Patient Develops a Pulmonary Embolism After Plastic Surgery

This case involves a female who underwent bilateral breast augmentation and abdominoplasty. While recovering from surgery in the hospital, the patient began to experience calf tenderness, fever, and chest pain. The patient underwent testing which confirmed the diagnosis of pulmonary embolism. The patient required lifelong anti-coagulation with warfarin and aspirin. The patient indicated that the surgical complication was never discussed with her. However, she does recall hearing some of the complications just prior to surgery but was unable to remember specifically because anesthesia was already being administered to her. She claimed that she would not have went through with the procedure if she was aware of the complication.

Question(s) For Expert Witness

1. Have you ever administered consent to a patient while they were being prepped for surgery, and have you ever had a patient that developed a pulmonary embolism as a result of breast augmentation and/or abdominoplasty?

Expert Witness Response E-000976

I have never administered consent to a patient while they were being prepped for surgery and I have never had a patient that developed a pulmonary embolism as a result of breast augmentation and/or abdominoplasty. There are a lot of considerations in this case though: 1. age, 2. medical history, 3. weight, 4. length of surgery time, 5. any precautions against clots used pre-, during, or post-surgery, 6. inpatient or outpatient, 7. length of stay, 8. position of bed, 9. surgical techniques used, 10. skill of surgeon, etc. All could have a contributed to the development of the embolism, but based on the severity of the harm, it appears that the standard of care was not met.