Ashish Toews, 33, died less than two weeks after undergoing cosmetic surgery at a private clinic in Calgary. ((Courtesy Facebook))

One of the plastic surgeons who performed surgery on a Calgary woman who later died told a provincial fatality inquiry on Tuesday that her death was an extremely rare event.

Ashish Toews, 33, died 13 days after she underwent an abdominoplasty — also known as a tummy tuck — and liposuction at a clinic in Calgary in July 2008.

Dr Mark Haugrud, one of two cosmetic surgeons who treated Toews, told the inquiry that to the best of his knowledge there is nothing that he or anyone could have done at the clinic operated by Surgical Centres Inc. to prevent the tragedy.

Toews was taken to hospital the day after undergoing surgery, when a post-operative headache became debilitating, the inquiry heard last month.

Haugrud told the inquiry that Toews couldn't stay at the private clinic — even if she was experiencing post-operative pain — because the clinic is not an accredited overnight medical facility.

Toews had breathing difficulty after surgery

Toews was perfectly healthy on the day of her surgery, he said.

Haugrud said he didn't suspect anything was wrong until shortly after the procedure, when the anesthesiologist told him Toews was having trouble breathing.

They used oxygen to try to stabilize her.

They discussed sending her to hospital, but since she was improving the anesthesiologist and recovery staff decided to discharge her, Haugrud testified.

She was breathing normally when she was discharged, the doctor added.

Last month two Foothills Hospital doctors told the inquiry there was nothing they could have done to prevent the young woman's death.

Dr. Michael Dunham told the inquiry that Toews was in a coma by the time he saw her at the emergency department of the Foothills hospital.

Doctor recalls Toews unsure about liposuction

According to a report from medical examiner Dr. Sam Andrews, the mother of two young children died from fat embolism syndrome, a rare complication associated with liposuction.

Haugrud testified he told Toews of the risks of a tummy tuck and liposuction.

Earlier, Toews's husband testified his wife was adamant that she didn't want the liposuction.

Haugrud said he remembers Toews was unsure about that. He said he couldn't recall the details of their conversation, but testified he would have had to tell nurses in advance to prepare for that procedure because it requires additional equipment.

The Alberta's Fatality Inquiries Act doesn't assign blame in cases. The goal is to identify what went wrong and make recommendations to prevent similar deaths.

The inquiry will resume on May 16, at which time the anesthesiologist is expected to take the stand.