Anonymous wife and husband v. Unnamed Physicians, their Medical Groups and an Unnamed Hospital
(Failure to timely diagnose and properly treat an abdominal wound)

Case Facts: On October 9, 2007, our client, a 48 year old woman, tripped and fell in her home while carry a glass, which splintered and resulted in two shards of glass going into her abdomen. She was able to remove one of the shards, but the other required medical attention.

She went to the emergency room near her home. She was seen by the medical staff, who after radiographic testing confirmed that she had a retained small piece of glass, which they unsuccessfully tried to remove. After closing the wound and giving her a prescription for antibiotics, she was discharged from the emergency department.

The next day, while still in pain, she returned to the same emergency department. She was then seen by a different physician and nurses, who were nonetheless aware that she had been there the day before with the same complaints and history.

This emergency room doctor entered in the medical record that the patient now was presenting with a fever, redness, and swelling of the wound with foul-smelling (anaerobic) straw-colored drainage from the site. This same defendant physician further documented an examination in which she stated that the wound demonstrated, in her medical judgment “spreading cellulitis.” After further unsuccessful attempts by her at bedside removal of the remaining piece of glass, a call was placed to a general surgeon. This surgeon was given certain information but not complete information by the emergency room physician. Based on deposition testimony taken to date, it is clear and admitted that the emergency room physician failed to convey her assessment of “spreading cellulitis.” This lack of communication of what we believe to be ‘key information’ about the wound has been verified through deposition testimony by the surgeon, who received the call. The emergency room physician, in her deposition, has asserted that even though she types into the record her own entries (i.e. those bearing her initials, which this entry did), she really did not type this entry; the computer program must have done this somehow. We will be doing further discovery to determine just how this computer software changed her words on its own. This should be fascinating.

Based on the information he was given, the surgeon advised the emergency room physician that in his judgment the patient could be discharged for follow-up within a number of days in his office. The emergency room physician, exercising her own clinical judgment, but with knowledge of the “spreading cellulitis,” approved the discharge.

The next morning, October 11, 2007, still suffering intractable pain, our client presented to the surgeon’s office for follow-up care. When she arrived, she was seen by the prior surgeon’s younger partner, who had just joined the practice.

After again confirming the presence of the glass through diagnostic study, the surgeon then had our client immediately admitted to the hospital. Surgery was performed the same day to remove the glass and inspect the wound for abscess formation and/or further infection. Our client remained in the hospital over the ensuing days with constant complaints of fever, pain, and discharge from her wound. Nevertheless, according to the medical records, discharge plans were underway. The medical record reveals that the stated reason for the delay in discharge plans was due to no family member yet being trained to care for the patient at home.

On October 16, 2007, five days into her hospitalization, an infectious disease consultant was finally called in to assist in her care. Multiple IV antibiotics were administered. That same evening, since her condition had significantly worsened, she was returned to the operating room. Further and more extensive surgical exploration was performed.

As the days progressed, our client continued to experience incredible pain. Significant amounts of narcotics were administered. On November 1, 2007, more than three weeks after her first visit to the emergency room, she was transferred to a rehabilitation facility for follow-up wound care and IV therapy.

Less than 2 weeks later, on November 13, 2007, after again spiking a fever, she had to be returned to the hospital for further surgery the next day by the same defendant surgeon. IV antibiotics were continued. She was discharged on November 16, 2007.

After more weeks of intense pain and visits to the surgeon for follow-up care, on February 6, 2008, she was again admitted to the hospital with complaints of abdominal pain. It was determined that she now had a small bowel obstruction requiring hospitalization.

The Result: Over the following months, she continued to be seen as an outpatient in her surgeon’s office. At the time of her final visit with this defendant, on April 25, 2008, she was continuing to complain of pain. The defendant surgeon recorded in his office record that while she was presenting with a painful abdominal wall and flank, which he ascribed as being due to “closure of necrotizing fasciitis debridement,” the wound was now “amenable to revision.” He indicated that his office would provide the patient with a quote from his office’s billing department for the cost of this procedure. He told the patient she could return to work and resume all of her normal activities.

What follows thereafter – to the present day – is a horrific story of a wound that has been operated on seemingly countless times. Our client must pack her open would ever day with medicated dressings and then pull the dressing out of her raw skin each day for dressing changes. She has been hospitalized innumerable times.

What started out as a piece of glass well less than an inch in size has turned into a never-healing wound, unrelenting pain, and a life of constant pain and turmoil for this lovely couple.

Oh yes, we have now ‘discovered’ that the condition for which she was being treated and operated on a number of times by her surgeon – necrotizing fasciitis – according to his sworn deposition testimony – never really existed. We have lost count (last count in the dozens) of the number of times he rendered this very diagnosis in his own medical record entries over the six months he was treating her. Once again, we intend to prove, the words in the chart really don’t mean what they say. A properly and timely treated minor wound, we allege, does not progress to “spreading cellulitis” and then “necrotizing fasciitis” – which is commonly known as flesh-eating disease.

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The above “Cases in Suit” represent a sampling of the types of cases being handled by the lawyers and professional staff of Nash & Associates. Each case varies not only in the facts but also in terms of the jurisdictions in which they are litigated as well as many other intangible factors. We will continue to give you further examples of our cases, which we hope may be of interest to you.