Outpatient Surgery Magazine

Patient Experience - June 2019 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 21 of 112

and inflammatory reaction due to internal joint prosthesis. Wound cul- tures showed moderate growth of E. coli, and an indium white blood cell scan suggested osteomyelitis. He was transferred to another hos- pital, where a doctor advised Mr. Standley to "strongly consider the possibility of amputation" given the poor wound conditions and the extensive rehab that would be required if they could eliminate the infection. The doctor performed an excisional arthroplasty, antibiotic spacer insertion and deep wound closure. About 3 months later, Mr. Standley returned for revision of the spacer, and an infectious disease doctor recommended 2 more months of antibiotics. Five weeks later, he returned for evaluation, where he was informed that due to his extensive osteomyelitis, "nothing further could be offered to him from the orthopedic standpoint except amputation." The jury deliberated for less than an hour before returning the ver- dict. Dr. Rech didn't attend the trial and is reportedly no longer in practice. His counsel, Jay S. Weiss, withdrew before the trial once he saw there was no chance of a settlement. Take-home points The surgeon's duty to comply with the standard of care begins at the first moment of the patient encounter. The pre-op visit is when the surgeon determines whether a patient is an appropriate candidate for a proposed procedure. It's also when the surgeon educates the patient on the procedure so that the patient may give, or withhold, his informed consent. In this case, the plaintiff's attorney and his expert witness argued that Mr. Standley was not a knee replacement candidate because of his multiple knee surgeries and history of osteomyelitis. Contraindication to surgery is the most powerful plaintiff argument, as it explicitly means that the patient could not possibly have suffered Medical Malpractice MM 2 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 9

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