Cardiothoracic surgery

Cardiac Surgery claims in clinical negligence.

Expert witness reports on alleged failings during or after coronary artery bypass grafting (CABG), valve replacement and other cardiothoracic procedures. Claims typically arise where post-operative complications, graft failure or delayed recognition of ischaemic events are in issue.

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  • CABG complications
  • Valve surgery negligence
  • Post-operative ischaemia
  • Bolam · Bolitho · Montgomery
what we cover

The surgical questions and the legal questions they raise.

Cardiac surgery negligence claims typically arise from alleged failings during coronary artery bypass grafting (CABG), valve replacement or other cardiothoracic procedures, with post-operative complications such as graft failure, tamponade or delayed recognition of ischaemic events frequently in issue.

Our experts assess whether the surgical decisions, intra-operative technique and post-operative management adhered to current NICE and ESC guidance, with reference to the Bolam and Bolitho standards. The reports address whether the alleged breach caused or materially contributed to the adverse outcome.

  • Breach questions typically address whether the surgical technique, graft selection or valve choice fell below the accepted standard, and whether post-operative monitoring and intervention were timely and appropriate.
  • Causation questions turn on whether the alleged breach directly caused or materially contributed to the outcome — graft failure, stroke, perioperative myocardial infarction or death — on the balance of probabilities, with material contribution analysis where pre-existing pathology is in issue.
  • Post-operative complications such as tamponade, low cardiac output syndrome or sepsis are frequently in scope, with the report addressing whether timely recognition and intervention would have altered the outcome.
  • Informed consent under the Montgomery standard is often in issue, particularly where the risks of alternative procedures (such as TAVI versus surgical aortic valve replacement) or conservative management were not adequately discussed.
Clinical scope

The clinical questions our experts answer.

Reports address the surgical and post-operative decisions in issue against current guidance and the Bolam and Bolitho standard.

Included in scope

Questions addressed

  • Whether the surgical technique, graft selection or valve choice adhered to current cardiothoracic standards.
  • Whether post-operative monitoring, including echocardiography and haemodynamic assessment, was timely and appropriate.
  • Whether the threshold for re-exploration or intervention — in the event of post-operative complications such as tamponade or graft failure — was met and acted on within a reasonable timeframe.
  • Whether the risks and benefits of the procedure were adequately discussed with the patient under the Montgomery standard, including reasonable alternatives such as TAVI or conservative management.
  • Whether, on the balance of probabilities, earlier recognition or intervention would have altered the outcome.
Out of scope

Not covered without separate instruction

  • Interventional cardiology decisions during angiography or PCI, which sit with interventional cardiology instruction on procedural complications.
  • Non-cardiac surgical complications, such as those arising from anaesthesia or general surgery, which require separate instruction from the relevant specialty.
  • Examination of the claimant or prognosis evaluation, which requires a separate condition and prognosis report.
  • Quantum, life expectancy and care needs, addressed through dedicated reports where the case progresses to that stage.
Common cases

Common scenarios we report on.

These patterns recur in cardiac surgery negligence claims, most turning on intra-operative decisions or post-operative management.

  • CABG · Graft failure

    Early graft occlusion post-CABG

    Patient underwent elective CABG with venous grafts. Post-operative echocardiography demonstrated graft failure within 48 hours, leading to myocardial infarction. The report addresses whether the graft selection, intra-operative technique or post-operative antiplatelet management fell below the accepted standard.

    Often paired with: Breach of Duty Causation

  • Valve surgery · Consent

    Inadequate consent for valve replacement

    Patient underwent aortic valve replacement without documented discussion of the risks of stroke, heart block, or the alternative of transcatheter aortic valve implantation (TAVI). Post-operative stroke occurred. The report examines whether the consent process met the Montgomery standard.

    Often paired with: Breach of Duty Causation

  • Post-operative · Tamponade

    Delayed recognition of cardiac tamponade

    Patient developed hypotension and oliguria post-CABG. Echocardiography was delayed, and tamponade was only recognised after cardiac arrest. The report addresses whether the post-operative monitoring and the threshold for echocardiography fell below the accepted standard.

    Often paired with: Screening & Merits Breach of Duty

  • Post-operative · Ischaemia

    Missed post-operative ischaemia

    Patient showed signs of low cardiac output post-valve surgery. Serial ECGs and troponin measurements were not performed and the diagnosis of ischaemia was delayed. The report tests whether the post-operative monitoring and threshold for investigation were appropriate.

    Often paired with: Causation Condition & Prognosis

Reports

Report types commissioned for this condition.

These cases typically progress from screening into full liability work, with causation often the central battleground. Reports are prepared by consultants with subspecialty expertise in adult cardiac surgery.

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Send a short note on the alleged failings with the records bundle. Quotation returned the same working day; fast-track available where the trial window or limitation deadline requires it.

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