Virginia Lawyers Weekly

Plaintiff underwent an angioplasty procedure (percutaneous transluminal coronary angioplasty or “PTCA”) to correct an earlier stent that had failed. During the course of the PTCA, the interventional cardiologist perforated the distal left circumflex coronary artery causing bleeding in the pericardium that was visible on an angiogram (and recognized by the defendant after the fact).

The bleeding in the pericardium compressed plaintiff’s heart and ultimately led to a life-threatening cardiopulmonary arrest.

Plaintiff’s interventional cardiologists would have testified at trial that the perforation should have been recognized during the procedure and dealt with by placement of a balloon distally to prevent the compression.

Under these circumstances the blood could have been drained in a planned, non-emergent fashion by pericardiocentesis. The patient would have been observed for a period of time in the cardiac unit and would have recovered uneventfully.

However, the perforation was not recognized and the patient was transferred to the floor. Shortly after admission to the floor, the patient’s condition deteriorated, and he became hypotensive and tachycardic and complained of severe chest pain – all symptoms of fluid in the pericardium.

The experts would have testified that the patient needed immediate and emergent treatment, including drainage of the blood by pericardiocentesis. Instead, a lengthy delay occurred in transporting the patient to the cardiac unit, obtaining a confirmatory echocardiogram and performing the pericardiocentesis. During this delay the patient suffered a permanent anoxic brain injury rendering him vegetative and requiring full-time care. His minimum life-care needs far exceeded the cap on recovery for medical malpractice.

[09-T-106]

Type of Action: Medical malpractice
Injury: Anoxic brain injury/cardiac tamponade in setting of arterial perforation/angioplasty
Name of the case: Confidential
Verdict or Settlement: Settlement
Amount: $1,700,000
Plaintiff’s Attorneys: Lewis T. Stoneburner and Bellamy Stoneburner, Richmond; John E. Lichtenstein, Roanoke

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