Law Pushing for Cameras in the Operating Room

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“Julie’s Law” is a Wisconsin bill named in honor of Julie Ayer. The patient had breast augmentation surgery in 2003. Sadly, the patient flatlined during the procedure. CPR was initiated, but too late. The patient was transported back to Wisconsin where she died three months later.  

According to the patient’s brother: 

“The doctor had no license in anesthesia. He was required by state medical law to have an anesthesiologist present. He decided knowingly and conscientiously to bypass this and operate,” said Ayer.  

Fast forward, more than a decade later, the brother has made it his mission to obtain justice for his sister. He wants to increase transparency in operating rooms and teamed up with a state Representative to propel a law enabling patients to request audio and visual recordings of what goes on in operating rooms.  

A similar bill was proposed in 2015 and six state medical societies argued against it. The Wisconsin Hospital Association distributed a memo encouraging lawmakers not to sign the bill. The Wisconsin Medical Society noted that the operating room is already a high stress environment. Adding cameras and audio recording to this environment would increase the underlying stress without benefit.  

One counterargument: 

“With the successful implementation of cameras in other areas of our lives, like transportation and law enforcement, why are they not in an area where lives are so clearly on the line,” says Chris Nowakowski, who says his wife died from medical malpractice.  

To me, the analogy to a black box in an airplane breaks down. The black box records a plane’s vital signs and cockpit recordings. There are no cameras in the cockpit. And indeed, when adding cameras in the cockpit was proposed, pilots vehemently argued against it. Further, a black box is triggered only during a tragedy, such as a plane wreck. Black boxes are not routinely opened up for analysis. A law enabling access to video and audio in the operating room as if it was part of the medical record would be a formula ripe for misinterpretation and abuse. There are already many devices in the OR recording any number of variables. I’m not sure what extra benefit would be gained by listening to the operating room banter. But, I can easily imagine how such video could be used for fishing expeditions.

What do you think? Share your comments below?

10 thoughts on “Law Pushing for Cameras in the Operating Room”

  1. It’s a two-edged sword. On one hand, it might well add to stress in the OR. On the other, it might go a long way toward explaining seemingly poor decisions–which were in fact inspired, but went south. I see it as analogous to police wearing body cams. They can be exculpatory or damning, depending on the situation.

    If you’re in a tight spot, nothing standard works, and you make the right decision, you’re a genius. If it doesn’t and the patient does poorly or dies, you’re incompetent asshole, regardless of where things were already going.

    There is, of course, a tertium quid: doctors could voluntarily agree to have cameras in their OR’s–or not. Patient gets to choose whether that’s a deal breaker for them, which ultimately makes the most sense.

    And, ~also~ of course: no plaintiff’s expert can testify unless he, too, has OR cams and they, too, get to be shown to the jury. Fair’s fair.

  2. I’m a surgeon. I don’t like the idea on multiple levels. Who gets to review the video? On a practical level you really won’t be able to see much anyway. There are already machines that monitor the patient. What does anyone think we are going to gain by this?

  3. I would love to have cameras in the OR. To show that yes I did say a cuss word when the staff tells me that they don’t have the instruments or supplies that I need. The families and patients would be cussing along with me and appalled at these situations. Also they could have cameras in the scheduling suit when they make decisions to under staff. They could also have cameras in the administration offices so that we could see them making poor decisions that are financial and trying to hide some of their errors and b/c they poorly staffed. The fraud in the system is systemic but the most of it is b/c of the health care “system” and not the doctors.

  4. I have had video and audio recording in my surgery center in every public room for more than 14 years. This has provided ex-cop a Tory evidence and the fans in more than 15 accusations and petitions during that time. Not once have I had the clothes circuit system video or audio evidence used against me. I would recommend all hospitals and physicians offices immediately place video for their defense.

  5. Why not have video cameras not only in the OR but during all patient encounters from A to Z? And with every E.D. patient visit. And during all procedures or tests in the hospital. And in the administrative offices of the hospital. And food preparation. But who will serve as the ‘film critics’, i.e. sheriff. Slippery slope

    • Your unlicensed peers – Aka the public of course! The same ones that are ultimately behind your paycheck. As a pilot, I would welcome a video in the cockpit and actually this was once the norm until a fatal crash occurred. Investigators said it was too traumatizing for the folks in back prior to see just seconds prior to their death – the ground and buildings rushing up to meet them. Graphically this would be no different if a wing was lost that created this condition out the side windows. My argument for this is more from standpoint of the fact that we have our 4 yr old son set up for surgery – with all of the OR mistakes that are occurring these days I would like an extra set of eyes for accountability. Also to ensure that cover ups are not possible or at least far less likely. Bring accountability and understand why those that dont want it, dont.

  6. This makes absolutely no sense. Her surgery occurred in Florida and not Wisconsin. She had her surgery performed in an office, by an oral surgeon and without any anesthesia providers administering the anesthesia. Her brother has misplaced anger and guilt, the real issue is with the state of Florida and he should push for the presence of anesthesia personnel at all surgeries and for the OR to have all necessary emergency and monitoring equipment.
    If she was in an OR with anesthesia she would still be alive.

  7. Big Brother is alive and well in our local hospital with cameras in 16 operatories, but no microphones. It’s to keep the charge nurse abreast of OR happenings. Ugh.

  8. The last paragraph in the article nails it. I agree 100% with it.

    There is already too much stress in the medical community from different areas, such as too much superfluous documentation, budget cuts which extends to staffing cuts, and trickles down to all areas of patient care. My example is the VA.

    High stress areas in hospitals such as Emergency Rooms and OR’s, do not need Big Brother watching their staff. If cameras are implemented in the hopes of “fishing expeditions,” which I guarantee will be used by ambulance chasing attorneys, then adding to the stress of the staff performing their duties, will not end well. There will be more experienced health care workers leaving the field. There is already a critical shortage in patient care because of medical care workers leaving the field.

    I followed the case of the woman who died. She died in Florida at a cosmetic clinic. From what little I understand about the law, clinics follow different regulations. Since more and more clinics are performing cosmetic surgeries, maybe the idea for cameras should apply to them, or change the laws in cosmetic clinics where they are up to par with patient safety.

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Jeffrey Segal, MD, JD
Chief Executive Officer & Founder

Jeffrey Segal, MD, JD is a board-certified neurosurgeon and lawyer. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country's leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

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