A patient requesting an abdominoplasty had a history of deep vein thrombosis. Three physicians examined her and approved the surgery, according to the surgeon, but she died after surgery due to complications from the DVT. The patient's parents sued the cosmetic surgeon, claiming he failed to take steps protect her from her condition, but a jury found he had met the standard of care and rejected the lawsuit.

Stephanie Sanzone was referred to cosmetic surgeon Daniel Markmann, MD, in Ellicott City, Md., for an extended abdominoplasty, but she had DVT, a condition in which a clot may break off and move through the bloodstream, causing severe damage if it enters the brain, lungs or heart. But according to Dr. Markmann, Ms. Sanzone was examined by 3 different physicians and they all approved her for surgery.

The 2009 operation lasted about 6 hours. After she was sent home, her mother found her hyperventilating on the bathroom floor. She was transported to the hospital where she died due to a pulmonary embolism. Ms. Sanzone's parents filed a malpractice lawsuit against Dr. Markmann, alleging he failed to evaluate her surgical risks and obtain other physicians' clearance beforehand, and failed to manage her condition directly after the operation. Specifically, they said, Dr. Markmann should have directly consulted with experts on her health before surgery, and should have given her a blood thinner after surgery.

In his defense, Dr. Markmann produced a note from Ms. Sanzone's medical record, stating she told the surgeon she had been examined by her hematologist, cardiologist and primary care physician, and each approved the operation, says Christian A. Lodowski, the Sanzones' attorney. Dr. Markmann also called another surgeon as an expert witness who said he did not give blood thinners after surgery.

Mr. Lodowski questions the validity of the note Dr. Markmann produced. The attorney argues that examining physicians normally send the results of their examinations directly to the surgeon, rather than relying on the patient to tell the surgeon. In any case, Mr. Lodowski said he could verify just 1 examination of Ms. Sanzone, and it was not done by the physician, Ms. Sanzone's OB/GYN, but by her PA. The Sanzones produced an expert witness who argued that giving blood thinners was a standard of care, but his statement was put into question by Dr. Markmann's expert.

A jury in Baltimore County Circuit Court determined in October 2011 that Dr. Markmann didn't depart from the accepted standard of care and dismissed the lawsuit. Heather J. Kelly, the attorney for Dr. Markmann, didn't respond to requests for comment.

Leigh Page