$4.135 million Tacoma verdict for vascular surgeon’s failure to manage patient’s hypercoaguable state

At the end of July 1999, our client was hospitalized by her vascular surgeon for treatment of a deep venous thrombosis (DVT) in her lower leg. Her personal profile and personal and family history put her at extremely high risk for lifetime issues with abnormal clotting. When she was discharged from the hospital, the vascular surgeon prescribed Coumadin, an anti-coagulation medication that would protect her from blood clots. Soon thereafter, her vascular surgeon went on an extended vacation and left a local general surgeon to cover his practice. During this time, our client experienced some vaginal bleeding. The general surgeon concluded the vaginal bleeding indicated our client needed a hysterectomy. He scheduled her for surgery and instructed her to stop taking the Coumadin (standard procedure before a surgery of this kind).

Upon the vascular surgeon’s return from vacation, he resumed management of our client’s still-resolving DVT. He saw her twice before the scheduled hysterectomy. No one ever asked him his opinion about the wisdom of operating on our client, and, if he had one, he never offered it.

We argued that the vascular surgeon should have communicated to both the patient and to the general surgeon how dangerous it was for this high-risk patient to go to surgery. We argued the vascular surgeon should have recommended waiting before undergoing surgery and that alternative treatment would have proven our client did not need a hysterectomy after all. The vascular surgeon argued it was not his job to second-guess the general surgeon, who had more expertise in gynecological issues than he did.

The hysterectomy occurred as scheduled on September 20, 1999 at a local surgical center. Our client did not return home for nearly a year. The surgery had started what became a cascade of hematological abnormalities and complications: recurrent deep venous thrombosis, recurrent cardiopulmonary arrests, thrombocytopenia, hypovolemic shock and the microvascular clots of purpura fulminans. The clotting problems ultimately led to widespread tissue necrosis and amputations of her left leg below the knee, her right foot, and the fingers of her right hand.