A routine surgery is supposed to reduce risk, not create a crisis. When a patient declines rapidly after surgery and warning signs are missed, delayed, or brushed aside, families are often left with the same painful question: How did this happen in a hospital setting designed to keep patients safe?
In hospital quality discussions, this kind of breakdown is sometimes described as failure to rescue (FTR). It generally refers to a hospital’s inability to prevent death after a treatable complication develops. In real life, it can look like a patient whose oxygen level drops, whose blood pressure becomes unstable, or who shows signs of infection or internal bleeding, but does not receive timely assessment and escalation of care.
If your family is coping with severe complications or a wrongful death following a routine procedure, you may be wondering whether the harm was preventable and whether New Jersey law allows you to pursue accountability. Speaking with South Jersey medical malpractice attorneys can help you understand whether delays in post-surgical care may point to negligence under New Jersey law.
To discuss your concerns, contact The Law Offices of Andres, Berger & Tran by phone or through the online contact form to schedule a free, confidential consultation.
What Failure to Rescue Means After Surgery
Failure to rescue is not a medical diagnosis. It is a widely used patient safety metric that focuses on what happens after a complication occurs. Complications can arise even when surgery is performed correctly. The key concern, clinically and legally, is how the hospital team responds when a complication develops.
Hospitals are generally expected to monitor post-surgical patients, respond to changing vital signs and symptoms, and escalate care when a patient shows signs of deterioration. When that chain breaks down, patients can suffer cardiac arrest, sepsis, stroke, respiratory failure, uncontrolled bleeding, or other catastrophic outcomes.
Families often describe this experience as watching a loved one worsen while the help that was needed did not arrive quickly enough.
Common Post-Surgical Complications That Require Rapid Response
Some complications are widely recognized as time-sensitive. In certain situations, even short delays can change the outcome. Others begin subtly and can progress quickly if not addressed.
Common examples include:
- Internal bleeding: Blood loss after surgery that may show up as falling blood pressure, a rising heart rate, increasing pain, swelling, dizziness, confusion, or new weakness
- Sepsis: A life-threatening response to infection that may begin with fever or low temperature, chills, rapid breathing, confusion, and abnormal lab findings
- Respiratory compromise: Worsening breathing linked to pneumonia, aspiration, blood clots, airway obstruction, or medication-related suppression
- Pulmonary embolism: A blood clot that travels to the lungs may cause shortness of breath, chest pain, a rapid heart rate, fainting, or sudden collapse
- Stroke or neurologic decline: Sudden confusion, weakness, speech changes, facial droop, or vision changes that may signal stroke or bleeding
- Cardiac instability: Dangerous rhythm changes or reduced perfusion tied to electrolyte shifts, blood loss, infection, or physiologic stress
A complication alone is not proof of negligence. The question is whether warning signs were recognized, documented, and escalated in a timely way based on accepted standards of care. That leads directly to the rescue process.
Where the Rescue Process Can Break Down
Effective post-surgical care depends on a system where staff identify deterioration, communicate it clearly, and escalate care without delay. Breakdowns at any point in that chain can contribute to failure to rescue, including:
Missed or Minimized Warning Signs
Some cases involve clear indicators that a patient was deteriorating, but those signs were not treated with urgency. Families sometimes report repeated complaints of severe pain, difficulty breathing, confusion, or worsening weakness, followed by long stretches without meaningful evaluation.
Delayed Escalation to a Higher Level of Care
Delays in escalation, such as calling a rapid response team, ordering urgent consultations, or transferring a patient to intensive care, can have severe consequences. A treatable complication can become life-threatening when escalation happens too late.
Communication Failures Between Providers
Post-operative care requires coordinated effort among surgeons, hospitalists, bedside nurses, anesthesiologists, and other specialists. Gaps in communication, or a failure to address concerns raised by nursing staff, can lead to delayed interventions and poorer outcomes.
Gaps in Monitoring and Follow-Up
Failure to rescue can stem from insufficient monitoring of key indicators such as vital signs, oxygen saturation, urine output, lab trends, or imaging. It can also occur when concerning results are not acted on promptly.
Each of these failures can carry different legal implications. A careful review of the medical record is often needed to assess whether the hospital’s response fell outside acceptable standards of care.
A Simple Question Families Can Ask When Reviewing What Happened
After a sudden post-surgical decline, families are often told a complication was “a known risk” or “just one of those things.” Sometimes that is true. But in failure to rescue cases, the most important question is often not whether a complication occurred. It is whether the care team recognized warning signs and responded in time.
A practical way to frame the review is this: When did the first signs of deterioration appear, what did the hospital team do, and how quickly did care escalate?
Medical records often show a trail of clues, such as:
- Abnormal vital signs
- Worsening pain
- Breathing changes
- New confusion
- Lab results suggesting infection or bleeding
The focus is on whether those clues were evaluated promptly and whether appropriate steps were taken to prevent the situation from becoming irreversible. If symptoms were documented well before a crisis, the next question becomes whether the response matched what the situation required, such as reassessment by a physician, additional testing, urgent treatment, rapid response activation, or transfer to intensive care.
