Patient Develops Fatal Blood Clots Following Cardiac Ablation Procedure

Case Overview

This case involves a 52-year-old male patient in the recovery unit following an ablation procedure for atrial fibrillation. When the patient met the appropriate recovery criteria, his sheath was removed. Upon removal, the patient’s blood pressure began to drop drastically. The decision was made to administer bolus saline. Shortly thereafter, the patient developed a hematoma in the right leg. He coded and passed away within a few days of the ablation procedure. An expert nurse with experience caring for post-cardiac ablation patients in a hospital setting was sought to determine whether the standard of care was followed.

Questions to the Cardiology expert and their responses

Please briefly describe your experience serving as a nurse to post-cardiac ablation patients in a hospital setting.

I worked as an electrophysiology nurse for 7 years at a renowned referral center for electrophysiology procedures. Our center was among the first to do catheter ablations for atrial fibrillation. For 5 of those years, I managed two electrophysiology labs and an outpatient pacemaker/ICD clinic. We were one of the first electrophysiology labs to do procedures of pulmonary vein isolation for patients with A-fib. I have lectured on this topic at electrophysiology heart rhythm society conferences and collected data for the physicians I worked with related to the success of these ablations. I am currently pursuing a doctorate degree in nursing and my research is in this procedure to alleviate atrial fibrillation.

What percentage of your practice is dedicated specifically to post-cardiac ablation nursing?

75% of my time is spent directly caring for cardiac ablation patients both pre-op and post-op.

About the expert

This highly qualified expert has 30 years of experience in nursing, and she specializes in medical-surgical and critical care nursing. She obtained her BSN from Northern Illinois University and her MSN from the Rush University Medical Center, before receiving her DNP from the University of Illinois at Chicago. Today, she is a licensed registered nurse. This expert is also a certified adult care nurse practitioner, and she is certified in advanced cardiac life support. Moreover, she is an active member of several professional organizations, including the Advanced Practice Nurses Association, the American Academy of Nurse Educators, and the American Association of Critical Care Nurses. She is also active in academia, having researched and published on topics related to medical-surgical and critical care nursing. This expert previously served as a staff nurse in the cardiac telemetry step down unit, as an assistant manager, and as the nurse education manager at the Lutheran General Hospital, as well as the electrophysiology nurse supervisor and program coordinator at the Advocate Illinois Medical Center. She is currently a clinical assistant professor of adult medical-surgical nursing, the associate department head of adult medical-surgical nursing, and the director of undergraduate studies in the department of adult medical-surgical nursing at a major university in Illinois.

E-056108

Specialties:

Cardiology

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.