Pre-operative condition

Jessica was admitted to the HSC on Wednesday, March 23. The cardiology note written by Dr. Salvador described Jessica as being well hydrated with no congestive heart failure. However, she had lost 500 grams since her last examination at VCHC. He wrote, "She definitely looks wasted. Fit for the OR - need to observe for stools here." (Exhibit 13, page ULI 54)

The pre-operative physiotherapy assessment indicated that Jessica had good air entry, with a clear chest. No pre-operative concerns were identified. Reimer, the anaesthetist, reviewed the chart and examined Jessica. He wrote, "Increased risk due to age, weight, CHF. Proceed as planned." (Exhibit 13, page ULI 67)

A chest X-ray done that day showed an enlarged heart with a prominent increase in pulmonary blood flow (as compared with February 16). There were new added densities suggesting atelectasis and possibly some edema in the lung tissue. This was a sign of potential chest problems that could become more severe following surgery.