Orthopedic surgeon fails to rule out serious infection in his knee-replacement patient.
Walkon Law Firm by Bradley J. Walkon, San Juan Capistrano.
LaFollette, Johnson, DeHaas, Fesler & Ames by Brian M. Meadows, Santa Ana
Stuart M. Gold, M.D., orthopedic surgery, Torrance.
Patrick Joseph, M.D., infectious diseases, San Ramon.
Frederic G. Nicola, M.D., orthopedic surgery, Marina del Rey.
Howard Pitchon, M.D., infectious diseases, Beverly Hills.
Claimant underwent a left total knee replacement at Kaiser on April 1, 2019. On April 8, 2019, he presented to Kaiser with symptoms of infection at the left knee. It was diagnosed as cellulitis and he was sent home.
On April 9, 2019, claimant presented to Kaiser's Emergency Department and was admitted. On April 10, 2019, he was evaluated by his orthopedic surgeon, who continued to feel his patient merely had cellulitis. On April 12, 2019, claimant underwent an Irrigation and Debridement surgery and was diagnosed with necrotizing fasciitis. On April 20, 2019, claimant underwent a left above-the-knee amputation.
As to standard of care: That when plaintiff presented to Kaiser on April 8 his symptoms were consistent with a left knee infection.
Necrotizing infections are life and/or limb-threatening. Accordingly, if a patient has signs and symptoms consistent with a potentially necrotizing infection, the standard of care requires that a reasonable orthopedic surgeon take action to rule out that disease. Here, the standard of care required that Kaiser's orthopedic surgeon rule out a potentially necrotizing infection on April 10, 2019. Had this been done, claimant's necrotizing infection would have been diagnosed and controlled such that he not require an amputation.
As to causation: As claimant's infection was not adequately controlled before April 12, 2019, it gained momentum and became extremely difficult to control, necessitated numerous surgeries, and culminated in the need for above-the-knee amputation. Timely control over this infection, if obtained on or before April 10, 2019, would have halted the momentum of the infection and prevented amputation.
As to standard of care: It was reasonable to conclude that claimant merely had a left knee cellulitis and the standard of care did not require action to rule out a potentially necrotizing infection until April 12, 2019.
Causation: Given the type of necrotizing infection that afflicted claimant, nothing could have been done at any point to prevent him from requiring an amputation.
Claimant suffered the amputation of his left leg, above the knee.
Claimant's spouse maintained a loss of consortium claim.