State accuses a Miami doctor of malpractice in a Jackson heart surgery patient’s death
A longtime Miami anesthesiologist didn’t make sure a patient was properly ventilated after heart surgery at Jackson Memorial Hospital, leading to the patient’s brain death, the Florida Department of Health said in an administrative complaint.
The complaint starts the disciplinary process for Dr. John Sciarra, licensed in Florida since 1997, according to his Florida Department of Health online profile. The profile shows no previous disciplinary actions against Sciarra. It lists Larkin Community Hospital South Miami as his main practice address and that he holds staff privileges at University of Miami Hospital and clinics.
Reached Friday morning by phone, Sciarra said he couldn’t comment on the administrative complaint.
Ventilation after the operation
The patient, called “P.S.” on the complaint, was a 57-year-old man having a coronary artery bypass graft at Jackson on Jan. 18, 2018. The surgery “was performed without complications,” the complaint said.
But, the surgery, as P.S. went from the operating room table to his bed, the complaint says his “ventilation machine was disconnected from the circuit.”
The complaint said keeping that connected was part of Sciarra’s duties and “due to [Sciarra’s] ventilation failures, the patient was not well ventilated for two to nine minutes.”
P.S. then “developed severe bradycardia,” which is a slowed heart rate, followed by a “full ventricular fibrillation cardiac arrest.”
CPR began. The complaint said the cut in the sternum used for the heart surgery had to be reopened for a cardiac massage.
“Before the implementation of closed chest compressions in the early 1960s, open cardiac massage was a common procedure performed during cardiac arrest,” wrote Mayo Clinic Dr. Ryan S. D’Souza and Luke Law in an article posted on the National Center for Biotechnology Information website. “Some recommend open cardiac massage when standard advanced life support protocols do not restore spontaneous circulation within 5 to 10 minutes.”
But, during that massage, the complaint said, P.S.’s right ventricle was punctured and he had to be put on a cardio pulmonary pump. He was taken to intensive care, where he died.
The complaint said Sciarra committed “medical malpractice” by “failing to ventilate P.S.; failing to timely recognize a prolonged lack of ventilation; failing to timely recognize a ventilation failure and timely ventilate P.S.; failing to prevent a transient inadvertent disconnect from the anesthesia circuit.”
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