Dubai: In a case of botched surgery, a young 24-year-old Emirati woman lapsed into coma following a routine cosmetic procedure carried out at a cosmetic surgery clinic in Dubai, officials said on Thursday.
The woman underwent a rhinoplasty performed by the clinic’s leading plastic surgeon. Rhinoplasty, commonly known as a nose job, is a plastic surgery procedure involving reconstructive surgery for correcting or augmenting the shape of the nose for cosmetic or functional reasons.
However, the woman had a possible oxygen deficit to the brain leading to the coma. She is said to have been in coma for over a fortnight and was air lifted to the Cleveland Clinic Abu Dhabi.
The 24-year-old young Emirati fell into a coma due to dangerous complications ... The patient suffered from
a severe drop in blood circulation and blood pressure. Oxygen also stopped reaching her brain.
Sources said the surgeon, a Syrian national, who was attempting to flee was apprehended at the airport.
Dubai Health Authority takes action
Following the case of the Emirati patient who entered a coma due to malpractice, the Dubai Health Authority (DHA) announced that it has stopped the “First Med Day Surgery Centre Dubai” from conducting any surgeries until the results of the investigation are complete.
The DHA has also stopped the two doctors who conducted the surgeries — ENT surgeon, S.H, and anaesthesia specialist and Medical Director of the Centre, S.D — from practicing, due to malpractice and added that legal action will be taken against all those who risk the lives of patients.
Dr Marwan Al Mulla, CEO of the Health Regulation Sector at the DHA, confirmed that the authority has taken all the needed measures, both legal and administrative, after it was notified of the case.
It has also immediately started an investigation, which found — in its preliminary findings — that the Emirati patient, who was admitted to surgery for a simple nose procedure to correct a deviated septum, was a victim of malpractice.
Due to the doctors’ negligence, her health deteriorated during surgery, causing her to fall into a coma.
“The 24-year-old young Emirati fell into a coma due to dangerous complications that she suffered during a Septoplasty procedure by S.H and S.D, at the First Med Day Surgery Center. The patient suffered from a severe drop in blood circulation and blood pressure. Oxygen also stopped reaching her brain, which caused her heart to stop for several minutes and put her into a deep coma, which she still did not wake up from. The patient was transferred to a specialised hospital and is currently in the intensive care unit,” he said.
Dr Al Mulla said the authority immediately formed a medical team to investigate the case and find the clinical reasons that caused the patient to fall into this tragic state. Preliminary investigation of the patient’s medical files and history found that the patient did not suffer from any cardiovascular or vascular diseases prior to undergoing the surgery.
Medical negligence
Preliminary investigation results found that there was medical negligence by both physicians. It was found that they did not take the correct medical procedures for surgical intervention, such as conducting medical examination before the surgery.
It was also found that the patient’s clinical case was not accurately documented by the anaesthesiologist in her anaesthesia records during surgery and it was found to be incomplete. Also, it did not document the patient’s vital signs while the level of oxygen dropped and when her heart stopped working.
The anaesthesiologist also did not record the time he gave the patient the anaesthesia and did not write what the vital signs were prior to giving her the anaesthesia. This caused confusion in managing the case once it started deteriorating during surgery. The needed medical records of the patient were also not available when the patient was transferred from the centre to the hospital.
Dr Al Mulla stressed that the DHA aims to ensure the safety of patients by ensuring the implementation of the best medical practices across all health specialties. He said the authority does not take any medical negligence that risks patients’ lives lightly and so has decided to stop both doctors from practicing until the final results of the investigation are out.
The authority has also banned the centre from conducting any surgical procedures until the investigation is complete.
The investigation on all those involved in the case is still ongoing and is being conducted by a qualified medical committee.
The Dubai Health Authority stressed that it will be taking deterrent action against all those who do not abide by medical rules and regulations that ensure the safe and effective practices in healthcare.
How can rhinoplasty go wrong?
Rhinoplasty, commonly known as a nose job, is a plastic surgery procedure involving reconstructive surgery for correcting or augmenting the shape of the nose for cosmetic or functional reason. According to Dubai’s leading reconstructive and cosmetic plastic surgeon Dr Mohan Rangaswamy, one of the commonest procedures to be carried out in cosmetic and reconstructive surgery, rhinoplasty, is said to be a safe procedure with minimal impact of the procedure on the human body systems. “It can be done under local anesthesia or local with sedation or full general anesthesia.”
However Dr Rangaswamy said: “Under pure local anesthesia the patient’s reflexes are intact and so he or she can protect his or her airway. Under general GA an anesthetist will be in attendance to protect airway. However local anesthesia with sedation has an inherent risk where the patient may aspirate the blood that may ooze out during the surgery. This aspiration can be very dangerous, can affect oxygen delivery to the body and the brain and if not recognized and treated promptly can have dangerous consequences
Performing this procedure under local anesthesia with sedation , is popular but for safety reasons an anesthetist should be monitoring the sedation,” he cautioned.
A very likely condition during administration of anesthesia was rise in body temperature. “In some cases the patient is prone to a condition called malignant hyperthermia. In other words, the patient reacts to anesthetics with sudden uncontrolled rise in temperature which may cause brain damage.
There was also a chance that while carrying out the fracture to reconstruct the nose the fracture line could have extended to the base of the skull. This could cause cerebro-spinal fluid to leak through the nostrils , leading to complications.”
