Bronchoscopy

A bronchoscopy is a routine medical procedure that doctors use to view the airway. Medical providers rely on this diagnostic test to inspect the lungs, trachea, and bronchial tubes. While many bronchoscopies occur without any issues, medical malpractice during or around the bronchoscopy procedure can result in catastrophic outcomes. Accordingly, a negligent bronchoscopy or a delayed procedure can cause permanent physical injuries, chronic impairment, or life-threatening complications.

Understanding how a bronchoscopy works, what it can reveal, and where errors occur helps patients and families navigate potential medical malpractice claims.

Anatomy of the Airway and Lungs

To understand a bronchoscopy, firstly you must understand human respiratory anatomy. Air enters through the nose or mouth. It then travels down the larynx into the trachea, commonly known as the windpipe.

The trachea splits into two mainstem bronchi. The right bronchus leads into the right lung. The left bronchus leads into the left lung. These primary airways then branch into smaller airways called bronchioles. At the end of the bronchioles are small air sacs called alveoli, where oxygen then moves into the blood.

The tissue lining these structures is delicate, fragile, and heavily vascularized. Therefore, any blunt force or improper technique during a medical procedure can easily puncture or tear airway walls. This can result in bronchoscopy medical malpractice.

What Is a Bronchoscopy and How Is It Administered?

A bronchoscopy is a procedure that allows a doctor to look directly at your lungs and breathing passages. The practitioner uses a specialized instrument called a bronchoscope.

Types of Bronchoscopes

• Flexible Bronchoscope: This thin, flexible tube contains a light source and a small camera. Doctors use flexible scopes most frequently because they navigate small airways easily without requiring deep general anesthesia.
• Rigid Bronchoscope: This straight, solid metal tube allows access to larger airways. Doctors use rigid scopes primarily to remove large foreign objects, clear severe bleeding, or place stents.

How the Procedure Works

Before the procedure begins, medical personnel administer local anesthesia, conscious sedation, or general anesthesia.The doctor passes the scope through the nose or mouth, past the vocal cords, and down into the trachea and bronchi.

During the test, the physician views live video feed on a monitor. The provider can pass small tools through the scope to collect tissue samples, perform washes, or clear blockages.

What Medical Providers Order and Perform a Bronchoscopy?

A wide range of doctors may determine that a patient needs a bronchoscopy:

• Primary Care Physicians and Internists: These providers order the procedure during evaluations for persistent coughs, unexplained lung spots, or chronic infections.
• Oncologists: Cancer specialists order bronchoscopies to evaluate suspected lung tumors or stage lung cancer.
• Infectious Disease Specialists: These doctors order bronchoscopies to identify complex or antibiotic-resistant lung infections.

The actual procedure is performed by qualified specialists, including:

• Pulmonologists: Physicians specializing in lung conditions perform the vast majority of diagnostic and therapeutic bronchoscopies.
• Thoracic Surgeons: Surgeons utilize bronchoscopy before or during chest operations.
• Interventional Pulmonologists: These specialists perform advanced, minimally invasive airway procedures.
• Critical Care Specialists: Intensive care unit doctors perform emergency bedside bronchoscopies on ventilated patients.

What a Bronchoscopy Can and Cannot Show

A bronchoscopy provides valuable diagnostic insight on medical malpractice, but the procedure also has clear physical limitations.

What a Bronchoscopy Can Show

• Direct visual evidence of airway inflammation, narrowing, or collapse
• Blockages caused by mucus plugs, tumors, or inhaled foreign bodies
• Suspicious lung nodules, lesions, or bronchial tumors
• Sources of internal airway bleeding
• Active fungal, bacterial, or viral lung infections via tissue biopsies or washes

What a Bronchoscopy Cannot Show

• Deep Parenchymal Tumors: The scope cannot reach lesions located in the outermost periphery of the lung tissue.
• External Airway Compression: It cannot directly show tumors or masses outside the lungs pressing inward,though it shows the resulting narrowing inside.
• Microscopic Vascular Pathology: It cannot diagnose microscopic blood vessel diseases that do not create visible surface lesions.

