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Real-World Success Lends Credibility To Medical Experts

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When you need a medical expert for a medical malpractice case or other legal matter, you want to be sure you have someone who is highly qualified. Only an expert who is knowledgeable, thorough, articulate, and experienced can be a convincing witness and help you build a powerful case.

The story of a unique procedure that saved a woman’s life

This is especially true in complex sub-specialties such as cardiac surgery. A board-certified surgeon has years of education and training, and ongoing continuing education is required to stay up-to-date with advancements in the field. More importantly, these surgeons make real-life decisions that have serious consequences for the lives of their patients.

Here is a story involving one of our experts, Dr. Michael Koumjian – and how he helped save the life of a woman through a complicated surgical procedure many thought couldn’t be done.

A grim diagnosis that led to pain and worry

One day in 2015, Melissa Peffer was at her customer service job in Las Vegas when she suddenly felt a pain in her chest that radiated down her left arm. Her doctor referred her to a cardiologist, who found that her left descending (LAD) artery was 100% blocked with plaque buildup.

A wholly blocked LAD artery is very dangerous, as it can deprive the heart of blood supply and cause a “widowmaker heart attack,” said Dr. Niraj V. Parekh, interventional cardiologist and medical director of LLUMC-Murrieta’s Heart & Vascular Center.

But the blockage was inoperable, Peffer was told. She would have to take heart medications instead.

She continued to experience chest pains and shortness of breath. She consulted multiple cardiologists over the years to try to find one willing to try removing the blockage through surgery, but she could not find a surgeon willing to try.

Parekh said Peffer’s unique anatomy and small vessels, the precarious placement of the blockage, and risks of the procedure were all factors in the refusal of specialists to attempt surgery.

A creative strategy to approach a complicated problem

After 8 years, Peffer had quit her job, limited her physical activity, and feared what would happen next.

"I was facing a complete death sentence and a silent killer heart attack, like a ticking time bomb waiting to take my life," she said.

After moving to southern California, Peffer decided to try again. Dr. Parekh ran meticulous imaging tests and created a “clear roadmap” of blockages and vasculature near her heart. Cardiothoracic surgeon Michael Koumjian, MD analyzed the roadmap – and found a way forward.

The surgical team explains their approach was creative. First, Dr. Koumjian cleaned out plaque in Peffer’s arteries through an endarterectomy, including the blockage in the LAD. This procedure is unusual in coronary arteries because of their smaller size. But Koumjian needed to clear the plaque in order to create room for a double bypass.

Dr. Koumjian then created alternate routes to bypass the blockage sites by suturing arteries from other parts of the body to the coronary arteries and aorta, allowing blood and oxygen to reach her heart.

The procedure was successful. Peffer has resumed an active life and has dedicated herself to spreading the word about this unique procedure to physicians and patients. "I see everything brand new," she said of her life after Dr. Koumjian's successful surgery.

Real-world experience and success strengthens expert credibility

It is this type of successful approach that helps make experts credible in the eyes of judges and juries. And it’s one of the things we look for in all of our experts.

Rieback Medical-Legal Consultants provides the legal community with highly qualified medical experts across all medical specialties who have substantial experience improving the lives of patients - the same doctors and nurses we would see for medical treatment ourselves. If you need an expert for a case you are handling, we can help. Contact us today to learn more.

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