Emirati woman dies after cosmetic surgery abroad
Clinic claims rare reaction to anaesthesia led to tragedy but family says antidote delayed
An Emirati woman engaged to be married in January died on the operating table while undergoing a cosmetic procedure in the Philippines on Tuesday.
Fatmah Abdullah Nahyoul Al Danhani, 25, went in as a healthy, jovial individual for a cosmetic procedure at McGill Cosmetic Surgery, a clinic in Taguig, 11km south-east of Manila, and hours later, she was rolled out lifeless.
Fatmah, who worked in the aviation industry, had travelled along with her sister, Khadijah, and the two were scheduled to undergo the same surgery a day apart. Khadijah went under the knife first on Monday. When she regained consciousness on Tuesday, she overheard a commotion concerning her youngest sister.
“Because I was under anaesthesia, they couldn’t tell me that Fatmah had passed away. I heard my mum crying in the other room and managed to walk over there with my tubes Malignant hyperthermia is a rare genetic condition that could be triggered under general anaesthesia, said Dr Ali Reza Eghtedari, Consultant General Surgeon, Medeor 24/7 Hospital Dubai.
Dr Eghtedari told Gulf News: “Malignant Hyperthermia is a condition triggered by an anaesthetic agent owing to a genetic precondition. This involves a sudden rise in body temperature beyond 42C, which results in muscle contractions and coagulation of body proteins that can be fatal.”
Because of its rare incidence, hospitals around the world seldom screen the patient. Dr Eghtedari pointed out: “The condition is so rare that doctors do not conduct a pre-surgery screening test to determine if a patient is likely to have this condition. Usually, having such a rare condition [would mean] a patient would know of it if there were any such fatal incidents amongst close family members. In that case, the patient must undergo a preventive screening.”
Standard screening for this procedure would be conducting a presurgery biopsy or injecting the anaesthetic agent in small amounts and recording the carbon dioxide levels in the body. “Every hospital usually stocks the antidote for this condition, which is Dantrolene.” still attached. When I saw [my sister], her nose was bleeding and there was blood on her back,” Khadijah, 29, told Gulf News via phone from Manila.
“The doctor said he tried his best to save her life.”
Death certificate
The death certificate mentioned the cause of Fatmah’s death as malignant hyperthermia, a life-threatening condition where the body temperature shoots up and the muscles severely contract when given general anaesthesia.
Initially, only Khadijah was supposed to undergo the surgery but, while discussing the procedure with the doctor in the Philippines, Fatmah too got excited and decided to undergo one herself.
“We came all the way from Dubai to the Philippines just for the surgery and, suddenly, my sister passed away,” Khadijah said. She added that the UAE Embassy in Manila has since been in touch with her family and assisted them in repatriating Fatmah’s body. The family refused to get an autopsy done in the Philippines for personal reasons. Fatmah’s body was brought to the UAE on Thursday morning and the last rites were performed immediately in Dibba, Fujairah, in keeping with local customs.
Embassy to family’s help
Khadijah said a UAE embassy official had offered to help the family if they wanted to file a case against the clinic on the day Fatmah died but the family was too overwhelmed by grief to consider such a step. The embassy has arranged for them to meet with a legal counsel next week.
When contacted, a spokesperson from the McGill Cosmetic Surgery said the clinic and staff concerned performed all the procedures by adhering to stipulated standards of care.
Fatmah, the spokesperson said, underwent the standard pre-screening laboratory tests, the results of which were all normal. “Her personal, family and medical histories were unremarkable as well. There was no contraindication to proceed with [the surgery]. After the surgical procedure had been completed, Fatmah suddenly developed Malignant Hyperthermia (MH). Because of its very low incidence rate [rarity], there is no standard pre-surgical screening test for MH being done in medical institutions worldwide, including in the Philippines,” the spokesperson told Gulf News in a statement.
“The course of Fatmah’s MH was so rapid that in about five minutes from the initial signs and symptoms of MH, Fatmah went into cardiac arrest. In rapidly progressive cases of MH like these, treatment is almost impossible. She expired despite extensive resuscitative measures.”
The spokesperson stressed that “there was no medical negligence or wrong committed at any point during the course of [treatment of] this patient.”
Without an autopsy, it would be impossible to determine the real cause of death and whether there is any legal culpability in Fatmah’s death.
The family alleged that the clinic didn’t administer the antidote that could have saved Fatmah’s life.
The clinic’s spokesperson contended: “There was coagulation [internal bleeding] five minutes after the MH started. There was no time to administer Dantrolene since the patient almost immediately went into cardiac arrest at the same time as MH started and we had to start resuscitative measures.”