Simonian

BACKGROUND

Razmi Simon, age 76, who suffered from chronic cardiovascular disease, hypertension and hyperlipidemia, was admitted to Glendale Adventist Medical Center requiring immediate surgery for a fractured hip. Dr. Vahe Badalian, Simon’s cardiologist and primary care provider, examined Simon at his bedside and contacted Michael Abdulian, a surgeon, who performed surgery on Simon’s hip on the morning of November 20, 2018. Simon, who took aspirin and prasugrel as antiplatelet therapy, had a preoperative hemoglobin level of 12.6 grams per deciliter, an amount raising no medical issues. He lost only 50 milliliters of blood during the surgery, not an amount to raise concern of excessive bleeding. In the evening of November 21, 2018, Simon developed tachycardia and complained about pain in his leg and chest. Dr.

2 Badalian ordered a complete blood count test, which revealed that Simon’s hemoglobin had dropped to 6.8 grams per deciliter, reflecting critical perioperative blood loss. An electrocardiogram was ordered, which showed Simon was suffering a heart attack. Simon was taken to the ICU, where he underwent a series of interventions before dying on the morning of November 23,…