Vascular Surgery
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CASE: Vascular Surgery / Occluded Popliteal Artery
FACTS: The sixty-one year old plaintiff with metastatic fallopian tube cancer fell and injured her leg. She was seen at an Urgent Care Center the following day with complaints of right calf pain. A physical exam revealed a cold, pale, and possibly ischemic foot.
She was transferred to the defendant hospital where she was examined in the emergency department. No Doppler pulses were detectable in her foot. She was assessed as suffering from arterial insufficiency and admitted for evaluation. The defendant physician who took over her care was unable to palpate pulses in her foot and ordered a venous ultrasound, which showed no DVTs. The defendant physician neither ordered an arteriogram, or consulted with a vascular surgeon. The plaintiff was mistakenly diagnosed as suffering from a muscle pull.
Despite continued signs and symptoms of ischemia, including pain, temperature change, discoloration, and weak pulses, she was discharged approximately 46 hours after admission. The following day the plaintiff was taken to a different hospital, where she was promptly diagnosed as suffering from a popliteal artery occlusion. Despite undergoing a thrombectomy, her leg was irreversibly ischemic and she underwent an above-the-knee amputation.
DEFENSE: The defendant denied negligence and causation.
INJURIES: Amputation of the right leg, reduced duration and quality of life.
SPECIAL DAMAGES: Medical bills: $75,222.52
SETTLEMENT: The parties agreed to settle for a confidential amount.
PLAINTIFF’S COUNSEL: Randolph J. Reis, Esquire (Reis Law, PLLC)
NAMES/COUNTY: Anonymous v. Anonymous
CASE: Vascular Surgery / Occluded Popliteal Artery
FACTS: A forty-one year old male suffered a tibial plateau fracture in a jet ski accident. He was transported to a local hospital where it was noted that the foot on his injured leg was pulseless, even with a Doppler. He was diagnosed with “probable vascular compromise” and emergently transferred to a tertiary hospital for treatment of his vascular and orthopedic injuries.
The defendant vascular surgeon never took a history, nor performed an examination of the plaintiff prior to surgery, instead he relied on other care providers to evaluate his patient. An angiogram was performed approximately 10 hours after the patient’s arrival at the tertiary hospital, which confirmed the presumptive diagnosis of an occluded popliteal artery. The plaintiff continued to exhibit signs of ischemic compromise, including absent and diminished pulses, a cool foot, and decreased capillary refill. Despite those indications for emergent revascularization, surgery did not occur until approximately 42 hours after injury and 24 hours after angiogram. Also, neither prophylactic fasciotomies, nor compartment pressure testing were performed to diagnose and treat the likely reperfusion syndrome and compartment syndrome that often follows revascularization surgery after prolonged ischemia.
DEFENSE: The defendant denied negligence and causation and alleged that the plaintiff’s occluded popliteal artery did not result in a “critically “ ischemic leg because of his collateral blood supply. Thus, the defense maintained that this was a non-emergent situation that could be monitored for progression of ischemic symptoms. Further, the defendant alleged that all harm to the plaintiff occurred as a result of an occluded by- pass graft, as opposed to the lengthy pre-operative period of ischemia, or compartment syndrome.
INJURIES: The plaintiff suffers from peroneal nerve palsy, foot drop, and osteomyelitis. He likely will require a below the knee amputation of his leg.
SPECIAL DAMAGES: Medical bills: $132,368.51; Costs of amputation: $94,683.00 to $122,087.00
SETTLEMENT: The parties agreed to settle for a confidential amount.
PLAINTIFF’S COUNSEL: Randolph J. Reis, Esquire (Reis Law, PLLC)
NAMES/COUNTY: Anonymous v. Anonymous