Ongoing Pain/suffering Radial Fracture...malpractice???????

[neddie]

I am writing to describe a matter and inquire about it's validity as a cause of action for medical malpractice.

I am a 42 year old woman who suffered a high-impact wrist fracture in mid-August as a result of my dog tripping me, causing a fall down a large flight of stairs.  I was referred to a local,(Mid-Michigan) orthopedist by a walk-in clinic.  The Dr. indicated I had a severe fracture of the distal radius and performed an open reduction with a surgical pinning.  The days following the surgery I was experiencing excruciating pain.  I had been advised to contact the Dr. if I had a pain level that was not relieved by the mild pain medication I had been prescribed post-op.  For several days, many times a day, I called and left emergency messages at the office and answering service that went unanswered.  I resorted to seeing the Nurse Practitioner at the office of my primary Dr., who addressed the pain management and expressed concern about possible infection at the pin site.  Within the week I saw the orthopedist who denied the presence of infection and indicated everything looked normal.  My concern about infection continued as the pin site became increasingly red, swollen, and draining pus.  The appointment the following week resulted in the Ortho Dr. acknowledging infection and prescribing a course of antibiotics.  Despite the antibiotics, the infection continued to worsen.  The pain was usually a 9 on a scale of 1-10 and I developed a high fever and vomiting.  I went to the ER, when in addition to those symptoms, I developed a stiffened jaw and difficulty speaking.  The ER physician contacted my Ortho Dr. who agreed to see me the following day.  During that visit, the Dr.diagnosed a cellulitis infection at the pin site, and without any anesthetic, simply held my hand down on the table and pulled that pin from the bone.  I almost fainted from the pain and was yelled at by the Dr. to "quit being a baby" and "making things so difficult" for him.  I was told to continue the antibiotics and left the office in tears.  The fever persisted and the vomiting became so severe that I was unable to hold down the antibiotics.  I called the office of the Ortho Dr. to advise them of this and asked if something could be prescribed to stop the vomiting.  I was rudely disregarded and told by the nurse that such issues would not be addressed by that office.  I then called my primary doc's office and was prescribed an anti-vomiting medication but was advised that cellulitis was a potentially life-threatening infection and that if I continued to be unable to hold down the oral antibiotic, I would have to be admitted to the hospital for IV administration.  Luckily, the vomiting subsided and the infection responded to the antibiotics.  During the next two visits with the ortho doc, the last of which was in mid-November, I continued to complain of severe pain and concern about the deformed look of my wrist and particular pain at the site of an obvious protrusion in the ulnar region of my wrist which was opposite from the location of the radial break.  I was told that everything had healed normally and that the pain was from irritation caused by the ulnar portion of my wrist resting on the splint.  I was told that the deformity would decrease over time but that I would likely always feel pain "especially at this time of the year".  I was not advised of the need for any further follow-up appointments.

Since then, the pain has been constant, the deformity has increased, and I have very little ability to use or control my left hand.  I had however reconciled that as a condition that I simply needed to accept as the Dr. had stated.  The pain at times became unbearable and began to result in terrible anxiety attacks feeling the need to faint.  The last such episode was especially scary as it occurred in the Las Vegas airport.  I had to lay on the floor of the waiting area and ended up missing my flight.  I saw the NP at my primary doc'soffice to address the pain and anxiety attacks.  Upon seeing the deformity of my wrist,she ordered CAT scan.  The conclusion of the scan was: "Interval healing of commuted angulated intraarticular fracture of the distal radius with significant foreshortening of the distal radius"  as well as a "displaced ununited fracture of the ulnar styloid process".  

Today I saw an orthopedic surgeon in a neighboring county.  I was told that I would require a surgical shortening of my ulna, but significant ligament and soft tissue damage made it much more complicated.  He does not even know of a surgeon in the area who could address the multiple issues.  He perscribed oxycontin for pain and I'll be having a specialized ortho MRI w/ dye next week to assess the extent of the soft tissue damage. I feel that from the beginning, my care and treatment by the orthopedist qualifies as negligent and has resulted in undue suffering and decreased functioning and an over-all decrease in my quality of life.  I'm not sure how to proceed from a treatment standpoint as I was advised by my primary doc that the local orthopedists function as something of a "good ole boys club", and are often unwilling to treat or disagree with the findings of a colleague.

Thank you for taking the time to read this lengthy e-mail.  I would appreciate your opinion about the viability of legal action against the orthopedist.

ANSWER: Deborah,

As you already expect, it appears the physician was well below the standard of care as well as decency based on your facts.

I strongly suggest you speak to a malpractice attorney in your area.

I also suggest you contact the Board of Medical Examiners in your state and file a complaint against this physician.  This physician treated you extremely poorly and should not be allowed to treat others in a similar manner.

Very truly yours,

Paul D. Friedman, M.A., Ph.D., J.D.

---------- FOLLOW-UP ----------

Thank you VERY much Dr. Friedman for your response.  I contacted a local attorney who advised me that my matter couldn't be considered for litigation until my course of treatment including surgeries and follow-up therapies had been completed so the full picture, including permanent conditions and long-term prognosis' could be assessed.  I can understand that point of view, but wouldn't it also be helpful to have an attorney who would advise me regarding handling my treatment in anticipation of a lawsuit(ie: obtaining the proper documentation and which practitioners could help/hurt future litigation)?

I have heard through the grapevine that local attorneys are very reluctant to take cases against orthopedists since they have relationships that can be lucrative in other accident and personal injury claims.

Your attention to my issue is very appreciated and valued.

Deborah

[Constantinos]

Deborah,

I believe the attorney is telling you to wait because he/she wants to see if you have a permanent injury to determine if your case is worth litigating.  If you don't meet the threshold for damages, it may not be cost effective to take your case.

However, you are correct that it is better to receive guidance as early as possible so as to best protect your interests.

I suggest you go outside of your community to a larger city to find counsel.  For instance, I have handled cases from other small towns in Arizona even though I am 200 to 300 miles from those locations.  The same will also be true for experts in that local experts generally do not want to testify against another local physician so counsel often will look to teaching hospitals or experts in other states.

I wish you the best.  Look around for the right attorney with whom you feel a connection and level of trust.

Very truly yours,

Paul D. Friedman, M.A., Ph.D., J.D.