EMAIL TO A COLLEAGUE COMMENT

 

Failure to Diagnose Compartment Syndrome; Emergency Surgery


A patient presented to the emergency room (ER) complaining of left shin pain after playing basketball. The college athletic trainer had referred the patient to the ER due to suspected compartment syndrome based on the patient’s symptoms. A sports medicine fellow and the ER attending physician examined the patient. X-rays were taken. The patient was discharged with instructions to take an over-the-counter nonsteroidal anti-inflammatory drug and follow up with an orthopedist or sports medicine doctor.

 

The patient’s pain persisted. Five days later, the patient saw a sports medicine doctor. After examining the patient and taking an x-ray, the sports medicine doctor diagnosed the patient with compartment syndrome, a painful and dangerous condition caused by pressure buildup from internal bleeding or swelling of tissues. The sports medicine doctor directed the patient to go to a hospital. The patient returned to the hospital. The patient underwent emergency surgery for compartment syndrome.

 

The patient brought a medical malpractice action against the hospital, sports medicine fellow, and ER attending physician. The complaint alleged the hospital, sports medicine fellow, and ER attending physician failed to timely diagnose and treat the compartment syndrome during the patient’s first ER visit.

 

The hospital, sports medicine fellow, and ER attending physician moved for summary judgment. In support of the motion, the defendants submitted an affidavit from a board-certified vascular surgeon, who opined that the hospital, sports medicine fellow, and ER attending physician did not depart from the accepted standard of care in the treatment of the patient because the patient did not have symptoms consistent with compartment syndrome at the time of the first ER visit.

 

In opposition to the motion, the patient submitted an affidavit from an expert, a physician certified in general surgery. The patient’s expert opined that the patient originally presented to the ER with symptoms of compartment syndrome and that the hospital, sports medicine fellow, and ER attending physician departed from the accepted standard of care by failing to perform adequate testing and diagnose the compartment syndrome.

 

The Nassau County Supreme Court granted a motion for summary judgment and dismissed the complaint against the hospital, sports medicine fellow, and ER attending physician.

 

The Appellate Division of the New York Supreme Court, Second Department, reversed. The court held that the trial court erred in dismissing the complaint against the hospital, sports medicine fellow, and ER attending physician.

 

The trial court erred in dismissing the complaint against the hospital, sports medicine fellow, and ER attending physician. The hospital, sports medicine fellow, and ER attending physician failed to establish, prima facie, that the defendants did not depart from good and accepted standards of medical care, or that any such departure was not a proximate cause of the patient’s injuries. The defense expert merely recounted the treatment rendered and opined in a conclusory manner that such treatment did not represent a departure from good and accepted medical practice. The court concluded that the trial court should have denied the motion for summary judgment.

 

The Appellate Division of the New York Supreme Court, Second Department, reversed the trial court’s entry of summary judgment in favor of the hospital, sports medicine fellow, and ER attending physician.

 

See: Kelly v. Rosca, 2018 WL 4101005 (N.Y.A.D. 2 Dept., August 29, 2018) (not designated for publication).

 

See also Medical Law Perspectives Report: When Urgency Leads to Errors: Liability for Emergency Care

 

See also Medical Law Perspectives Report: Arthritis Pain and Inflammation: Diagnosis and Treatment Risks

 

 

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