Case #1099: Amputation

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In May, the Plaintiff began to feel aching and burning in her legs and feet and her right foot appeared to be paler and cooler than her left. Her primary care physician recommended an arterial Doppler study of the Plaintiff’s lower extremities with specific attention to the right foot, which revealed diffuse disease in the right lower leg primarily in the region of the superficial femoral and popliteal arteries. As a result of these abnormal findings, the Plaintiff was referred to the Defendant vascular specialist, who ordered an MRA (Magnetic Resonance Arteriogram), which is notorious for false findings. The magnetic form of an arteriogram is utilized to rule in vascular disease, but a negative finding does not rule occlusive disease. The classic arteriogram is the gold standard and was absolutely mandated in view of the Plaintiff’s condition and the results of the arterial Doppler.

Following the Defendant’s advice that she had no vascular disease, the Plaintiff returned to the primary care physician. When the primary care physician learned from the Defendant that the Plaintiff had no vascular source of her complaints, he sent the Plaintiff to an orthopedic surgeon and neurologist. Both physicians ruled out processes in their respective specialties as the cause of the Plaintiff’s ongoing signs and symptoms. Subsequently, the primary care physician told the Plaintiff to return to the Defendant and advise him of the negative findings of the other specialists. Accordingly, in December of that same year, the Plaintiff again telephoned the Defendant, indicated that her symptoms continued, that she saw other specialists, with negative results, and asked whether she could get an arteriogram. In response, the Defendant refused to schedule the arteriogram and advised the Plaintiff that she had no occlusive vascular disease which required his care or surgical intervention.

On January 20, the Plaintiff’s primary care physician referred her to another orthopedist due to pain in her right leg. He detected the absence and/or diminution of pulses, and telephoned the Defendant with his results and discussed arteriography. Amazingly, the Defendant said that the findings were not vascular in nature. The orthopedic surgeon ordered a second MRA on January 21, which noted an occlusion of the superficial femoral artery. Accordingly, the Defendant was advised of the findings and saw the Plaintiff that day but still failed to admit her to the hospital until the following day, where an interventional radiologist attempted thrombolytic therapy which predictably failed. On January 24, the Defendant finally took the Plaintiff to surgery which proved too little and too late. The day following surgery, the leg and foot was not viable due to gangrene. Accordingly, on January 26, the Plaintiff underwent below knee amputation on the right side.