911 call after liposuction not made for 2 1/2 hours
July 17, 2009
Robert Cribb
STAFF REPORTER
As liposuction patient Krista Stryland lay unconscious and struggling for breath, Dr. Behnaz Yazdanfar called 911 and quietly reported that her patient was "bleeding a bit more than usual."
The call to 911 was made more than 2 1/2 hours after a coroner has determined Stryland first became "unstable."
Stryland, 32, would never regain consciousness and would be declared dead in hospital hours later, following the operation in 2007.
A recording of the emergency call was played yesterday at Yazdanfar's disciplinary hearing before the College of Physicians and Surgeons, where she faces allegations of mistreatment involving 28 patients.
"She's crashing," Yazdanfar had said softly in reference to Stryland. "She's not responding." The call was made at 3:52 p.m. on Sept. 20, 2007.
Asked about her patient's state, Yazdanfar told the 911 operator she was breathing "with intubation."
When the operator asked if paramedics should enter through the front door, she paused and said: "No if you just – if someone can just come in and say you have arrived, we will take you to the back door ... Or we can wait outside."
When paramedics arrived five minutes later, they – along with firefighters – performed CPR on Stryland's unconscious body, paramedic Jeff Carter testified yesterday.
It did little good.
"At no time did anybody find a pulse on the patient," he said.
Carter asked a nurse from Yazdanfar's clinic named Mia Sircar to come in the ambulance to hospital.
"She seemed to me to be a little bit shocked," he said. "She said this was only her second day and it would be her last day at the clinic ... She said she was frustrated by the care (she saw at the clinic) and didn't want to come back to work."
The nurse expressed another concern, Carter said.
"An ambulance should have been called sooner, she felt."
Others agree.
An expert report done for the coroner concluded there was a "major delay in getting the patient to hospital. Her condition became unstable at (1:15 p.m.) and paramedics were called at (3:52 p.m.)." It also found Stryland suffered "massive blood loss."
Once in hospital, Stryland lay "in a bunch of bloody fluid" with "chalky white" skin colour, Carter said.
"My partner asked to have a smock to control the fluid from splashing over him. I was surprised to see it," the paramedic testified.
The anaesthetist caring for Stryland during the procedure testified yesterday he shared responsibility for monitoring her deteriorating condition in the recovery room.
"(Patient recovery after surgery) is a shared responsibility between the surgeon and the anaesthetist," Dr. Bruce Liberman said.
Liberman, who routinely worked at Yazdanfar's Toronto Cosmetic Clinic, has come under scrutiny for his handling of Stryland's failed recovery. His medical competence is under investigation by the college.
Another report, written for the college by Toronto plastic surgeon Dr. Stephen Mulholland, concludes Stryland's post-operative care "fell grossly below the standard of care for an anesthesiologist caring for liposuction patients."
Toronto Star
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