This document appears to be from a presentation on medical legal issues related to radial access. It discusses a case where a 34-year-old woman died from a coronary artery dissection during a routine cardiac catheterization performed through femoral access. It also mentions common features of medical malpractice suits, such as when an unexpected event occurs, and issues that can arise when risk, benefits and skill sets are unclear, such as for radial learners and legacy femoral operators.

1. Medical Legal Radial
Ian C Gilchrist, MD, FACC, FSCAI
Professor of Medicine
Pennsylvania State University
Heart & Vascular Institute
Hershey, PA
2nd Advanced International Masterclass
AIM-RADIAL 2013

2. CME Disclosure Statement
AIM-RADIAL 2013
Nothing

3. Left Main Coronary Dissection
AIM-RADIAL 2013
August 30, 2013
34 yo woman died of coronary artery dissection due to “routine” cardiac catheterization.
It was a femoral case

4. Common Features of Suits
AIM-RADIAL 2013
Something bad happened
Communications
Event was not expected

5. AIM-RADIAL 2013
In the Beginning
When Risk, Benefits, and Skill sets unclear

6. AIM-RADIAL 2013
Example 1

7. AIM-RADIAL 2013
Example 2

8. Example 3
AIM-RADIAL 2013

9. Improper Management of RAO
AIM-RADIAL 2013
Radial occlusion surgical consultationinappropriate actions
Resulting in iatrogenic, collateral neurologic injury

10. Radial Matures
AIM-RADIAL 2013
What is going to happen to the femoral operator?

11. What about the Legacy Operators?
AIM-RADIAL 2013

12. Risk, Benefits & Alternatives
AIM-RADIAL 2013
Femoral Only Operator

13. AIM-RADIAL 2013
Food for Thought
How best to legally manage:
The Radial Learner
Legacy Femoralist