Permanent Physical Injuries and Bronchoscopy Medical Malpractice

Medical malpractice involving bronchoscopy generally falls into two distinct categories: permanent physical injuries directly caused by a botched bronchoscopy, and permanent injuries evaluated or missed by a bronchoscopy.

1. Permanent Injuries Caused by Bronchoscopy Medical Malpractice

When a medical provider performs a bronchoscopy improperly, the patient can suffer severe and irreversible injuries.

• Tracheal or Bronchial Perforation: Puncturing airway walls can cause massive tissue tears. This damage can requires major thoracic surgery and can result in permanent scarring or narrowed airways.
• Pneumothorax and Hypoxic Brain Damage: Aggressive sampling or puncture can collapse a lung. If medical staff fail to detect a collapsed lung promptly, severe oxygen deprivation can occur, leading to permanent hypoxic brain injury.
• Severe Airway Lacerations and Hemorrhage: Tearing pulmonary blood vessels can lead to catastrophic internal bleeding, permanent loss of lung function, or death.
• Permanent Vocal Cord Damage: Careless insertion of the bronchoscope through the larynx can tear or paralyze the vocal cords, leading to chronic speech deficits and severe swallowing difficulties.
• Cross-Contamination and Superbug Infections: Inadequate sterilizing of reusable scopes can introduce antibiotic-resistant bacterial infections into the lungs, leading to chronic respiratory impairment or severe sepsis.

2. Permanent Medical Malpractice Injuries Evaluated or Missed by Bronchoscopy

In other cases, a bronchoscopy is required to evaluate a pre-existing permanent injury caused by previous medical negligence. Conversely, failing to perform a bronchoscopy properly can allow a condition to worsen into a permanent disability.

• Inhalation or Aspiration Injury During Anesthesia: If an anesthesiologist fails to protect a patient’s airway, chemical aspiration can cause severe chemical lung burns. A doctor uses bronchoscopy to assess this permanent tissue destruction.
• Delayed Diagnosis of Lung Cancer: If a doctor misinterprets bronchoscopy biopsy results or fails to order a bronchoscopy when symptoms present, cancer can metastasize. The delay converts a localized, curable condition into a permanent terminal illness.
• Tracheal Stricture from Prolonged Intubation: Improper ventilator management can cause airway scarring. Doctors use bronchoscopy to measure this permanent airway narrowing.

Available Types of Medical Malpractice Claims Relating to Bronchoscopy

Patients who suffer permanent harm due to bronchoscopy errors have several legal avenues for compensation.

Surgical Error Negligence Claims

If the physician lacks skill or uses excessive force during scope insertion, cutting or puncturing healthy tissue, the patient can file a surgical negligence claim.

Misdiagnosis or Failure to Diagnose or Delayed Diagnosis

If a physician fails to order a bronchoscopy despite clear warning signs, or fails to properly identify abnormal tissue seen during the scope, the patient may hold the doctor accountable for resulting disease progression.

Hospital and Facility Negligence

Hospitals must maintain strict cleaning standards for reusable instruments.  If poor reprocessing procedures lead to scope contamination and severe infection, the medical facility can be held directly liable.

Conclusion on Bronchoscopy Medical Malpractice

A bronchoscopy is an essential medical tool. However, it requires care, expertise, and proper follow-up. When medical providers fail to maintain the standard of care during or around a bronchoscopy, the physical consequences can be life-altering. Victims of medical malpractice deserve clear answers and full legal accountability when medical negligence results in permanent physical injuries.

If you have any concerns or questions about medical malpractice, then visit our free consultation page or video. Then contact the Kopec Law Firm at 800-604-0704 to speak directly with Attorney Mark Kopec. He is a top-rated Baltimore medical malpractice lawyer. The Kopec Law Firm is in Baltimore and pursues cases throughout Maryland and Washington, D.C.