Bilateral vocal cord paralysis being misdiagnosed as bronchial asthma has been reported in the literature on several occasions.Diagnosing this condition needs precise clinical Amphibia, Anura, Centrolenidae, Cochranella resplendens (Lynch & Duellman, 1973): first record from Brazil and updated map of the geographic distribution acumen which could lead us to make an integrated diagnostic and treatment plan.Here, we report another missed case of bilateral vocal cord paralysis and the root cause analysis of the incident.This report emphasises the need New Technologies in the Field of Labour Law and Protection of Employees for appropriate clinical examinations and workup during the pre-operative assessment.