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Case Overview:

A 59 year old patient was 8 days post-op following a coronary artery bypass and developed respiratory distress shortly after extubation. Attempts to reintubate by placing an endotracheal tube were unsuccessful, so a surgery consult was called to establish an emergency airway. The surgery consult attempted a bedside percutaneous tracheostomy which was unsuccessful. The patient became increasingly unstable and went into cardiac arrest. Efforts to secure an airway were unsuccessful and the patient expired. The defense focused on the appropriateness of the decision to extubate, as well as the decision to perform a percutaneous tracheostomy rather than a cricoidthyroidotomy. The jury found in favor of the defense.