$800,000 For Botched Rotator Cuff Repair: A Virginia medical malpractice lawsuit alleging that an orthopedic surgeon failed to properly perform a rotator cuff repair, acromioplasty, and distal clavicle excision and failed to properly provide post-operative management was settled before trial in January 2023 for $800,000.
The 60-year-old plaintiff alleged that her orthopedic surgeon excessively shaved the acromion during the surgery that led it to fracture sometime between the date of her surgery and her six-week follow-up appointment, and that the orthopedic surgeon further failed to observe or document her clinical signs and symptoms during her six-week post-operative appointment that were consistent with an acromion fracture. The orthopedic surgeon’s alleged breaches of the standard of care resulted in the failure to diagnose the woman’s acromion fracture for nine months, until she sought care from another orthopedic surgeon for an unrelated wrist problem.
The woman alleged that as a result of the orthopedic surgeon’s breaches of the standard of care regarding the acromion fracture, her shoulder is disfigured due to a permanent droop and she is unable to raise her arm above eye level.
The defense argued that the orthopedic surgeon did not breach the standard of care, that the surgeon’s actions did not cause the woman’s alleged injury, and the defense minimized the woman’s injury.
The $800,000 settlement, which was reached one month prior to the scheduled trial, did not include any amount for medical expenses because the plaintiff did not require additional surgery. She also did not claim lost wages because her lost time from work was minimal.
Acromial Fracture After Reverse Total Shoulder Arthroplasty
A study of the incidence of acromial fracture after reverse total shoulder arthroplasty (RTSA) published in December 2019 found that the incidence of acromial fractures after RTSA ranges from 0.6% to 15.8% (the investigators’ systematic review of 15 studies found the overall incidence was 4.0%). Because of the longer arm length and greater deltoid tension after RTSA, the force on deltoid muscle origin increases. Thus, fractures after RTSA can occur at various locations from the acromion to the scapular spine. Acromial fractures after RTSA are a complication neither uncommon nor negligible.
Acromial fractures after RTSA can be either nondisplaced or displaced fractures. Nondisplaced fractures, if detected early, can be treated conservatively, whereas management of displaced fractures with delayed or neglected diagnosis is challenging because of high rates of malunion or nonunion, functional deterioration, and inconsistent results after operative treatment. The investigators found in their systematic review that the overall union rate was 50.0% (43.8% for conservative treatment and 87.5% for operative treatment).
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