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Court upholds claim in breast reconstruction case

A plastic surgeon was negligent in a breast reconstruction procedure, Ontario's top court ruled Friday in case involving another doctor who has come under fire for performing mistaken mastectomies.

Wendy Revell had a double mastectomy in 2000 after a breast cancer diagnosis by Dr. Barbara Heartwell, who then referred her to friend and plastic surgeon Dr. Isabel Chow.

Chow performed reconstructive surgery on her breasts using tissue from the abdomen and Revell developed a large, open wound in her abdomen that stayed that way for two years.

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"It was incumbent upon Dr. Chow to explain to Ms. Revell that because she was a smoker, obese and had an abdominal scar, it was more likely that she would suffer from the risk of delayed wound healing," the court wrote in its decision.

"Further, Dr. Chow had to explain to Ms. Revell the consequences of delayed wound healing, one of which was a possible delay in receiving the chemotherapy she needed because of the cancer."

Heartwell, a Windsor, Ont., surgeon, is the subject of a number of investigations that were started after reports surfaced that two women who had mastectomies at the hospital did not have cancer.

Heartwell and Chow are friends who make and sell jewelry together in their spare time under the name Designer Docs.

Revell initially sued both Chow and Heartwell, but the claim against Heartwell was dismissed before the trial.

The trial judge found that Chow failed to adequately explain to Revell the material risks of the reconstructive surgery and that a reasonable person in Revell's circumstances wouldn't have had the procedure if the risks were adequately disclosed.

Revell was awarded $154,000 in damages plus legal costs.

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Chow appealed, but in a decision released Friday the Court of Appeal for Ontario dismissed the appeal and awarded Revell a further $25,000 for legal costs.

One year after the surgery Revell still had an open eight-centimetre-by-eight-centimetre abdominal wound and the mesh that had been used to close the incision was still exposed.

She was referred to a surgeon in London, Ont., and a full year later - two years after her breast reconstruction surgery - the wound was closed in surgery.

Heartwell is facing an unrelated lawsuit in one of the mistaken mastectomy cases. Laurie Johnston of Leamington, Ont., has filed a suit after having a mastectomy at Hotel-Dieu Grace Hospital last November and then learning she did not have cancer.

The other woman who came forward, Janice Laporte, sued Heartwell under similar circumstances in 2001. The case has ended, but Laporte cannot discuss the outcome because of a confidentiality clause.

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