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Perspectives in Vascular Surgery and Endovascular Therapy
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Mock Trial: Who Is Responsible for Access to Emerging Technology, Specifically Endoluminal AAA Surgery?

Hugh E. Scully, M.D.

Division of Cardiovascular Surgery, Toronto General Hospital, Toronto, Ontario

Wayne R. Tanner, M.D.

Don Valley Medical Center, Toronto East General Hospital, Toronto, Ontario

Frank J. Veith, M.D.

Department of Surgery, Division of Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, XY

Scott Rowand

Hamilton Health Sciences Corporation, McMaster University Health Center, Hamilton, Ontario

Philip C. Hébert, M.D.

Sunnybrook Health Sciences Center, Toronto, Ontario, Canada

Madame Justice M. MacDonald

Superior Court of Justice, Toronto, Ontario

The case is a 75-year-old male patient with a large abdominal aortic aneurysm (AAA). He has a very high operative risk because of associated cardiac disease, and is turned down for elective repair. One month later, the aneurysm ruptures and the patient dies. The family reads in the newspaper that similar AAAs can be repaired using minimally invasive techniques, that are only available in Canada on a compassionate basis because of the high cost. The family decides to initiate a civil suit. Presentations are heard from the defense (vascular surgeon), prosecution expert witness, hospital administration, and an ethicist. At the conclusion, a legal judgment will be provided by a justice of the Supreme Court of Ontario. Who is responsible?

Key Words: Endovascular • aneurysm • stent

Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 14, No. 1, 129-162 (2001)
DOI: 10.1177/153100350101400116
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