This case takes place in Tennessee and involves a 71-year-old female patient who experienced complications following a TRAM flap procedure. The patient, who is obese and previously had a mastectomy, consulted with the defending doctor for new breast reconstruction. The surgeon immediately opted for the TRAM flap procedure. It was performed with complications; the patient lost use of her right arm, has issues breathing and suffered tremendous scarring. The plaintiff filed suit and hired a plastic surgery expert witness to review the records to determine if the surgery was contraindicated due to the fact that she was greater than 70 years old and she had artery disease.