Danville Trial Verdict
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MichieHamlett Attorneys Les Bowers and Tony Russell Receive $3,000,000 Verdict on Behalf of Client in Orthopedic Malpractice Case
Victor Williams v. Spectrum Medical, Inc.
Danville City Circuit Court Case No. CL19-485
Hon. James J. Reynolds
Feb 13-16, 2023 (three prior continuances)
Les Bowers and Tony Russell
Coreen Silverman and Neal Lewis, Hancock Daniel
- Romney Anderson, MD (orthopedics, Newport News, VA);
- Mark Rowley (orthopedics, Myrtle Beach, SC);
- John Hostetler (infectious disease, Rome, GA); and
- Daryl Fanney (radiology, Virginia Beach, VA)
$325,000 past meds
$3MM without interest
Vic Williams, age 63, fractured his patella on August 1, 2018 when his vehicle came out of gear and rolled backwards, dragging him with it. He went to the ER and was referred to a surgeon at Spectrum Medical. As this was a rather routine repair, he was scheduled for surgery in 8 days. In the ensuing eight days, he healed his “road rash” abrasions. His repair surgery on August 8, 2018 was uneventful. However, on August 15, his knee began to look red, swollen, and warm to the touch, with significant pain. By August 17th, the redness, swelling, warmth, and pain had all increased, and there was new drainage from the knee. The surgeon evaluated the patient and prescribed Bactrim, an antibiotic that is effective only for a superficial wound infection. Four days later, the symptoms substantially worsened.
The surgeon initially refused to see him because it was his OR day, but after the patient went to the ER, the surgeon was called down to the ER and took the patient back to the OR. Though he documented that he suspected a potential joint infection, he only did a superficial incision and drainage. During that I&D, he found gross purulence in the superficial tissues, but he never inspected or tested the joint space despite the fact that he and his experts acknowledged that the joint space was permeable to an infection above, and was at increased risk of infection for a variety of other reasons. He cultured the pus from the superficial tissues and it returned staph aureus (MSSA). Though the patient had essentially all of the hallmark symptoms of a joint infection, and had numerous risk factors predisposing him for a joint infection, the surgeon did not obtain labs (ESR and CRP) that might suggest a joint infection, nor did he perform the “gold standard” test of aspirating fluid from the joint and culturing it, nor did he open the knee joint to drain it of any infection.
After the incision and drainage, the patient was put on IV antibiotics by infectious disease. However, the surgeon discontinued the stronger antibiotics at discharge three days later and restarted oral Bactrim. Despite never running any test whatsoever to definitively rule in or rule out joint infection, he documented that he did not believe the patient had a joint infection.
Mr. Williams improved somewhat in the ensuing two weeks, but he began to worsen again after his Bactrim ran out. His knee wound opened up and began draining serous fluid, and the redness, swelling, and warmth returned again. On September 28, 2018, the surgeon did the same thing and hoped for a different result: he took the patient back to the OR and did a superficial incision and drainage. Again, he did not open the joint to drain it, he did not aspirate any fluid from the knee to test it for bacteria, and he did not obtain any labs. He placed a wound vac that would stay in place for over two months. And he discharged the patient the same day without any antibiotics at all.
Just a few days later, the patient’s nurses called in concerned about infection and requested that he be seen or be prescribed antibiotics. Neither occurred, and instead he was referred to PT. Two days later, he returned to the clinic and the notes stated that family was concerned about infection. Still, no antibiotics were given and the joint fluid was not tested. Over the course of October 2018, the knee wound had a “fist-sized hole in it.” By the end of October, tendons were visible through the wound and the doctor said he might need to consult plastic surgery. Even still, there was no test for, diagnosis of, or treatment for joint infection. By the end of November 2018, the wound was spitting out sutures from the patellar tendon repair. Instead of being concerned for infection, and instead of being concerned that his extensor mechanism repair was failing/had failed, the surgeon said he did *not* think there was a joint infection. Again, he did not test for joint infection.
Mr. Williams continued to suffer in December 2018 with pain and stiffness, although the superficial wound did begin to close. However, by mid-January 2019 the knee became red, hot, swollen, painful, and was draining fluid. The PCP prescribed more Bactrim, because that is what the surgeon had been giving, and sent him back to his surgeon for further evaluation. Again, nothing was done to test for or treat infection. Mr. Williams returned again on February 1, 2019 with the same symptoms he’d been having for more than five months: a knee that was red, hot, stiff, swollen, painful, and draining fluid. The surgeon finally ordered and MRI and lab tests, but did not aspirate any fluid from the knee. The lab tests came back “off the charts”, and the MRI revealed a likely septic knee, with osteomyelitis of the femur and tibia.
After the MRI results returned, the surgeon referred Mr. Williams to Carilion (as a standard referral – not urgent), but his family managed to get him in to be seen the next day. At Carilion, he was told that his knee was so bad off that they would have to amputate above the knee or perform a fusion, and that they could not tell which until they did the surgery. During the surgery, Mr. Williams had his patella, patellar tendon, and diseased portions of femur and tibia cut out. The Carilion doctor also took cultures from inside the joint, which later came back positive for MSSA – the same organism that the defendant surgeon had cultured from the superficial tissues over five months prior. Same organism, same infection all along.
The Carilion doctor also began the process of external fixation for a knee fusion. The cultures that he obtained came back positive for MSSA – the same thing that the surgeon had cultured from the superficial tissues months prior. The patient underwent three additional procedures to revise the external fixator, and then to remove it seven months later. He currently can only ambulate with a rollator while essentially “dragging” his fused right leg.
Plaintiff’s two orthopedic experts, and one infectious disease expert, said that Mr. Williams had an infection of his joint with staph from the original repair surgery (August 8) and that it was clinically apparent by August 17. They testified consistent with the literature that joint infection cannot be ruled out clinically and that when joint infection is suspected, aspiration of synovial fluid is mandatory. They testified that the defendant orthopedic surgeon violated the standard of care at every encounter from August 17, 2018 through February 6, 2019. The defense argued that although the surgeon documented that he suspected joint infection, there were insufficient indications to aspirate fluid from the joint, that a joint infection can be sufficiently ruled out with clinical exam alone, and that while there was “possibly” an infection in 2018, it did not become “apparent” until January 2019.
Closings were on Thursday morning, and the jury was out for just short of three hours. MichieHamlett partner Les Bowers said he would ask for $3 million in opening, and he asked for $3 million plus prejudgment interest in closing. After about three hours of deliberations, the jury returned a verdict for the Plaintiff in the amount of $3 million without prejudgment interest.