Failure to Obtain Necessary Follow-Up Lab Work For Woman With Foot Problems
Peripheral Vascular Occlusive Disease Necessitates Amputation of Toes and Results in Neuropathy - $900,000 Minnesota Settlement.
The plaintiff, age forty-four at the time, went to her primary health care provider with complaints of bilateral foot pain for one year with symptoms worsening over the last three months. She reported that the toes on both feet ached constantly, that they always itched, and they appeared discolored and purplish. On occasion they would get red, hot and swollen. Soaking of the feet in hot water made the symptoms worse. The plaintiff was seen by a nurse practitioner who observed biphasic color changes in the toes and noted tenderness and palpation at various locations on the feet and in the right popliteal area. The assessment was bilateral foot pain of unknown etiology with metatarsalgia and biphasic color changes of the toes. The nurse practitioner ordered blood work and told the plaintiff she would be in touch if there were problems.
The woman returned to the clinic ten days later with complaints of a sore throat. The chart indicated that the lab work had returned with high white blood cells, high sedimentation rate, positive anti-nuclear antibodies and positive ANA screen. The plaintiff claimed she was never told of these results. The nurse practitioner, however, wrote in the chart that the plaintiff was told at the time of the second clinic visit. The nurse practitioner at deposition had no recollection of the visit and testified that the chart note suggested that she would have called the patient. The chart note also indicated that the lab abnormalities required that additional lab work be obtained. The additional lab work was not obtained.
The plaintiffs foot discomfort waned over time, but returned about eight months later and she went back to the clinic and was then seen by a family practice physician. That physician noted that the additional lab work had not been done and made arrangements to obtain it. This lab work was positive and suggestive of lupus inhibitor or antiphospholipid antibody syndrome. A referral was made to a vascular surgeon and the plaintiff underwent aortal-bi-iliac bypass with reimplantation of inferior mesentery artery, left superficial femoral artery embolectomy, left superficial femoral artery embolectomy, left femoral to above knee popliteal in situ greater saphenous vein bypass, and distal left anterior tibial and posterior tibial embolectomy surgeries. The plaintiff later required amputation or partial amputation of all of the toes on the left foot. The plaintiff has also been left with left foot drop and left lower leg neuropathy.
The plaintiff alleged negligence in the failure to obtain the additional lab work and to properly follow-up. The plaintiff
claimed that timely follow-up would have resulted in her being placed on anticoagulant and anti-inflammatory medication, which would have been successful in preventing progression of her peripheral vascular occlusive disease and the need for surgery or the development of neuropathy. The defendant claimed that the lack of the blood work did not cause the need for surgery or the plaintiffs disability. A $900,000 mediation result was obtained for the plaintiff. Mary Doe v. Central Minnesota Healthcare Provider, unknown Minnesota venue. Robert J. King, Minneapolis, MN for the plaintiff.
[http://www.nso.com/case/cases_area_index.php?id=115&area=Outpatient]
With permission from Medical Malpractice Verdicts, Settlements & Experts; Lewis Laska, Editor, 901 Church St., Nashville, TN 37203-3411, 1-800-298-6288.
The plaintiff, age forty-four at the time, went to her primary health care provider with complaints of bilateral foot pain for one year with symptoms worsening over the last three months. She reported that the toes on both feet ached constantly, that they always itched, and they appeared discolored and purplish. On occasion they would get red, hot and swollen. Soaking of the feet in hot water made the symptoms worse. The plaintiff was seen by a nurse practitioner who observed biphasic color changes in the toes and noted tenderness and palpation at various locations on the feet and in the right popliteal area. The assessment was bilateral foot pain of unknown etiology with metatarsalgia and biphasic color changes of the toes. The nurse practitioner ordered blood work and told the plaintiff she would be in touch if there were problems.
The woman returned to the clinic ten days later with complaints of a sore throat. The chart indicated that the lab work had returned with high white blood cells, high sedimentation rate, positive anti-nuclear antibodies and positive ANA screen. The plaintiff claimed she was never told of these results. The nurse practitioner, however, wrote in the chart that the plaintiff was told at the time of the second clinic visit. The nurse practitioner at deposition had no recollection of the visit and testified that the chart note suggested that she would have called the patient. The chart note also indicated that the lab abnormalities required that additional lab work be obtained. The additional lab work was not obtained.
The plaintiffs foot discomfort waned over time, but returned about eight months later and she went back to the clinic and was then seen by a family practice physician. That physician noted that the additional lab work had not been done and made arrangements to obtain it. This lab work was positive and suggestive of lupus inhibitor or antiphospholipid antibody syndrome. A referral was made to a vascular surgeon and the plaintiff underwent aortal-bi-iliac bypass with reimplantation of inferior mesentery artery, left superficial femoral artery embolectomy, left superficial femoral artery embolectomy, left femoral to above knee popliteal in situ greater saphenous vein bypass, and distal left anterior tibial and posterior tibial embolectomy surgeries. The plaintiff later required amputation or partial amputation of all of the toes on the left foot. The plaintiff has also been left with left foot drop and left lower leg neuropathy.
The plaintiff alleged negligence in the failure to obtain the additional lab work and to properly follow-up. The plaintiff
claimed that timely follow-up would have resulted in her being placed on anticoagulant and anti-inflammatory medication, which would have been successful in preventing progression of her peripheral vascular occlusive disease and the need for surgery or the development of neuropathy. The defendant claimed that the lack of the blood work did not cause the need for surgery or the plaintiffs disability. A $900,000 mediation result was obtained for the plaintiff. Mary Doe v. Central Minnesota Healthcare Provider, unknown Minnesota venue. Robert J. King, Minneapolis, MN for the plaintiff.
[http://www.nso.com/case/cases_area_index.php?id=115&area=Outpatient]
With permission from Medical Malpractice Verdicts, Settlements & Experts; Lewis Laska, Editor, 901 Church St., Nashville, TN 37203-3411, 1-800-298-6288.
posted by Nurse To Go at 12:26 PM
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