When Failure to Rescue May Point to Hospital Malpractice in New Jersey
To pursue a medical malpractice claim in New Jersey, the claim generally must show that a healthcare provider or facility failed to meet the accepted standard of care and that this failure caused harm. The standard is not perfection. The central issue is whether the care provided was reasonably appropriate under the circumstances.
Families in Camden County, Burlington County, Gloucester County, and across South Jersey often want to know whether the outcome was preventable and whether warning signs should have triggered faster action.
Malpractice concerns may arise in failure to rescue scenarios when the evidence indicates:
- Delayed assessment: A patient showed signs of deterioration, but no timely physical evaluation or diagnostic workup occurred.
- Delayed intervention: Abnormal vitals or symptoms were documented, but treatment, imaging, or consultation was not initiated promptly.
- Delayed escalation: A patient met criteria for rapid response or ICU transfer, but escalation occurred only after a crisis.
- Inadequate monitoring: Monitoring was insufficient for the patient’s risk level, procedure type, or evolving symptoms.
- Documentation gaps: Records do not clearly reflect appropriate reassessment, communication, or follow-through.
Catastrophic outcomes are often the result of a chain of failures, not a single mistake. Those failures can involve individual providers, hospital policies, staffing, and systemic process breakdowns.
Who May Be Responsible In a Hospital Malpractice Case
Liability in hospital-based negligence claims can involve the hospital, individual clinicians, or both. Depending on the facts, potentially responsible parties may include:
- Hospital staff: Nurses, hospitalists, and others responsible for monitoring, assessment, and escalation
- Surgeons or surgical teams: Providers responsible for post-op orders, follow-up, and response to complications
- Anesthesia providers: Clinicians involved in perioperative monitoring and medication decisions that affect respiratory and cardiac stability
- The hospital entity: Policies, supervision, staffing decisions, and safety procedures
A case evaluation often focuses on what the records show, including vital signs and nursing notes, medication administration records, lab results, consult requests, and the timing of any escalation.
Next Steps if Your Loved One Declined After Surgery
When a loved one declines after a surgery that was expected to be routine, families can feel pressured to accept unclear explanations. It is common for the outcome to be attributed to age, pre-existing conditions, or surgical risks. While those factors can matter, they can also distract from a preventable breakdown in monitoring, reassessment, or escalation.
If you are trying to understand what happened, these steps can help preserve the most important information:
- Request the full medical record: Make sure you receive all nursing notes, vital sign trends, medication administration records, lab results, imaging, consult requests, and discharge/transfer documentation.
- Write down a clear timeline: Include what you observed, what you were told, who responded, and when the condition worsened.
- Identify key people and units involved: Note all available information about the surgeon, hospitalists, nurses, specialists, and the unit(s) where care occurred (post-op floor, step-down, ICU).
- Avoid assuming the outcome was inevitable: Many failure to rescue cases turn on when warning signs appeared and what actions were taken in response.
These steps do not prove malpractice on their own, but they can preserve the details that matter most, especially the timing of deterioration, reassessment, and escalation.
Timing and Legal Requirements in New Jersey Malpractice and Wrongful Death Cases
In New Jersey, medical malpractice and wrongful death claims are governed by strict deadlines, and waiting too long can limit your options. In New Jersey, most medical malpractice claims are subject to a two-year statute of limitations, although exceptions may apply in certain situations, including delayed discovery in some cases. Wrongful death claims are also generally subject to a two-year deadline measured from the date of death. Related claims may also include a survivorship action, which can involve different timing rules depending on when the injury occurred and when it was discovered.
New Jersey also requires an affidavit of merit in most professional negligence cases. In general terms, a qualified medical professional must certify that there is a reasonable probability that the care fell outside acceptable standards. It is typically due within 60 days after the defendant files an answer, and courts may allow one extension up to 120 days for good cause.
If the care involved a public hospital or a provider that may qualify as a public entity, the New Jersey Tort Claims Act can impose additional notice requirements, including deadlines as short as 90 days in many cases. Because deadlines can be fact-specific, it helps to have counsel confirm what applies.
Why These Cases Are So Difficult for Families to Navigate Alone
From a family’s perspective, a failure to rescue may feel clear because the decline was visible. Legally, however, these cases often turn on clinical details and timing. Key considerations include whether the signs of deterioration warranted escalation, whether alternative diagnoses were considered, and whether necessary interventions were carried out in time.
Hospitals and their insurance providers often argue that complications were unavoidable, citing high-risk conditions or an inevitable, irreversible decline. For many families, the clearest answers come from a careful, timeline-based review of the chart and whether escalation steps occurred and when.
Suspecting Failure to Rescue? Contact Andres, Berger & Tran Today
When a loved one suffers a sudden decline after surgery that was expected to be routine, it is normal to feel blindsided and to want clear, honest answers. Failure to rescue cases may involve subtle red flags that were not taken seriously, delays in calling for a higher level of care, or treatment that came too late.
At The Law Offices of Andres, Berger & Tran, our South Jersey medical malpractice attorneys can review what occurred, explain how New Jersey law may apply, and discuss whether responsibility may rest with a hospital, a provider, or both. Call us or contact us through our online contact form to schedule your free, confidential consultation.
Disclaimer: The articles on this blog are for informative purposes only and are no substitute for legal advice or an attorney-client relationship. If you are seeking legal advice, please contact our law firm directly.