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A 31-year-old man was referred to a general surgeon (Dr. M) with a right inguinal hernia.

Pre-op eval was completed by anesthesiologist Dr. Z.

The operation was done at a surgery center.

TAP block was done by Dr. Z, with TIVA including midazolam, fentanyl and propofol.

30 minutes into the operation, Dr. U relieved Dr. Z.

Around the time of the handoff from Dr. Z to Dr. U, there was no documented pulse ox.

He immediately place an oral airway.

Shortly thereafter, the patient went into cardiac arrest.

He was intubated while CPR was ongoing.

After a few rounds of compressions, ROSC was achieved.

911 was called and the patient was taken to a nearby hospital by ambulance.

He had a severe anoxic brain injury, surviving about 6 weeks before dying.

His family filed a lawsuit against Dr. Z, Dr. U, and the hospital.

They did not sue the surgeon.

The expert witness report is shown below: