ER Doctor’s Misdiagnosis Causes Man to Undergo Leg Amputation
An emergency medicine specialist’s failure to diagnose a 62-year-old man’s circulatory blockage caused a three-day delay in treatment that forced the man to undergo several unsuccessful surgeries to restore circulation and, ultimately, the amputation of his leg above the knee.
The man, who managed a used car dealership, was preparing for his morning walk when he experienced such severe pain in his right calf that he fell to the ground and was unable to get up for several minutes. He was taken to the hospital suffering from pain, numbness, and tingling in his right lower extremity. The emergency medicine specialist who saw him diagnosed a muscle spasm and discharged the man, with instructions to return if his condition worsened or if he had new symptoms.
Three days later, the man returned to the hospital and was seen by a different emergency medicine specialist. This doctor palpated the man’s peripheral pulses (took his pulse at various points near the outer boundaries of where the man was experiencing pain and numbness, in order to compare them to the pulse rates at the central points where pain and numbness was present); checked for capillary refill (determined how quickly blood returned to the capillaries after pressure was applied); compared the temperatures of the lower parts of both legs; and ordered diagnostic testing. As a result of these examinations and tests, the doctor diagnosed a thrombosed aneurysm of the common femoral artery. (The main artery of the thigh, the femoral artery supplies blood to the groin area and lower leg. In this case, a weakening of the vessel’s wall had caused it to expand and fill with clotted blood, virtually shutting off circulation.)
After consulting with a cardiovascular surgeon, the man was admitted to the hospital and underwent several surgical attempts to restore circulation in his lower right leg. The surgeries were unsuccessful, however, and he was forced to undergo amputation of his leg below the knee. Later, the amputation was extended above the knee.
The man filed suit against the hospital and the first emergency medicine specialist he saw, alleging medical malpractice and asking for just and reasonable compensatory damages, medical expenses, and future medical expenses.
Another emergency room specialist was prepared to offer expert testimony that the first doctor who saw the man had misdiagnosed his aneurysm as a muscle spasm and had failed to undertake the measures that the standard of care required, including taking an adequate medical history; palpating the man’s peripheral pulses; checking for capillary refill; comparing the temperatures and pulses in his legs; ordering diagnostic tests; and ordering a vascular consultation to rule out vascular deficits.
A vascular surgeon was prepared to offer expert testimony that the man had an acute arterial occlusion caused by a thrombosed femoral artery aneurysm when he saw the first emergency medicine specialist. It was this surgeon’s opinion that, had the first doctor ordered appropriate diagnostic tests and consulted with a vascular surgeon, the man would have been admitted immediately, would have undergone a surgical repair, and circulation would have been restored to his lower right leg, without the need for amputation. He also was prepared to testify that the three-day delay between the time the man saw the first emergency medicine specialist and the time he returned to the hospital was the cause of the amputations.
A registered nurse, who was a cost-of-care expert, estimated the present-day value of the man’s future medical and other expenses.
The matter was settled during mediation, with a covenant not to disclose the terms of the settlement.