California MDA lawsuit over CRNA scope of practice

Specialties CRNA

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OK, I'm confused over this lawsuit that's been filed in California and I was wondering if anybody has any information about it:

http://www.canainc.org/members/pdfs/CANA-CSA_complaint(083105).pdf

Apparently the California anesthesiologists filed a lawsuit because they had a problem with the BORN allegedly stating that CRNA's could practice without supervision. From what I had read on this board, I thought CRNAs did not need anesthesiologist supervision but that surgeon supervision is required. The lawsuit seems to imply that the BORN may have thrown out all supervision requirements with this new rule.

So then I go to the BORN website, and this page says that the new rule was revised, but it's not clear (at least to me) exactly what the revisions were.

http://www.rn.ca.gov/practice/nas.htm

Except there's this document that seems to imply that supervision is still required.

http://www.rn.ca.gov/practice/pdf/bp2825.pdf

So I don't understand why the anesthesiologists still sued. I go to the California CRNA website and the BORN's most recently posted board minutes, which mention the lawsuit but don't give the specifics of what the CRNA's position is on the case.

Does anybody know what's happening with this case and what the issues of law are here? It's a bit confusing.

:coollook:

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Sounds to me like the Cali BORN worded their act as such to threaten the pain mgmt MDA's. Physician supervision is really a broad way to state things. It does not require a MD in the room ect to admin anesthesia. You can have a surgeon and as long as he says the pt needs anesthesia to do his procedure you may deliver the anesthetic. He may and usually does not tell you what anesthetic to use though he may have his personal preferences say general, regional what ever. So the CRNA needs permission from either a MD, DO, DDS to admin the anesthetic then they can choose the anesthetic regimine, do the preop eval ect. The CRNA needs that green light to go then they can anesthetize the Pt. As in pain mgmt say if the CRNA was trying to get into that arena a pt couldnt go to him for say some kind of intrathecal steroid treatment without someone say a surgeon ordering the pt to get the procedure as opposed to the MDA which the pt can go straight to him and the MDA can decide Im going to do this treatment, he does not need that order from another MD.

Wording in these acts are very touchy and ify and can be inerpreted diff. ways by different parties. As far as emergent issues in the ER and what not it is within the scope of a CRNA to administer and order meds and tests detrimental to the pt as well as intervene approp. without a MD ok. in other words if you are on in house call as a CRNA and are called to a code and you are the most qualified person there you can give drugs, order xrays, put in lines basically run the code without MD supervision if the pt's life is a risk.

But as far as supervision it is a rather ambiguous term not meaning that you always have to have someone looking over your shoulder, you basically need that ok to administer the anesthetic from a MD, DO, DDS. The supervising physician does not have to be a MDA. You can work with a plastic surgeon in his office and put pt's to sleep all day with no MDA present just need his (plastics)order saying he needs your service. The order does not have to be type or drug specific as well once you get that order you may order whatever tests, drugs, interventions you feel necessary to admin. your anesthetic as long as its in your scope of practice.

Not sure whats up with this case but believe me it is not the first time the 2 sides have been to court over practice issues and it def. wont be the last.

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In reading the filing, I get the impression they've sidestepped the debate about supervision and pain management, and have objected to the way these changes were done. Either there was no authority for the board to do what it did, or it did so without following the appropriate procedures along the way. As always, it's hard wading through the legalese on these legal filings. Hell, my will takes 20 pages to say "give it all to my wife and child". ;)

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In reading the filing, I get the impression they've sidestepped the debate about supervision and pain management, and have objected to the way these changes were done. Either there was no authority for the board to do what it did, or it did so without following the appropriate procedures along the way. As always, it's hard wading through the legalese on these legal filings. Hell, my will takes 20 pages to say "give it all to my wife and child". ;)

Well, if you're having trouble reading the legalese like I am, how do you know the board didn't have authority or follow procedures? Especially since we don't have the CRNA or BORN side of the story ... which is what I'm looking for.

I'm just wondering if there is a California CRNA or, even better, association member here who might know what's going on.

:typing

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Well, if you're having trouble reading the legalese like I am, how do you know the board didn't have authority or follow procedures? Especially since we don't have the CRNA or BORN side of the story ... which is what I'm looking for.

I'm just wondering if there is a California CRNA or, even better, association member here who might know what's going on.

:typing

I don't know - I'm not saying they did or didn't, just that it appears that that is the basis of the suit.
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