Nilofer Nezami, a 38-year-old Victorian resident, died on 7 January 2019 following cosmetic surgery in Iran. She underwent multiple procedures including eye, breast, arm and abdominal surgery. Post-operatively, she developed symptoms including cold hands, pain and altered consciousness, progressing to cardiac arrest. A local hospital reported embolism as cause of death. Australian post-mortem examination could not establish definitive cause due to prior overseas autopsy, embalming, and incomplete medical records. Possible causes identified included cardiac arrhythmia, metabolic derangement, or pulmonary embolism following recent surgery. The case highlights risks of medical tourism including variable standards of care, limited follow-up, and difficulty investigating overseas deaths. Clinical lessons include the need for pre-operative screening, awareness of thromboembolism risk post-operatively, and consideration of performing multiple procedures on same day.
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Specialties
plastic and reconstructive surgeryanaesthesiaemergency medicine
Multiple surgical procedures performed in close proximity
Possible cardiac rhythm disturbance
Possible metabolic and biochemical derangements post-operatively
Possible pulmonary thromboembolism
Potential ischaemic hepatitis
Inadequate pre-operative screening
Limited post-operative monitoring
Incomplete medical documentation
Coroner's recommendations
The Victorian Chief Health Officer should publish an alert/advisory regarding the risks of medical tourism, including advice that the standard and quality of medical care provided in other countries may not be of the same standard as that provided in Australia.
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