Stenosis Delayed Diagnosis and Leg Amputation Lawsuit

Russell-Brown v. Surgical Associates

Leg ArteriesThis medical malpractice claim was filed in Prince George's County when a man's leg had to be amputated because his doctors failed to appreciate the significance of his arterial stenosis. It was filed in Health Claims Arbitration on March 8, 2018, and it is the 112th medical malpractice case filed in Maryland this year.

Summary of Plaintiff's Allegations

A man went to see a doctor at Surgical Associates with complaints of pain in his left foot, particularly his left fifth toe. The doctor performed an x-ray of the man's right and left arteries which revealed a blockage in the femoral artery and insufficient blood flow.

Despite suggesting that the man consult with a vascular surgeon, the doctor attempted to perform a surgical unblocking (angioplasty) of the left superficial femoral artery himself, but he couldn't bypass a blockage in the blood vessel. The doctor planned to try again three days later. In the interim, the man had developed a blood clot in the common femoral artery. Consequently, the doctor decided to perform a surgical removal of the blood clot along with the angioplasty.

After the surgery, another x-ray revealed that the upper segment of the man's tibial arteries had narrowed dramatically, restricting blood flow to his lower left leg. The man told the nurses that his left leg was numb below the knee and he was unable to wiggle his toes. In spite of the man's concerning symptoms and imaging results, the doctor never returned to the surgery center. Without reevaluating the man, the doctor incorrectly attributed his loss of sensation and paralysis to the anesthetic agents used during surgery.

The man's condition did not improve and he was transported to Southern Maryland Hospital. Even though a physician's assistant noted that he did not have a pulse in his left leg, the man was not evaluated by a vascular surgeon and no additional studies were performed. The next day, the man was transferred to Washington Hospital Center where he was emergently taken to surgery. Ultimately, as a result of the delay in appropriate treatment, the man had to undergo an above the knee amputation.

Additional Comments
  • So there are two main allegations of negligence. The first points to the surgeon failing to recognize that his numb left leg should have led him to the possibility of damage to the artery. The second claim is that the hospital should have acted when the man did not have a pulse in his leg. With respect to the latter claim, it is hard to imagine that the defendants will have the same version of these facts. It is hard to argue it is not negligence if the patient came in with all of the symptoms of compromised blood flow and the PA did nothing about it. If these are the facts, the only good defense might be causation, arguing that the die had already been cast by the time the patient arrived at MedStar Southern Maryland Hospital.

  • The first claim that the doctor "come back to the surgical center" is a little more difficult. The patient reported symptoms and got the appropriate testing that identified a problem.

  • Our law firm, Miller & Zois, had a similar popliteal artery case in 2016 in Baltimore City and received a $5.2 million verdict.

Jurisdiction
  • Prince George's County
Defendants
  • A cardiothoracic and vascular surgeon
  • Surgical Associates, Chtd.
  • A physician's assistant
  • MedStar Southern Maryland Hospital Center, Inc.
Hospitals Where Patient Was Treated
  • Southern Maryland Hospital
  • Washington Hospital Center
Negligence
  • Failing to perform all relevant studies to evaluate the nature and extent of the claimant's blood flow in his left leg.

  • Failing to request a surgical consult.

  • Failing to return to the surgery center and assess the claimant's extremity.

  • Failing to immediately refer the claimant to the hospital for appropriately vascular studies.

Specific Counts Pled
  • As a direct result of the defendants' negligence, the claimant suffered permanent damage to his left leg that resulted in an above-knee amputation.

Plaintiff's Experts and Areas of Specialty
  • Paul E. Collier, M.D., general and vascular surgery. Dr. Collier is based in Pennsylvania but has testified in a number of medical malpractice cases in Maryland and other states around the country.

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