Allegation:
The defendant orthopaedic surgeon had abandoned the patient’s care.
The Case:
The patient, a 55 YOM (6’, 364 lbs.), was referred to the defendant orthopaedic surgeon by a neurologist due to right shoulder, arm, and hand pain/numbness. His history included a motorcycle accident, two right hip replacements, and a left knee replacement. He had also been treated for DVT in the right leg. The patient presented to the defendant orthopaedic surgeon with recurrent pain and crepitus in his right shoulder, and difficulty with use of the right arm including any attempts at rotation of the extremity.
The patient elected to proceed with the surgical option of hemiarthroplasty using a Tornier Aequalis® Resurfacing Humeral Head, 52 x 19 mm. He missed his next scheduled evaluation, and was seen immediately prior to his surgery. The defendant orthopaedic surgeon reviewed the proposed procedure with him in detail at the hospital, and the patient signed a consent.
The defendant performed the procedure without incident. Post-operative x-rays showed the hardware intact and in good position. The patient appeared to be doing well at his two-week, post-operative visit, and continued physical therapy (PT). The patient canceled his eight-week, second post-operative exam; he stated he was doing well, and would call if he had any issues. He was not given a follow-up appointment after canceling the second post-operative visit.
Approximately two weeks following the patient’s canceled appointment, the defendant surgeon decided to move their practice. The defendant communicated intentions to patients by contracting with a company to send letters by mail and give patients who came to the office information in person. Communications also appeared in local newspapers.
At 15 weeks post-surgery, the patient was scheduled to follow-up with the defendant surgeon. The defendant surgeon had to cancel this appointment due to an emergency surgery. The following day, the patient’s fiancé called the defendant surgeon’s office stating the patient had not been seen for a while and was in a lot of pain. The office explained the emergency surgery, and offered to find a new appointment time. The fiancé demanded the patient’s records. A note in the defendant surgeon’s chart indicates the patient had asked for a referral to a different doctor.
The patient began treatment with another orthopaedic surgeon who performed remedial shoulder surgery due to complaints of pain and a presumed infection. The prosthesis was replaced with a smaller temporary prosthesis, along with an antibiotic spacer. Intraoperative cultures showed no growth. The patient never had the temporary prosthesis replaced. The patient refused the recommended PICC line. He was discharged with oral linezolid.
The patient saw an infectious disease specialist who recommended continued linezolid due to evidence of a propionibacterium infection. The infectious disease specialist noted the patient had a course of IV vancomycin, switched to linezolid, and then to moxifloxacin. He completed his course of antibiotics, and continued PT. The PT notes indicate the patient was not going to PT on a regular basis. The second orthopaedic surgeon’s notes indicate the patient was treated with six weeks of antibiotics, doing well, but still had some shoulder weakness.
The plaintiff filed suit alleging the defendant orthopaedic surgeon breached the standard of care in using the improper shoulder prosthesis resulting in an infection, and the need for additional surgery. Plaintiff's expert, an orthopaedic hand specialist, failed to testify that any of the alleged breaches proximately caused the injury. The expert, while also board-certified in orthopaedic surgery, testified he spent a majority of time in hand surgery. The plaintiff’s second orthopaedic surgeon was supportive of the care and treatment rendered by the defendant. He also stated this was an indolent infection, and he himself did not diagnose it immediately. The second surgeon did not believe the plaintiff suffered any complications from the defendant’s surgery.
The defense argued that the plaintiff’s expert witness was not qualified as the majority of his expertise pertained to hand surgery, and he failed to testify that any of the alleged breaches proximately caused an injury.
Verdict:
The trial court granted the defense motion for directed verdict and dismissed the case on the third day of trial.
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