$3M For Delayed Treatment Of Knee Infection Following Surgery: On February 16, 2023, a Virginia medical malpractice jury returned its verdict in the amount of $3 million after about five hours of deliberations for a 63-year-old man who suffered osteomyelitis that led to permanent knee fusion because his knee joint infection after surgery was not timely treated. The verdict was reduced to $2.35 million pursuant to Virginia’s cap on noneconomic damages in medical malpractice cases.
The Underlying Facts
The plaintiff had fractured his kneecap and tore his patellar tendon for which he had surgery seven days later, on August 8, 2018. Although the repair surgery was successful, he experienced pain and his knee was red, swollen, and was warm to the touch one week later, on August 15, 2018. His condition continued to worsen over the course of two days. His knee began to drain, which indicated that he had an infection in his knee, for which the surgeon prescribed Bactrim.
Because his condition continued to deteriorate over the next four days, he went to the emergency room. The surgeon was called and returned the plaintiff to the operating room to drain the knee joint. The surgeon found gross purulence in the superficial tissues but failed to inspect or test the joint space; the surgeon failed to aspirate fluid from the knee joint for culture and he failed to open the knee joint to drain for infection. A culture from the pus from the superficial tissues was positive for staph aureus (MSSA).
After the procedure, the plaintiff was placed on IV antibiotics, which the surgeon unilaterally discontinued at the time of discharge from the hospital three days later. The surgeon ordered oral Bactrim again, which is not effective for treatment for a joint infection (the surgeon did not believe that the plaintiff had an infection in his knee joint).
At first, the plaintiff’s condition improved slightly but his condition worsened after the Bactrim treatment was completed. The plaintiff’s wound opened and began draining serous fluid. His knee was again red, swollen, and warm to the touch. The surgeon performed a procedure on the plaintiff on September 28, 2018, again without opening the knee joint, aspirating fluid for culturing, or ordering lab tests. The surgeon ordered a wound VAC for two months but did not order antibiotics for the plaintiff.
During October 2018, the plaintiff’s knee developed a fist-sized hole and his tendons were visible through the wound. By mid-January 2019, his knee became red, hot, swollen, painful, and was draining fluid again. The plaintiff’s primary care provider prescribed more Bactrim as previously prescribed by the surgeon, and referred the plaintiff back to the surgeon. On February 1, 2019, the surgeon finally ordered an MRI and laboratory studies but did not aspirate any fluid from the plaintiff’s knee. The MRI revealed a likely septic knee, with osteomyelitis of the femur and tibia.
Another medical facility subsequently diagnosed the plaintiff with a chronic, long-standing severe joint infection. He was given the choice of an above-the-knee amputation or a knee fusion. The plaintiff chose the fusion. Cultures from inside the knee joint were positive for MSSA. The plaintiff underwent external fixation for a knee fusion. followed by three additional revision procedures and a removal procedure seven months later.
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