Patient suffers fatal brain injury during heart surgery

The patient, a 39-year old husband and father of three, was experiencing symptoms including shortness of breath, fatigue and dizziness. An echocardiogram on Nov. 21, 2001 revealed 3+ aortic insufficiency. A cardiac catheterization showed normal coronary arteries.

He was seen in cardiac surgical consultation on Jan. 9, 2002. A composite root replacement with homograft tissue was planned with replacement of the aortic valve using a composite replacement as a conduit. Surgery was scheduled for Jan. 16.

The plaintiff alleged that during the procedure, the surgeon inappropriately advanced a cannula too far into the patient’s subclavian artery, causing him to experience high left arterial radial line pressures, which were recognized by the perfusionist present for the operation.

The perfusionist testified at deposition that he alerted the surgeon as to the high pressures, but no action was taken. The operative report was dictated by the surgeon as uncomplicated and the patient went to postoperative care without difficulty. Later, when the patient failed to awaken, his medications were reversed without improvement.

Neurologic consultation and head CT scans indicated hypoxic damages to a number of significant areas of the brain. The damage worsened with subsequent brain herniation. A subsequent MRI of the brain showed bilaterally symmetric caudate nuclei consistent with anoxic brain injury. The patient died on Jan. 21, 2002.

The case settled prior to trial for $1.5 million.

Type of action: Medical malpractice

Injuries alleged: Anoxic brain injury resulting in death

Date: July 2009

Submitted by: Elizabeth N. Mulvey and David Suchecki, Crowe & Mulvey, Boston (for the plaintiff)