Death by Liposuction

What are the risks of liposuction? Not many, especially when you consider that the patients who get the procedure tend to be otherwise young and healthy. These patients are not seriously overweight, but typically seek contouring for unsightly folds of fat that resist dieting. Unusual complications of liposuction do occur, of course, even in the best of hands, but frankly, many, if not most, liposuction mishaps are malpractice-related. The case of Amy Fledderman is arguably the worst case of medical malpractice in a plastic surgery procedure I’ve ever heard of.

Amy died in 2001, but her story began in 1999 when she was sixteen. At 5’5” and 128 pounds, Amy could hardly be described as obese. On the contrary, she was athletic and had unusually large breasts, which caused her neck and back pain whenever she engaged in sports. Richard P. Glunk, M.D. did a breast-reduction, with a good result, and the next year Amy enrolled as a freshman at Penn State. Although an avid runner, Amy couldn’t get all the fat off she wanted, and in light of the good experience she had with Dr. Glunk with the breast reduction, decided to have some liposuction of her abdomen and under her chin. She made a fatal decision.

During the liposuction, Dr. Glunk somehow managed to cut an artery in Amy’s neck. She quickly became unstable. Dr. Glunk’s anesthetist turned off Amy’s monitor after the surgery and hours of recordings were not saved. Although Amy’s mother begged the doctor to call an ambulance, he kept reassuring her for more than two and a half hours that everything was under control. When he finally did call an ambulance, Dr. Glunk told the ambulance driver that he should arrive with the sirens and lights turned off.

It turned out that Dr. Glunk’s operating privileges at the local hospital were restricted. At various times during the litigation, Dr. Glunk blamed Amy’s death on the ambulance crew or on fat embolism.

It took seven years to get this case to trial. The jury hit Dr. Glunk for $15 million in punitive damages, $3.5 for Amy’s lifetime earnings, $2 million to Amy’s mother for emotional distress and an additional $5,000 for the surgical fee the family had paid Dr. Glunk, but he never refunded.

This past week, the Superior Court of Pennsylvania, which is Pennsylvania’s court of appeals, upheld the verdict, including the punitive damage award. The Superior Court also instructed the trial court to assess additional damages on Dr. Glunk for what it saw as his contribution to the excessive delay in bringing the case to trial.

A punitive damage award requires conduct that is intentional or so reckless that the defendant showed disregard for the consequences of his actions. Because doctors rarely act so recklessly, it is quite uncommon for a jury to award punitive damages in a medical malpractice case. Here, it seemed like the jury became angry at Dr. Gluck because of the lost medical recordings and his failure to get Amy to the hospital as soon it was evident that the case had gone sour.

Article first published as Death by Liposuction on Technorati.

Glenn L. Goodhart, M.D., J.D.