Vascular Surgeon May Provide Expert Testimony on Care Applicable to Orthopedic Surgeon Where Facts Support Connection Between Specialties

The plaintiff with arthritis in his knees saw an orthopedic surgeon for treatment and double knee replacement surgery was planned. The orthopedic surgeon performed the first total knee replacement successfully and three months later the surgeon performed the second knee surgery. The outcome was not positive. Immediately after the surgery, the man complained of numbness and tingling in his left foot. The orthopedic surgeon thought this was the result of either the anesthesia not wearing off completely or neuropraxia, a rare nerve injury related to the surgery. Both of these conditions usually resolve themselves quickly.


Over the next five days nurses and the orthopedic surgeon’s physician’s assistant noted that the man’s left calf swelled and bruised, the pulse in his left foot was weak, his pain increased, and the ability to move his left foot decreased.

After five days the orthopedic surgeon, unable to find a pulse in the man’s left foot, performed additional tests which led him to change his diagnosis from neuropraxia to compartment syndrome.  Compartment syndrome is the swelling of the tissue casings covering the leg muscles, which, if not treated successfully, can cause muscle death, nerve injury, and other serious complications. The orthopedic surgeon performed surgery to restore blood flow in the man’s left leg. The surgery was unsuccessful. The man was transferred to another hospital where vascular surgeons performed another unsuccessful surgery, leading to the amputation of the man’s leg below the knee.


The plaintiff sued the orthopedic surgeon for medical negligence for failure to diagnose the vascular injury which resulted in compartment syndrome requiring amputation. At trial, the man called an orthopedic surgeon as an expert witness to establish the standard of care. The man also called, as an expert witness to establish the standard of care and causation, a vascular surgeon. The jury found in favor of the man and awarded damages against the orthopedic surgeon.


The orthopedic surgeon appealed arguing that a board certified vascular surgeon cannot give expert testimony as to an orthopedic surgeon’s standard of care and that the trial court erred in failing to grant his motion for partial summary judgment, request for a jury instruction, and various post-trial motions.


The appellate court affirmed the judgment against the orthopedic surgeon holding that in the context of this case, the specialties of orthopedic surgery and vascular surgery are sufficiently “related,” within the meaning of the medical malpractice expert testimony statute, so that a vascular surgeon may provide expert testimony as to the applicable standard of care for an orthopedic surgeon’s postoperative treatment.


Additionally, the orthopedic surgeon’s reasoning underlying his argument that the trial court erred in failing to grant his motion for partial summary judgment, request for a jury instruction, and various post-trial motions, hinged on the notion that the only harm to the man was the amputation of his left leg below the knee. This reasoning ignored the other harms the man suffered including progressive intense pain, compartment syndrome, an unsuccessful surgery performed to attempt to restore blood flow to the leg, and another unsuccessful vascular surgery performed to attempt to save the man’s leg.


See: DeMuth v. Strong, 2012 WL 2025376 (Md.App., June 6, 2012) (not designated for publication).