could mean many of these patients wouldn’t have to have one.

When one hears of the potential, and often very common complications, that are almost expected rather than just “potential” most people would simply gasp. OMG might be another reaction. A small sample of the complications include, death, infections, bleeding, permanent damage to vocal cords, damage to your oesophagus, air trapping (causing a life-threatening condition) and the list goes on. And on.

Yet thousands upon thousands of patients are consenting to this sometimes life saving procedure. The key word here is sometimes. In so many cases, it could have, or should never been performed in the first place. The consent forms for these procedures are lengthy, and varied. Many read like something out of a horror show. All too often, the result is exactly that horror show.

Why you may ask, are these tracheostomies performed so often then?

Sometimes the procedure is the only option the patient actually has. Far too frequently however, that simply isn’t the case. Doctors today, are far too ready and eager to perform these procedures. It has simply become routine. For some medical establishments, the fees can be upwards of $250,000. Shock. Horror. It makes money. The past decade has seen a substantial the increase in tracheostomies. In that same decade, so have the payments for compensation relating to these procedures. Most pay-outs are in the millions.

Rarely will the doctors who convince their patients that this is the only option for them explain that other options might work for them. Non-invasive ventilation has come a long way in the last decade. There are two types currently available, Mask based ventilation, and Biphasic Cuirass Ventilation. It could well be that one or the other has failed, and the physician will then jump straight to a tracheostomy. The fact is, that very often, where one method has failed, the other could well work. Jumping straight to a tracheostomy without at least trying both options is like amputating your hand because it got infected. It’s like saying, we tried one antibiotic and it didn’t work, so we won’t bother to try another. Amputate!

Without question, it is negligent. It borders on criminal.

By jumping to a tracheostomy, without trying everything possible to avoid it – at the very least both forms of ventilation, (Mask based, and Biphasic Cuirass Ventilation) they are leaving the door wide open to a claim of a particularly costly case of medical negligence.

Gary Mefford of Hayek Medical, a device manufacturer that specializes in Biphasic Cuirass Ventilation commented “We see this all too often. Patients are being pushed into it [a tracheostomy]. They simply are not being given the chance to avoid it. We have helped thousands upon thousands of patients worldwide. It’s proven. Case after case after case, it’s just unbelievable.”

The aftercare costs often run into millions. Infections which are incredibly common costs huge amounts of money to treat. Health Insurance companies ought to start questioning whether they ought to pay for these costs if the procedure could have been avoided in the first place.

Perhaps when the multimillion dollar pay-outs for negligence outweigh the amount earned by these procedures, the rules about when these procedures are appropriate will change. In the meantime, Doctors should start seriously evaluating the distress and anguish they are causing patients, and question if they have really exhausted all other avenues of treatment.

Personal injury lawyers are in for quite the payday.

NOTrach is an organisation dedicated to educating and helping patients and their families find alternatives to tracheostomies.