Delay Between Clearance and Surgery


Did the 9-month delay between the stress test for clearance prior to elective knee surgery constitute negligence?


Patients undergoing elective joint replacement often require cardiology consultation for preoperative clearance. Although cardiology expert witnesses opine in a variety of areas, only a cardiology expert witness who routinely performs preoperative evaluations can opine on the applicable standard of care.


A 66-year-old woman was scheduled to undergo elective bilateral total knee arthroplasty. As part of her preoperative clearance, she saw a cardiologist who performed a nuclear stress test. For various reasons, nearly nine months lapsed prior to her actual surgery. The patient was cleared for the operation, but during surgery she suffered a cardiac arrest. She was eventually resuscitated though the anesthesiologist had difficulty establishing an airway. She survived with an anoxic brain injury. The plaintiff law firm contacted Elite Medical Experts to secure a leading cardiology expert witness to determine what occurred. Elite also recommended an anesthesiology expert since the anesthesiologist had an independent duty to assure that the patient was stable for surgery. Consequently, the firm required an anesthesiology expert witness to evaluate the patient’s intraoperative anesthesia care and resuscitation.


Our free physician-level case consultation identified the need for both a cardiology expert witness and an anesthesiology expert witness. Elite refined the case strategy and worked with the firm throughout discovery.


Elite quickly secured a hand-vetted Professor of Cardiology from a major medical university. The cardiology expert witness was specifically chosen due to extensive experience with preoperative clearance. Elite also secured a leading Professor of Anesthesiology from a different US university. Between the two, the experts had 133 publications, book chapters, and presentations.


The cardiology medical expert determined that the preoperative clearance was adequate and that is was incumbent upon the anesthesiologist to realize that the interval between evaluation and surgery had been too long. The anesthesiology expert witness agreed. Reports were written by both the cardiology expert witness and the anesthesiology expert witness. The case settled for an undisclosed amount.

Looking for the right team of experts for your case? Contact Elite Medical Experts today and speak to a physician or nurse case strategist to discuss your case.

E-Case Studies are brief clinical vignettes based upon actual cases handled by Elite medical Experts. Identifying information has been redacted or altered to protect case confidentiality.

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