Experts debate ramifications of videotaping surgeries
Wade Ayer calls them America’s darkest secrets: the unseen occurrences behind closed doors of operating rooms and surgical suites.
Twelve years ago, Ayer’s older sister, Julie Ayer Rubenzer, stopped breathing during breast augmentation surgery in Sarasota, Fla., and eventually died. Records indicate Rubenzer, who was 38, received excessive amounts of propofol — the anesthetic that killed megastar Michael Jackson — during the procedure.
Ayer, 47, of Random Lake, Wis., embarked on a crusade for criminal charges against the operating doctor, Kurt Dangl, because a licensed anesthesiologist did not treat Rubenzer. Dangl, who was not charged, lost his medical license in Florida but resurfaced years later as an oral surgeon and dentist in Erie.
He did not return calls seeking comment.
Devastated by the lack of charges, Ayer shifted his focus to an effort that caught the attention of Wisconsin lawmakers and could make its way to other states: the use of cameras in operating rooms.
“The camera doesn’t lie,” Ayer told the Tribune-Review. “What takes place in the operating room, the sequence of events, it’s all captured if we have cameras in there. If there’s nothing to hide, there should not be a problem.”
Skeptics counter that a so-called “surgical black box” could damage the relationship between patients and doctors and increase frivolous medical malpractice claims.
“As health care professionals, we are continually working to reduce medical errors and improve quality,” said Dr. Sam D. Reynolds, chief quality officer for Allegheny Health Network. “The jury is still out on whether having cameras in the operating room will help us achieve those goals.”
In June, several Wisconsin state representatives introduced the “Julie Ayer Rubenzer Law,” believed to be the first of its kind in the United States. The proposed legislation requires any facility performing surgery to offer patients the option of having their surgeries videotaped.
Rep. Christine Sinicki, D-Milwaukee, worked with Ayer before authoring the proposed bill, which includes a clause requiring patients to pay the recording costs. Although she doubts the bill will pass initially, she’s pleased with the ensuing dialogue.
Ayer has written to members of Congress to push the idea of a federal law requiring surgical cameras.
“This really makes a lot of sense,” Sinicki said of her proposed state bill. “In my mind, it not only protects the patients, it protects the doctors as well. I know there’s going to be opposition, but I’m tenacious.”
A surgeon in Toronto, Dr. Teodor Grantcharov of St. Michael’s Hospital, designed a black box in 2014 that he modeled after aviation recording systems. Grantcharov’s creation, which is the size of a laptop, mounts on operating room walls and records audio and visual details of an operation along with other patient data.
Grantcharov said he geared his concept as a teaching mechanism, not a litigation tool. He said that a pilot project involving recordings of 54 procedures found that 75 percent of mistakes were not noticed by the surgical team.
“The operating room is one of the most secretive environments in modern society,” Grantcharov said. “We can change that and acknowledge, as doctors, that we are not perfect. The more data we can generate, the better.”
Officials at UPMC, Western Pennsylvania’s largest hospital system, declined to comment on the issue of recording surgeries. At independent St. Clair Hospital in Mt. Lebanon, spokesman Robert Crytzer said nobody would comment. Grantcharov said he’s not surprised.
“People don’t want to talk about it,” he said. “It’s part of the culture that what happens in the operating room stays in the operating room.”
Even if videos wound up in court, Grantcharov said he believes, in most cases, they could benefit doctors.
“The recordings would prove what did and what did not happen,” he said. “No doctor wakes up and thinks, ‘I am going to go to work and harm some patients today’; and I think video evidence would show that.”
Brendan Lupetin, a Pittsburgh medical malpractice attorney, agreed.
“I think, costs permitting and patient permission depending, that this is a great idea,” he said. “Just like police having to wear body cameras. Personally, I think videotaping would improve safety and also improve justice for both the patients and doctors.”
Reynolds of Allegheny Health Network is not convinced.
“We need to see results from early piloting of this technology in order to determine its potential benefits,” he said. “The technology could be costly and difficult to maintain and could significantly increase the cost of surgical procedures.”
Ben Schmitt is a Trib Total Media staff writer. Reach him at 412-320-7991 or firstname.lastname@example.org.