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The case of a Missouri patient who was awake during surgery is as it appears that his sevoflurane was never turned on, leaving him aware for at least 13 minutes of his procedure.

Last summer, Matthew Caswell went into Progress West Hospital in O'Fallon, Missouri, for hernia repair and removal of a lipoma on the back of his neck.

But he realized early in the procedure that something was wrong.

"I knew I was in trouble when I felt the cold iodine hit my belly and they were scrubbing me off. At any second I was waiting to go out, but all of a sudden I just got stabbed in my stomach," Caswell .

Caswell's lawyer Kenneth Vuylsteke told 番茄社区app that his client had already been given a paralytic agent, and then the mask was put on to receive sevoflurane for general anesthesia, but the gas was never turned on.

It remained that way for 13 minutes, with Caswell able to feel pain and hear operating room conversation, he told KCTV.

During that time, Caswell's vital signs surged, Vuylsteke said. Records shared with 番茄社区app show a baseline heart rate in the 65 to 70 range, which shot up to 115 beats per minute within a few minutes of the first incision.

Caswell's blood pressure also skyrocketed, from a baseline of 113/73 mm Hg to 158/113 mm Hg -- severe hypertension -- after the first incision.

That should have been more than enough warning that something was likely wrong with the anesthetic, Vuylsteke noted.

He said the story he's gathered so far is that Caswell was brought into the operating room and given the paralytic agent. Either the anesthesiologist or nurse anesthetist put the mask for the inhalational anesthetic on him, but then the surgeon asked to see the lipoma before starting.

The mask was taken off and Caswell was turned over so the surgeon could see the lipoma. He was then returned to supine positioning, and the mask was put back on, but the sevoflurane was never turned on, Vuylsteke said.

Hospital records include a "Significant Event Note" that acknowledges that a "review of the anesthetic record demonstrates a delay in initiating inhalational anesthetic after induction of anesthesia."

The note indicates that Caswell and his mother were "immediately informed regarding the delay in initiating the inhaled anesthetic agent until after the start of the surgical procedure." The hospital "provided emotional support and discussed our intention to ensure his pain and anxiety over the event were well controlled in the immediate term." The hospital also recommended a psychology consult for which they would cover the cost.

Caswell charges that he's suffering from post-traumatic stress disorder and panic attacks because of the experience.

He's suing anesthesiologist Bruce Weber, MD, and nurse anesthetist Kathleen O'Leary, CRNA, as well as their employer, Washington University in St. Louis.

"I would have rather died on that table," he told KCTV.

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