Dennis Rockenbach’s Story
On January 27, 2003, Dennis “Rocky” Rockenbach checked into St. Joseph Hospital in Bellingham, Washington for an outpatient surgical procedure. Rocky was to have a minor polyp removed from his vocal cords. It was benign, but causing hoarseness in his voice. Doctors worried that the growth could become cancerous.
Rocky had undergone similar procedures to remove polyps from his vocal cords twice before in 1982 and 1992. Both times, surgical scissors were used to remove the polyps.
This time, doctors recommended laser surgery. He told Rocky it was the best option for permanent success–that the laser would be used to burn the surface of the vocal cord to eliminate regrowth of the polyp.
Rocky went into the operation with great optimism. He trusted the doctors that this would probably be the last operation, because future polyps could be prevented with the laser treatment.
Rocky was to return home the same day– a friend would meet him that afternoon to drive him home.
In the operating room, the surgical team inserted an oxygen tube to allow Rocky to continue breathing during the procedure. Although 40 percent oxygen should be used, the anesthesiologist allowed 100 percent oxygen to flow through the tube.
During the procedure, the laser perforated the cuff on the oxygen tube. The cuff isolates oxygen to the lungs, maintaining a safe field for laser surgery. A blue marker dye was used to highlight leaks, and when the cuff tore, the surgeon spotted this and stopped the procedure.
If a tear occurs in the cuff or oxygen tube, the manufacturer gives clear instruction that the cuff or tube be changed immediately to prevent fire.
Instead of following this instruction, the surgical team debated whether or not they would change the cuff since they were nearly finished with the procedure. They elected to continue without changing the cuff.
When the laser hit the cuff a second time, it exploded, setting Rocky’s throat on fire.
Rocky’s wife Jody was called and gave permission for placement of a tracheotomy as a life-saving measure. When Jody arrived at the hospital, doctors again explained that there had been a fire in the operating room – and that during the tracheotomy, it was found that Rocky’s esophagus had also been burned. The surgical team also speculated that smoke and debris from the fire had been inhaled into Rocky’s lungs – and that he would need to be induced to cough to expel the debris and reduce the risk of lung infections.
When Rocky awoke from surgery, he struggled against the tubes that were inserted on an emergency basis, not understanding what had taken place. He was sedated again almost immediately.
The second time Rocky awoke, he was more aware. He remembers a roaring in his ears and his wife explaining that during surgery the oxygen tube exploded and a fire started in his throat.
Rocky’s first awareness of his injury was just the beginning of a tortuous recovery. He remained in the Intensive Care Unit for a month. Within a few days of the initial injury, Rocky began to realize how devastating the damage was. He began coughing continuously. Breathing becme increasingly difficult. He was not able to eat, so a feeding tube was placed through his nose, and another through his skin and directly into his stomach.
He was prescribed a series of 26 different medications. The fluid that was serving as a substitute for food would not stay in. Rocky was dropping weight at an astounding rate. He lost 30 pounds in the hospital and another 30 after he went home.
Through this time, the hospital staff discussed “tissue regeneration” with Rocky, leading him to believe a full recovery was imminent.
Within five weeks of his discharge from the hospital, Rocky’s tracheotomy tube was removed. He could breathe on his own, though it was labored. Rocky began moving around the house and regaining a sense a hope.
It was short-lived. On March 19th, Rocky was barely able to draw breath through his throat. His ability to breathe was so diminished that he could no longer walk or care for himself.
No one at St. Joseph had mentioned the danger of scar tissue. Rocky decided to continue his care at the University of Washington Medical Center. There, he learned that scaring would continue for 12 months after the burn injury.
A second tracheotomy was performed without the benefit of anesthesia. Doctors tried injuecting steroids directly into the scar tissue in hopes of dissolving it. This was unsuccessful.
Eventually the tracheotomy tube was replaced with a T-tube, a plastic pipe placed in the part of Rocky’s airway that was most affected. It takes a considerable amount of maintenance each day, but is less intrusive than a full tracheotomy tube.
Rocky later underwent another procedure at th University of California, Los Angeles. This operation was to remove the scar tissue in his airway and form a new enlarged airway. During the course of the surgery, doctors noted that Rocky’s scar tissue was the worst they had ever seen. As a result, he continues to need the T-tube today, and may need it for the rest of his life. This means Rocky will also have to endure the four operations a year the T-tube requires for maintenance and replacement.
Nearly 11 months after his initial injury, Rocky had the feeding tube removed from his stomach and began to eat by mouth again. He recalls that the change involved lots of choking, but the taste of real food was worth it.
As of August 2005, Rocky has endured 18 surgeries just so he can breathe. A plastic tube holds his throat open so he can breathe, but breathing is difficult. His vocal cords are gone. Rocky can whisper, but not well-and too much whispering results in hours of severe pain. He is able to swallow most of the time.
Rocky still does not understand why the surgical team did not take the time to switch the cuff on his oxygen tube during the surgical procedure.
“If only the surgeon, the anesthesiologist, the head nurse, the laser safety nurse, or any one member of the surgical team had acted appropriately, my life may now be the one I had planned for myself,” says Rocky. “But they took that away. So I’m making a new plan, albeit with different parameters. This time without a voice, with limited ability to breathe or swallow, no business, and a plastic pipe sticking out of my neck.”
Because of his preventable injuries caused by medical negligence, Rocky is opposed to Initiative 330 (a legislative initiative in Washington State). If I-330 were to pass, there would be no exceptions to the $350,000 cap for cases of medical negligence. The cap would apply, even in extreme cases like Rocky’s – even though he has to live like this for the rest of his life.