Top 25 Medical Malpractice Cases of a 25 Year Career – Cardio Thoracic Surgery

By Angela Price-Stephens
Categories: Blog, Medical Malpractice

Medical malpractice cases are very complex.

In this series of articles BC and Alberta personal injury and medical malpractice lawyer Angela Price-Stephens describes her top 25 notable medical malpractice cases of her 25-year career to date.  Her selection of cases is a representation of the breadth of her experience, the complexity of cases, the twists and turns in the evidence and the dramatic benefit to her clients and their respective families by successfully pursing their claim with Angela and her team.

Angela has litigated cases across Canada and England and Wales.  The names and distinguishing details of the cases referred to in this series of articles have been changed to protect the client. In all cases of settlement for medical malpractice the lawyers for the defendant healthcare providers insist on a confidentiality clause in which the existence of a settlement (payout of money to the former patient, irrespective of whether an admission of liability was made) must remain a secret.

In the second of this series of articles we look at the case of Sandy, a 19-year-old student who was discovered to have a congenital hole in the heart and suffered a devastating complication during surgery by virtue of the negligence of the cardiac surgeon.

What makes this case memorable, and frankly shocking, was the attitude of the cardiac surgeon who continued to deny, what Angela characterized as, gross negligence had caused the global hypoxic brain injury despite the clear evidence as to the contrary.

Sandy was born an apparently healthy child and met all her developmental milestones.  She later reported that she did appear to have less energy than her peer group, but not to such an extent that a cause was ever investigated.  That was until one day when she lost consciousness in the bathroom and was taken into the local emergency department. Testing revealed that Sandy had been born with a hole in the heart.  This defect meant that the heart function was less than optimal which accounted for the reduced level of energy and the fainting episode in the bathroom.  The size of the heart defect meant that surgery was required. Sandy and her parents were reassured by the cardiac surgeon that the surgery was “straightforward” and that he expected Sandy to make a full recovery.

The surgery required that Sandy be placed on heart by-pass.  This is a machine that replaces the function of the heart and lungs during the surgery that permits the surgeon to stop the heart, repair it and then re-establishing the circulation by taking the patient off by-pass and then re-starting the heart.

Massive Air Embolus Caused Global Hypoxic Brain Injury

The surgeon negligently failed on two serious counts.  Firstly, he failed to notice the line designed to carry the oxygenated blood to the brain was not flushed with blood but remained filled with air and secondly, he failed to clamp the aorta before connecting the line. Rather than feeding the brain with oxygen-rich blood, Sandy’s brain received a huge volume of air causing a massive stroke affecting both sides of her brain (global hypoxic brain injury).

Despite immediate steps that could have been taken to reduce the impact of the air embolism, the defendant surgeon told no one in the operating room of what had happened.  He continued with the surgery, patched the heart, restarted Sandy’s heart, closed her chest and only then directed the patient be taken for hyperbaric chamber treatment. Whether this behavior reflected a cool, calm and professional surgeon, as claimed by the defendant, or the conduct of an arrogant cardiac surgeon as claimed by other professionals in the operating room added an element of drama to the case with the defendant anesthesiologist (named as a defendant before fully understanding the mechanism of the injury) denouncing the surgeon’s conduct.  In a rare moment of ‘public’ self-preservation the anesthesiologist had written a candid note in the clinical records of what the surgeon had said and when, effectively distancing himself from the surgeon’s conduct.  Usually, medical professionals are encouraged to write such statements in an incident report, which remains hidden from the patient, even during litigation.

Despite the obvious breach in standard of care (failing to ensure the line was devoid of air) and the unusually straightforward causation (injecting air directly into the brain will always cause a stroke which was well-imaged on multiple MRIs) the surgeon refused to admit liability.

Simplifying the Complexity of Heart and Lung By-Pass Procedure was Key to Proving Liability

Through the use of experienced and objective experts Angela demonstrated, in layman’s terms, how the errors had been made.  By demystifying and simplifying the complex by-pass procedure it became easier to illustrate that the surgeon’s errors were fundamental in nature and negligent, not the result of an error in judgment or a recognized but unavoidable risk of the procedure, as originally argued by the surgeon.

A reconstruction of the heart and lung by-pass procedure by an expert perfusionist enabled an accurate calculation of the likely volume of air injected into the brain. The volume of air alone put the magnitude of the error into perspective.

Angela’s ability to assess the issues and engage experts to break down the component parts of the surgery was a critical component of proving the claim and securing a successful outcome for Sandy.  While the costs of these expert reports are high, the costs are ultimately recovered from the defendant in the settlement.


Angela Price-Stephens is an English and Canadian lawyer who focuses on serious personal injury arising from the negligence of others, mostly health care professionals.  Of her 25-year career approximately half of that time has been spent defending heath authorities, doctors and other healthcare professionals.  That experience is now used exclusively for the benefit of injured patients.

For more information on this article, or for a confidential discussion of your claim, contact Angela Price-Stephens at 250 869 1124, or send her a confidential email at price-stephens@pushormitchell.com