This case involves a woman who was injured when another passenger’s bag fell on his leg during a flight. The woman had a past medical history of DVT and was being treated with anticoagulants at the time of the incident. The bag caused some significant bruising but no fractures. Since the incident, the patient claimed that her existing DVT had been exacerbated, and that the airline should have taken steps to ensure that baggage did not fall on passengers.
Question(s) For Expert Witness
- 1. Do you routinely treat patients with DVT?
- 2. What impact may mild trauma to the calf have on the patient's DVT?
Expert Witness Response E-007690
If the patient is adequately anticoagulated, she should not develop new deep vein thrombosis. Deep vein thrombosis does occur after minor leg injury. (van Stralen et al. Minor injuries as a risk factor for venous thrombosis, Archives of internal Medicine 2008) If she is anti- coagulated, bleeding could have resulted; the bleeding usually results in a bruise which eventually resolves. Bleeding in a muscle can result in compartment syndrome, which can cause require surgical intervention and result in permanent damage. Just having deep vein thrombosis can damage the leg vein which can result in chronic leg swelling (“postphlebitic syndrome”). This occurs in about 1/3 the cases of venous thrombosis and might explain the patient’s new symptoms and would be independent of the new trauma.