Allegation
The patient’s husband alleged inadequate pre and post operative care related to development of deep vein thrombosis (DVT) and pulmonary emboli which led to the patient’s death. The husband believed the podiatrist failed to disclose the high-risk nature of the surgery.
Case Details
A 58-YOF (5’6”, 238 lb.) was referred to the podiatrist by her primary care physician for a possible tendon rupture of the left ankle tibialis posterior. She was treated conservatively, and her symptoms resolved. Approximately a year later, she returned to the podiatrist with complaints of bilateral pain in her Achilles tendons that had been present for six weeks. Upon physical examination, the podiatrist noted that the patient’s left Achilles tendon insertion was swollen and exhibited tenderness on palpation at the Achilles tendon insertion. Radiological films revealed bony proliferation at the Achilles tendon insertion on the calcaneus. The podiatrist diagnosed a possible rupture of the left Achilles tendon, and tendonitis of the right and left Achilles tendons. An MRI of the left foot and ultrasound of the left Achilles tendon insertion were highly suggestive of a partial rupture of the Achilles tendon.
The podiatrist discussed treatment options and the risks and benefits with the patient and her husband who was present for all her appointments. The treatment options included conservative treatment with use of a removable walking cast and physical therapy or surgical repair of the Achilles tendon. The patient opted to have her left Achilles tendon surgically repaired. The patient returned for a pre-operative visit during which the podiatrist went over the informed consent and discussed possible complications to include infection, re-rupturing of the tendon, chronic swelling, pain, numbness, stiffness in the ankle, recurrence of the problem, blood clots, and the need for prolonged immobilization following surgery.
The patient agreed to proceed with the surgical option and signed the informed consent and was scheduled for a pre-operative screening appointment at the hospital and the exam was unremarkable. The podiatrist performed a surgical repair of the left Achilles tendon. The patient was transferred to the recovery room in stable condition. The patient was discharged home with instructions.
The patient returned for her one-week post-operative appointment. She was noted to be healing as expected and was instructed to begin partial weight bearing. A week later, the sutures were removed. The patient had no complaints of pain, and the incision was well-healed and was to return in two weeks.
The podiatrist’s assistant called the patient to confirm her next appointment. Her husband answered and stated his wife died the previous week from a blood clot. An autopsy was performed which revealed bilateral pulmonary thromboembolic and residual thrombi in the left popliteal and distal venous system.
Defense
The defense felt this case would be challenging as it involved the death of a patient, however, the podiatrist made the decision to take this case to trial. The podiatrist was experienced with an excellent reputation. In his deposition, he came across as a sincere and compassionate provider.
Resolution
The trial lasted two weeks and the jury reached a defense verdict.
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