Multi-million-dollar recovery for blindness after heart bypass surgery
Heart bypass surgery is one of the best-known advances in surgical care of the last several
decades. For many patients with coronary artery disease, it provides a new least on life, but it is
a complicated surgery that carries with it many risks. In this case, our client’s heart bypass
surgery was “successful” in the sense that doctors were able to improve the blood flow in the
arteries of the heart, but the patient came out of surgery and was totally blind.
Most open-heart surgeries are done with a use of a cardiopulmonary bypass machine which
allows the heart, in effect, to be taken “off line” and the blood that would normally circulate
through the heart and lungs is instead diverted through tubing to a bypass machine which
oxygenates blood much like our lungs would normally do and then returns the blood to the body
through another set of tubing. The advantage of taking the heart “offline” is that it is no longer
beating and, therefore, it is easier for a surgeon to operate on the organ while it is stationary.
Although that is the most common way in which heart bypass surgery is performed, on occasion
a surgeon may decide not to use the heart-lung machine and instead operate on the heart while it
is still pumping, something called “beating heart” surgery. Surgeons are able to operate while
the heart is still beating because of the recent development of small devices called stabilizers
which are attached to isolated areas of the heart that the doctor tends to operate on, and those
stabilizers keep that small area of the organ motionless. However, one of the disadvantages of
“beating heart” surgery is that the patient is still dependent on the heart, rather than a machine, to
pump oxygenated blood to the rest of the body. But, as the doctor lifts and manipulates the
beating heart throughout the surgery, gravity and other forces can reduce the pumping ability of
the heart. Therefore, it is absolutely critical during “beating heart” surgery that the surgeon and
the anesthesiologist closely monitor the patient to make sure that, as the operation proceeds, that
the patient’s body and vital organs are being adequately supplied or perfused with blood.
In this case, it was our contention that the anesthesiologist was not monitoring the patient closely
enough, and they did not detect that the perfusion or blood supply to the brain was lower than it
should have been. One of the areas in the brain that is particularly susceptible to low perfusion is
the artery which supplies the optic nerve which is critical for vision. In this case, our medical
experts believe that the low perfusion to the brain caused permanent ischemic damage to the
optic nerve and resulted in complete blindness to our client. The medical term for this event is
Posterior Ischemic Optic Neuropathy (PION).
In addition to not monitoring the patient closely enough, our expert in cardiac surgery felt that
the cardiac surgeon himself bore some responsibility for not pausing the surgery and connecting
the patient to the heart-lung machine once signs of low perfusion surfaced.
Our client was a married man in his late 60s with several adult children. Prior to this
catastrophic outcome from open heart surgery, he led a very active and vibrant life. In an instant, his life changed when he woke from the surgery and was totally blind. In a medical malpractice
case of this sort, the patient is entitled to be compensated for the drastic change in his day-to-day
life caused by the blindness. But he was not the only one affected; the husband’s blindness
placed a significant burden on his wife and affected their overall relationship. Therefore, the
wife also was entitled to compensation for what is known as “loss of consortium,” the legal word
for the relationship and companionship between spouses.