When complications arise while a patient is under general anesthesia, it's important to verify that any consultations with family or loved ones in the waiting area are made with people who are part of the treatment plan mentioned in informed consent documents.

Apparently, that's not what happened in April 2008 when plastic surgeon Beverly Carl, MD, of Bridgewater, Pa., got the go-ahead mid-procedure from Brittany Daly's fiance to insert saline breast implants rather than the silicone implants that Ms. Daly had requested.

Last month the Ohio woman filed suit in U.S. District Court for the Western District of Pennsylvania against Dr. Carl for battery and negligence because her fiancee, Sean Daly, was not authorized to make decisions for Ms. Daly while she was unconscious.

As a result of an office mix-up, the wrong implants were delivered for the day of surgery. Rather than cancel surgery, Dr. Carl asked Mr. Daly if she could substitute the saline implants and finish the procedure. According to court documents, Mr. Daly, who was not yet Ms. Daly's spouse, agreed. Dr. Carl didn't mention the switch after the procedure, and Mr. Daly didn't tell his fiancee until later that day when they returned home to Steubenville, Ohio, about 38 miles away.

Ms. Daly says in court documents that she has suffered mental anguish and outrage because the surgeon didn't stop the procedure and reschedule for another day when the proper implants would be available. Ms. Daly wanted silicone implants "because of the appearance they would provide and because of the durability, which would be more conducive to her athletic lifestyle," say court documents. Dr. Carl allegedly told Ms. Daly that saline implants were "more likely to ripple, deflate and were less durable."

Besides battery and negligence, Ms. Daly is also suing for infliction of emotional distress and false imprisonment because she was kept under general anesthesia for 2 hours, while the surgeon tried to figure out what to do. Ms. Daly is asking for at least $600,000 in compensation.

An attorney for Dr. Carl did not respond to a request for comment in the lawsuit. Both parties are scheduled to attend a pre-trial conference in June.

Kent Steinriede