| Complaint: | Complaint 21-26 |
|---|---|
| Respondent: | Bruno Boutet |
| Premises: | VetMed |
| Related: | 21-27, 21-28, 21-29 |
The complainants tell us that their dog went to VetMed for a cardiopulmonary examination; a heart murmur had been identified at another clinic prior to spaying so a referral was recommended. Boutet diagnosed the dog with patent ductus arteriosus and recommended a catheter procedure to go in and fix the shunt. The complainants mentioned they were going to be leaving the state for the next month; Boutet allegedly told them it needed to be done as soon as possible and that once done the dog could go with them provided the dog was kept sedated for 30 days. Boutet also allegedly said that the dog's recovery period would be the most dangerous time; he also claimed the procedure had a 98% success rate and that he loved doing them. In fact, Boutet allegedly said he was going to be on vacation but would come in just to do this one.
The surgery went forward. A couple of hours into the procedure the complainants received a call from VetMed stating the device used in the surgery had not opened as usual but would be okay. A half hour later another call indicated that the dog appeared to have aspirated and fluid was coming out of her air tube; the dog also had a cardiac arrest. CPR was performed and Boutet was alleged to have said several times that "this never happens." The dog's heart was restarted but then stopped for a second time, at which point the complainants said to stop CPR; Boutet said the dog was not in pain so they asked Boutet to let the dog pass on her own. Boutet offered that VetMed would pay for a necropsy at Midwestern University. The necropsy was inconclusive and suggested either a reaction to contrast or a blood pressure spike caused the death; Boutet allegedly said he felt a contrast reaction was more likely as blood pressure was monitored during the procedure. The complainants point out that not one but two doses of contrast were given to the dog because the ACDO device involved in the procedure failed to deploy correctly; they question whether this could have caused an overdose. They also question why the device failed to deploy in the first place; they wonder if Boutet and his colleagues botched it.
The complainants were initially offered a $525.37 refund (10% of the total costs) and Boutet said that he could at most authorize a refund of soft costs totalling $1600. They were referred to Foote, the responsible veterinarian for VetMed, told the complainants that was all the money they would be getting; she says they knew the risks bringing the dog to VetMed and that this could happen for any procedure, even setting a broken bone. Foote claimed that there had been no other deaths at VetMed when performing the procedure (nobody mentions how many of these procedures VetMed had ever performed nor where that 98% figure came from). The complainants also note multiple record omissions in the records they finally received; these omissions included who performed the procedure, who was present other than the veterinarians, how anesthesia was handled, the amount of contrast injected, and even no note that the patient died. They believe Boutet, Miller, and Hubert (the veterinarians involved in the case) should be disciplined and prevented from performing the procedure; they also have concerns about VetMed.
Boutet's response is rather sparse. He indicates that the actual procedure was uneventful (contrary to the complainants' recollection that they were called during the procedure to say the ACDO device had failed to deploy properly, nor any mention of their note that contrast was apparently given twice). He says that while the dog was recovering the dog suddenly went into respiratory arrest with "serosanguineous foamy fluid within the endotracheal tube" followed by the dog also going into cardiac arrest. They alerted critical care and handed the dog off to Nash, the VetMed criticalist, who got the heart restarted only for it to fail again; at this point the complainants issues a do-not-resuscitate order and the dog died. He says that a board-certified pathologist at Midwestern (who?) performed a necropsy and said that the procedure went appropriately and the device deployed as expected; the death is a tragic mystery.
The Investigative Committee said that it was always sad to lose such a young pet, especially when experienced professionals like those at VetMed are involved. Unlike the complainant they say that the pathology report indicates the device deployed properly; one wonders why the complainants had been informed otherwise on the phone in the middle of the procedure? They say that the contrast likely caused the dog's death but there's no discussion about the alleged second dose of contrast; there's quite a fatalistic attitude about it all, really. They point out that if 98% of procedures succeed then 2% fail and that Boutet had never lost a patient before. (Again, is that 98% figure a VetMed statistic or an industry average? And how many of these had been done at VetMed? I once asked Radlinsky, a boarded surgeon at VetMed, how successful they were at adrenalectomies; she said she didn't know and they didn't keep those kinds of statistics.) The Committee voted to dismiss with Dow recused.
| Source: | March 3, 2021 PM Investigative Committee Meeting |
|---|---|
| People: | |
| Bruno Boutet | Respondent |
| David Stoll | Respondent Attorney |
| Roll Call: | |
| Adam Almaraz | Aye |
| Amrit Rai | Aye |
| Brian Sidaway | Aye |
| Cameron Dow | Recused |
| Result: | Passed |
| Source: | April 4, 2021 Board Meeting |
|---|---|
| People: | |
| David Stoll | Respondent Attorney |
| Proposed By: | Robyn Jaynes |
| Seconded By: | Jane Soloman |
| Roll Call: | |
| Darren Wright | Absent |
| J Greg Byrne | Aye |
| Jane Soloman | Aye |
| Jessica Creager | Aye |
| Jim Loughead | Aye |
| Nikki Frost | Aye |
| Robyn Jaynes | Aye |
| Sarah Heinrich | Aye |
| Result: | Passed |
The primary source for the above summary was obtained as a public record from the Arizona State Veterinary Medical Examining Board. You are welcome to review the original records and board meeting minutes by clicking the relevant links. While we endeavor to provide an accurate summary of the complaint, response, investigative reports and board actions, we encourage you to review the primary sources and come to your own conclusions. In some cases we have also been able to reach out to individuals with knowledge of specific complaints, and where possible that information will be included here.