Podiatry Settlement: Failure To Timely Diagnose Charcot's Joints in Diabetic Patient (NJ)

Posted on September 13, 2008 by Michael Quinn

The plaintiff in her late 50s, a diabetic with peripheral neuropathy, contended that clinical signs including deformations in the bone, the collapse of the arch, an increase in pain and swelling and redness, should have led to a timely diagnosis of Charcot's joints, a degenerative condition that can result in the breakdown of bones and tissues of the foot. The plaintiff also contended, that she was sent for a bone scan three to four months later and that the defendant should have realized that early stages of the condition were evident. The plaintiff maintained that if diagnosed after the bone scan, more conservative treatment modalities such as the use of a total contact cast would probably have enabled the condition to resolve in the absence of surgery and the implantation of hardware which will permanently cause increased pain and difficulties ambulating.

The defendant maintained that the clinical signs prior to the bone scan were consistent with diabetes and peripheral neuropathy and denied that the failure to diagnose the condition this time constituted a deviation.

The defendant also contended that he recognized the early stages of the condition after the bone scan was taken and acted appropriately by prescribing a walking boot and referring her to her family physician. The plaintiff underwent the surgery approximately one year later.

Result: $ 300,000 Settlement

Source: Jury Verdict Review Publications, Volume 29, Issue 2 [PM News]
 

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Unnecessary Podiatric Bunion Surgery (Hohmann Osteotomy) to Treat Bunion $400,000 Settlement (IL)

Posted on May 20, 2008 by Michael Quinn
A female plaintiff alleged that the podiatrist-defendant had deviated from the podiatric standard of care by performing a Hohmann osteotomy that involved cutting through the right great toe bone to treat the plaintiff's mild bunion. The plaintiff also contended that the defendant was negligent by advising the patient that she could partially bare weight on the foot  four days following the surgery.

The plaintiff maintained that based on pre-operative X-rays and findings, a Hohmann osteotomy was not indicated since the pre-operative intermetatarsal angle was nine degrees which was normal.  It was further contended that the technique used to fixate the bones was unstable resulting in a malunion and hallux elevatus (elevation) along with shortening of the toe and of the foot. The plaintiff maintained that, despite consulting with over ten different doctors and undergoing six surgical revisions in her continuing efforts to have her right foot deformity and some residual sequelae corrected, she will permanently suffer pain, disfigurement, and disability. The plaintiff incurred $ 120,000.00 in lost income and $ 55,913in medical expenses.

The defendant contended that plaintiff's intermetatarsal angle was abnormally large, that it warranted the Hohmann procedure and that the procedure was well-recognized and accepted. He further contended that if he had only shaved the bunion down that it was likely to return. He also contended that plaintiff contributed to her own injury by stepping onto a step ladder to paint and by dropping a hair dryer on her foot. The plaintiff would have responded that she only got up on the first step with her left foot, did not put any pressure on the right foot and that the hair dryer was a small, travel size dryer that she dropped onto the top of her foot, not onto any of her toes.

Result: The case settled, at mediation, shortly before trial, for $ 400,000.

Plaintiff's Expert: Harold Schoenhaus, DPM, Philadelphia, PA

Defendant's Expert: Louis A. Sorto, Jr., DPM, Chicago, IL

Source: National Jury Verdict Review & Analysis, Volume 23, Issue 2
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