Death Follows Breast Implant : Medicine: A Laguna Beach mother just wanted to improve her bust line. She sank into a coma and died four days later.

The day of her breast enlargement surgery, Martha McClellan was in an upbeat mood.

On the way to the operation, she joked about it, teasing about the figure she was going to have when it was done, said her sister Erin Magner, who drove McClellan to the doctor’s office in Newport Beach.

McClellan had been planning the surgery for six months, family members said; after bearing two children, the 35-year-old Laguna Beach homemaker was looking forward to regaining a more youthful-looking bust line.

Besides, they added, the breast surgery performed March 8 in the office of plastic surgeon Edward J. Domanskis, was not supposed to be risky.

Magner dropped her sister off at Domanskis’ office near Fashion Island and went to the movies with her boyfriend.

But three hours later, when Magner entered a small recovery suite to pick up McClellan, she found her sister fully dressed, slouched on a bed, an intravenous tube in her left arm and a nurse beside her trying desperately to rouse her.

McClellan’s face was “gray-white,” Magner said. “The nurse was shouting her name and kind of shaking her, going ‘Martha! Martha!’ She heard me and she turned around and she said, ‘Why don’t you come out here.’ And she walked me out to the waiting room door.”

Taken by ambulance to nearby Hoag Hospital, McClellan never regained consciousness.

Four days later, her children, Matthew, 4 1/2, and Megan, 7, and two stepchildren, Page, 13, and Katy, 19, went to the hospital to “say goodby” to their comatose mother, said McClellan’s husband of eight years, Orange home builder Michael McClellan.

And on March 12, after hearing from two neurologists that her brain activity had ceased, Michael McClellan asked that his wife be taken off life-support systems. He said he held her hand as, 18 minutes later, she died.

Domanskis has declined to comment on what happened at his office. Del Ball, his office manager, said Wednesday that the incident was “a family matter” and therefore confidential.

But Michael McClellan and his attorney, Jay Horton, said they intend to file suit charging medical negligence and “wrongful death” as well as lodge a formal complaint with the Medical Board of California, the agency that oversees medical licenses.

They said tests at Hoag indicate that McClellan’s wife may have been deprived of oxygen for seven to 10 minutes at Domanskis’ office. Because of those tests, they question that she was properly monitored in the recovery room.

McClellan said the doctor who assisted Domanskis by anesthetizing his wife has assured him that she was checked “every couple of minutes” in the recovery room, but because of the brain damage she sustained he now doubts that. The anesthesiologist could not be reached for comment.

Meanwhile, the Orange County coroner’s office has the case “under investigation” but results from toxicological and other tests could take up to 16 weeks, an official there said.

Experts in plastic surgery said that deaths during a breast-augmentation procedure are extremely rare. The only Orange County case they could remember occurred a decade ago in a Santa Ana walk-in clinic when a 33-year-old mother of three went into a coma after breast-implant surgery and died five days later. Her physician, Ralph J.W. Small, pleaded no contest to involuntary manslaughter and was ordered to prison for two years. His patient allegedly suffered a heart attack during surgery, but Small allegedly kept her in his clinic for nine hours before getting her to a hospital.

Breast augmentation--the surgical implantation of sacs of silicon gel in the breasts--has been perfected over the last 20 years, said Newport Beach cosmetic surgeon Louis G. Brennan. The procedure typically takes from 45 to 90 minutes.

“Complications are rare. . . . It’s a freakish thing to have somebody die,” he said.

Brennan said he had heard about the death last week and believed that it may have been a reaction to anesthesia that occurred during the recovery period after surgery.

Dr. Bruce Achauer, president of the Orange County Society of Plastic Surgeons, also called McClellan’s death “quite unusual.” He also suggested that a patient could react to either general anesthesia or intravenous sedation. Always, “vital signs have to be monitored,” he stressed.

Still, “it is much more likely that you would get struck by lightning” than suffer complications from breast-implant surgery, he said.

According to Achauer, Domanskis is “an extremely well-qualified” member of the local plastic surgery society who has also passed exams in his specialty by the American Board of Plastic Surgery. Public files from the state medical board show Domanskis as a physician “in good standing” with no disciplinary actions against him.

Domanskis, 45, is a 1971 graduate of the University of Illinois College of Medicine.

On the day of the surgery, Michael McClellan said, he called the doctor’s office between 3:30 and 4 p.m.--about the time his wife was supposed to be going home but apparently was unconscious.

“I asked if Martha had gone home, and she (a woman who answered the phone) said, ‘I can’t talk to you right now,’ ” McClellan recounted. He asked if his wife had awakened from the anesthesia, and he said the woman replied: “The doctor is going to have to talk to you. . . . He’ll call you back as soon as he can.” But McClellan said the next call he got was from Magner’s boyfriend telling him his wife was in a coma.

Afterward at Hoag Hospital’s emergency room, Magner said, Domanskis came up to her at one point and told her what he thought had happened: that McClellan “was so relaxed” under the anesthesia “that her breathing became less and less until she didn’t take a breath.”

About 500 friends and relatives came to Christ Church by the Sea in Newport Beach last Friday for McClellan’s funeral. She was described as a vibrant person--a good mother and community volunteer.