This case involves a 56-year-old male patient at risk for pulmonary embolism who was unable to undergo anticoagulation therapy. The patient had an IVC filter implant placed. The patient complained of persistent pain for weeks following the surgery but was told this was normal and not a cause for concern. Within months, the filter migrated and perforated the patient’s vena cava wall. He eventually passed away from complications related to the implant. It was alleged that the implant should have been removed
Question(s) For Expert Witness
- 1. Do you routinely treat patients like the one described above?
- 2. Are you familiar with the FDA guidelines for timing of the removal of such a filter?
Expert Witness Response E-010104
I have treated patients who have developed the complications described above. I routinely perform IVC filter placements and perform complex retrievals and I am familiar with the FDA guidelines. Our group is one of the national leaders in complex filter retrievals. We established one of the first filter clinics in the country. We see hundreds of CT scans of the abdomen each year with filter struts perforating the inferior vena cava. Perforations of the caval wall are fairly common. Most are of no consequence, but some require intervention. I would need more details on the case, including the degree of migration and perforation.