Heart Surgery Malpractice Settlement: $1.75 Million
2012 Medical Malpractice Trial Report
49-year-old man dies following mitral valve repair surgery at Brigham & Women’s Hospital.
The plaintiff’s decedent was a 49-year-old man who died after living for several years in a persistent vegetative state following surgery for a mitral valve repair at a major Boston hospital. The patient elected to have minimally invasive mitral valve repair which had to be converted to full sternotomy when the patient suffered cardiogenic shock while on the operating room table. The chest had to be left open, with a plan to close it when the swelling went down.
Following the surgery, the patient was noted to be minimally responsive, and he was given a diagnosis of encephalopathy of unknown origin. There was gradual return of memory and other higher cognitive functions in the following days, however the patient developed atrial fibrillation/flutter which put him at risk for an embolic event.
The plaintiff claimed the patient needed to be on anticoagulation. Initially, the patient was put on anticoagulants, however as the time came to take the patient back to the operating room to close the sternum, the anticoagulation was stopped. During this time, the patient had other medical issues including persistent fluid overload and paroxysmal atrial fibrillation, he had gained 10 kg, had 4-plus edema of both arms and both lower extremities, and was diaphoretic. The doctors questioned whether the patient was behind on his diuresis or whether he had right ventricular dysfunction.
When the patient was taken back to the operating room, he suffered a hemodynamic collapse with frank cardiac arrest. An intraoperative echocardiogram revealed a left atrial thrombus, which was extracted from the left atrium. A ventricular assist device was placed. Clots were discovered in the left and right main pulmonary arteries. An IVC filter was placed. Testing showed the patient had suffered an ischemic stroke.
The defendants claimed the patient needed to be brought back to the operating room for closure of the chest and therefore the anticoagulation had to be stopped. Medical judgment required that anticoagulation be stopped prior to taking the patient for surgery.
The case settled a week before trial for $1,750,000.
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