a protection for our surgeon colleagues
One of the first questions we usually encounter when speaking with a new facility is "Are CRNAs really independent? Are there any liability issues with CRNAs for surgeons?"
CRNAs have never been required to be supervised by Arizona, this is only further demonstrated by Arizona’s “opt-out” status, which took effect in March, 2020, and thus, CRNAs have independent status. Regarding the question of surgeon liability for CRNA practice - the answer is a resounding "no". According to numerous legal analyses and decades of case law, liability in is an issue of exerting control. Additionally, Arizona proudly has the nation’s only specific legal immunity for surgeons when they are working with CRNAs, thanks to the efforts AzAS Managing Partners, as well as a broad coalition of supporters which included over 100 surgeons as well as other CRNA leaders.
“D. A physician or surgeon is not liable for any act or omission of a certified registered nurse anesthetist who orders or administers anesthetics under this section.”
There remains some outdated words throughout statute and regulation but as Arizona state law is the the most influential language on scope of practice issues, an important step has been taken to remove any concerns. Additional information on the topic of surgeon liability for anesthesia is available here.
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ARIZONA CRNA SCOPE OF PRACTICE:
32-1634.04. Certified registered nurse anesthetist; scope of practice; physician and surgeon immunity
A. A certified registered nurse anesthetist may administer anesthetics under the direction of and in the presence of a physician or surgeon in connection with the preoperative, intraoperative or postoperative care of a patient or as part of a procedure performed by a physician or surgeon in the following settings:
1. A health care institution.
2. An office of a health care professional who is licensed pursuant to chapter 7, 11, 13 or 17 of this title.
3. An ambulance.
B. In connection with the preoperative, intraoperative or postoperative care of a patient or as part of the procedure in the settings prescribed in subsection A of this section, a certified registered nurse anesthetist as part of the care or procedure may:
1. Issue a medication order for drugs or medications, including controlled substances, to be administered by a licensed, certified or registered health care provider.
2. Assess the health status of an individual as that status relates to the relative risks associated with anesthetic management of an individual.
3. Obtain informed consent.
4. Order and evaluate laboratory and diagnostic test results and perform point-of-care testing that the certified registered nurse anesthetist is qualified to perform.
5. Order and evaluate radiographic imaging studies that the certified registered nurse anesthetist is qualified to order and interpret.
6. Identify, develop, implement and evaluate an anesthetic plan of care for a patient to promote, maintain and restore health.
7. Take action necessary in response to an emergency situation.
8. Perform therapeutic procedures that the certified registered nurse anesthetist is qualified to perform.
C. A certified registered nurse anesthetist's prescribing authority to administer anesthetics or to issue a medication order as prescribed by this section does not include the ability to write or issue a prescription for medications to be filled or dispensed for a patient for use outside of the settings prescribed in subsection A of this section.
D. A physician or surgeon is not liable for any act or omission of a certified registered nurse anesthetist who orders or administers anesthetics under this section.