Patient Suffers Heart Attack and Death Following Facelift

58 y/o female has a history of ischemic heart disease and COPD. Surgical history of stent placement for LAD disease in 2003. In February 2012 seen by her cardiologist for recurring ischemic chest pain and is put on nitroglycerin prn. March 2012 goes  for a facelift. clearance is obtained by patient’s GP, but not cardiologist. Patient experiences chest pain, labored breathing upon administration of anesthesia for the face lift, but surgeon continues. Patient codes and dies of MI during procedure.

Issue:
Whether Patient was a candidate for procedure? Whether surgeon should have operated considering patient’s response to anesthesia? Whether cardiology clearance should have been obtained prior to procedure?

Expert Opinions:

Patient with significant cardiac history should have cardiac clearance in addition to generalist clearance especially since still requiring cardiologist’s care. Dr RM – Plastic Surgery

Symptoms merited aborting procedure & seeking emergency evaluation. Dr SK – Plastic Surgery