1. CONFIDENTIAL ATTORNEYWORK PROJECT: This is a confidential work project
prepared in anticipation of or directly related to litigation. Prepared for Will Win, Attorney
at Law.
RE: Ms. Darlene Darling
DOB: 03/8/1941
Dear Attorney Win:
I have completed my review of Ms. Darling’s medical records and other pertinent
documents regarding her surgery at My Favorite Surgery Center on 09/29/2008. I have
included my comments and recommendations at this time for your consideration
regarding this case.
HISTORY: Ms. Darling had bilateral breast augmentation using silicone implants in
1991 in New York City. She presented to Dr. Dan Dolittle on 02/21/2008 with the chief
complaint of breast asymmetry and requested a “redo” of her augmentation. Dr. Dolittle
performed a History and Physical on Ms. Darling. Important to note is that he states that
she had well healed scars bilaterally with grade 2 ptosis (a “sinking down” or prolapse
of an organ) meaning her breast were beginning to “sag”. He notes that there is no
discharge from either breast. The plan of treatment was for her to have a mammogram
(which she did) and then remove the silicone implants and replace them with saline
implants. He discussed the risks involved with the surgery which included “decreases or
lost nipple sensation, loss of nipple or other tissue”.
This is included because the defense may use it.
Pat Peters’s Affidavit: In Ms. Peters’ Affidavit, page 2 , paragraph 2, starting with line
6, she states that at approximately 7:00 pm she delivered to Ms. Darling her physician’s
discharge instructions and post op medication prescriptions. This is what I was
referring to the other day on the phone. There should have been a sheet with
discharge instructions. We have only the copy of her prescriptions. Attorney
Pucket questioned Ms. Hanson about this in her deposition. He even shows her
an example (from what I infer). Ms. Peters goes on to say that as part of her
discharge instructions, Ms. Darling would have been directed to immediately phone her
physician if she developed any complications or concerns when she got home. We
have no documentation of such instructions. If these instructions were delivered
to Ms. Darling, a copy of them should have been a part of the chart. The affidavit

2. conveniently left out the fact that there was no copy of these implied instructions. It also
left out any information that was given during the follow up phone call. However, In Mrs.
Hanson’s deposition, she states that they (the nurse making the follow up call) asked if
she had contacted the doctor. The nurse should have explained to her that because Dr.
Dolittle was out of town, there would have been a doctor covering for him; that she
should have called anyway and spoken to this doctor. The defense will try to use this
fact also; that she should have spoken to the doctor on call. On the final page of
Ms. Peters’ deposition, she states that she gave Ms. Darling Phenergan IV. This is not
uncommon for this area. If she needed it IV, that is an indication that she could not take
it by mouth due to the nausea. As far as I recall, I never gave anyone IV nausea
medication in the Phase II area.
Donna Bentley’s Deposition: Ms. Bentley’s Deposition was fairly unremarkable.
Everything seemed satisfactory to me.
Please let me know if I can be of further assistance in this case.
Very Truly Yours,
Debbie Fernando, RN, BS, CLNC
Certified Legal Nurse Consutlant