The SCIDUA 

The Special Committee Investigating Deaths Under Anaesthesia (SCIDUA) is an expert committee appointed by the Minister for Health. Its Terms of Reference PDF ~12kb are to subject all deaths occurring while under, as a result of, or within 24 hours after the administration of anaesthesia to peer review so as to identify any areas of clinical management where alternative methods could have led to a more favourable result.

Committee members PDF ~40kb are appointed for a fixed term of 5 years, at the end of which time the Committee advises the Minister whether their re-appointment is appropriate. In the event of a member vacancy the Committee may recommend a suitable replacement to the Minister. The Minister may also appoint a member who is a Departmental or Clinical Excellence Commission (CEC) representative. The Committee elects its own Chairperson, who must be a currently practicing anaesthetist.

The Committee tries to ensure that anaesthetists from a broad range of clinical specialties and professional organisations are represented. Nominations for membership come to the Committee from the Australian and New Zealand College of Anaesthetists (ANZCA), the Australian Society of Anaesthetists (ASA), and academic Departments of Anaesthetics. Currently there is also a Consultant Forensic Pathologist on the Committee to help review autopsy findings.

Reporting Deaths to SCIDUA 

In NSW, the death of a person while under, or as a result of, or within 24 hours after the administration of an anaesthetic for a medical, surgical or dental operation or procedure (Anaesthesia related death) is a category 1 scheduled medical condition in the Public Health Act 1991. Anaesthetists are legally required to report any anaesthesia related deaths to the Director-General by completing the Report of Death Associated with Anaesthesia/Sedation form (SCIDUA Notification Form) and sending it to the SCIDUA. 

The completed SCIDUA Notification Forms are to be mailed to:

Director-General
C/o Special Committee Investigating Deaths Under Anaesthesia
Clinical Excellence Commission
Locked Bag A4062
SYDNEY SOUTH  NSW  1235

Copies of the SCIDUA Notification Form can be ordered from Salmat (Ph: 02 9311 9999 or www.salmat.com.au). They should be made available at the Department of Anaesthesia at each hospital. 

The Committee's documents are privileged from subpoena under Section 23 of the NSW Health Administration Act 1982. All communications between the reporting anaesthetist and the Committee is strictly confidential. 

Review of cases

All anaesthesia related deaths are individually reviewed by the 2 or 3 member triage sub-Committee, which either classifies the death as due to factors not falling under the control of the anaesthetist or requests for further information from the reporting anaesthetist, using the SCIDUA questionnaire.

When the questionnaire is returned, information in this document is de-identified, copied and distributed to members of the Committee prior to its meetings. Cases are discussed at each meeting and classified using the nationally recognized Anaesthetic Mortality Classification.

A confidential reply by the Chair is sent to the anaesthetist explaining the Committee's decision. The Committee reports annually to the Minister on the results of its deliberations. The Committee also provides aggregate data to the National Committee on Anaesthetic Mortality, triennially.

Reporting

SCIDUA communicates with its key stakeholders as follows:

• Each individual anaesthetist who provides information to the Committee receives a letter from the Chairperson explaining the reasons behind the Committee's views on his or her case.
• An annual report for the preceding calendar year is provided to the Minister.
• The Committee provides data to the ANZCA Mortality Working Group, which produces the triennial report of ‘Safety of Anaesthesia: A review of anaesthesia related mortality reporting in Australia and New Zealand.
• Periodically, the Committee submits reports to peer-reviewed journals in which trends in anaesthesia-related mortality are described. These reports reach a wide range of anaesthetists in Australia, New Zealand and internationally.

Note: All of the Committee's proceedings, documents and correspondence are protected under Section 23 of the Health Administration Act 1982.