An ophthalmologist was named in a malpractice lawsuit after one of his patients passed away from a blepharoplasty procedure to correct a deformity in her right eyelid. The patient had a past medical history of hypercoagulability; she was an amputee above the knee from clotting and was on Coumadin, a widely used blood thinner. The ophthalmologist was allegedly advised that the patient was a high risk for blood clots, but proceeded with the procedure even after the patient allegedly informed him that she had not been able to receive bridge therapy prior to the operation. Two days after the operation, the patient began to experience severe stomach pain that was diagnosed to be a clot in her mesenteric artery that was causing gangrene in her bowel. She passed away not long after.
Question(s) For Expert Witness
- 1. Please discuss your background in performing these types of procedures.
- 2. Have you ever had a patient develop the outcome described in the case? What could have been done for this patient to avoid such an outcome?
Expert Witness Response E-006715
I am a neuro-ophthalmologist, so I do not surgically treat patients for eyelid procedures. I have never had a patient have a complication from a hypercoaguable state – the appropriate steps would have been either to keep the patient on Coumadin therapy in the first place or, if she was not on anticoagulants then, it would not be appropriate to proceed with eyelid surgery.
Expert Witness Response E-014907
I am an oculoplastic surgeon and routinely perform surgeries on eyelids, eye sockets, and tearing. I have never had a patient develop the outcome described in this case. To avoid this outcome, the surgery should not have been done, Coumadin continued, or bridge therapy initiated.