It is confusing because one is trying to jam-in an enormous amount if information in 400 words or less.
Simply put: accidental endobronchial intubation caused by distal cuff leak is not immediately catastrophic, but if not caught in extremely short order, they results are irreversible (eg, acute respiratory insufficiency, ischemic brain damage, death). It is ICU 101. A low sat (o2) needs to be evaluated and not assumed to be a vent issue. Hypoxic for 14 hours with a sat ranging low of 40% to high 64% is death. When I realized their fatal mistake, the doctors went on damage control. I want to put my mother to rest, but I was her advocate. I cannot sleep knowing my mother could be here today if they just used common sense. Again...medicine 101. If you want the full story/case, give me a good reason why you would be a good investigator...do you understand medical practices?