A woman who underwent a tummy tuck, breast lift, and liposuction sued her plastic surgeon for heart complications resulting from the procedures. Despite a recommendation from the patient’s hematologist, surgery was performed without a Greenfield Filter to prevent pulmonary emboli, or blocked arteries. At the time of the patient’s discharge, the surgeon had not yet ordered the Coumadin blood thinner, though he was instructed to do so by the same hematologist. After being discharged, the patient suffered a saddle embolism, where one of her lung arteries was blocked by a large, life-threatening blood clot. In order to prevent future fatal blood clots, the patient was told, she would need to take Coumadin for the rest of her life. An expert who could review records and opine on the standard of care in operating on patients with a known coagulopathy was needed.
Question(s) For Expert Witness
- 1. Do you operate on patients who have hypercoagulability?
- 2. Are there any instances in which you would not ask for or not take the recommendations of a hematologist with these patients?
Expert Witness Response E-004907
Embolisms are a known and severe complication of this particular surgery. The patient should not have been operated on without extreme caution and it sounds from the brief history that the surgeon displayed some degree of recklessness.
Expert Witness Response E-018789
I regularly operate on patients with coagulopathies and it would be extremely dangerous to not follow the advice of a hematologist if there was a known coagulopathy. In my experience, some patients have developed deep vein thrombosis after surgery, but not specifically the same circumstances.