Plaintiff claimed delay in surgery exacerbated injury – Defense Verdict

Plaintiff alleged that he was misdiag­nosed and received negligent treatment after a left biceps tendon rupture. After an injury at work, the patient was seen in de­fendant’s urgent care clinic. A physician as­sistant diagnosed a forearm and arm strain and referred the patient to the occupation­al medicine physician. The occupational medicine physician suspected distal biceps tendon rupture and referred the patient to an orthopedic surgeon. Treatment and scheduling approval issues led to an ap­pointment 20 days after the injury.

Surgery was performed almost five weeks after the injury. The treating ortho­pedic surgeon documented prior to surgery that the delay in the referral would result in difficulties. After conclusion of post-op­erative treatment, the patient experienced suboptimal recovery. The treating surgeon documented the surgical delay caused the patient’s poor outcome. A second surgery was performed to improve the patient’s pain and disability, but did not result in an­ticipated improvement.

Plaintiff argued the defendant clinic, including a physician’s assistant, a phy­sician, and the administrative staff, were negligent for failing to obtain timely op­erative treatment. Through testimony by his standard of care expert, causation ex­pert, and treating orthopedic surgeon, the plaintiff argued there was a three-week window of opportunity for surgically re­pairing the rupture. The plaintiff’s stan­dard of care expert testified the physician assistant misdiagnosed the injury. This expert also testified the physician failed to appreciate the existence of a three-week window of opportunity to repair the biceps tendon rupture, failed to order an urgent orthopedic referral, and failed to commu­nicate to the staff working on the referral that it was time-sensitive. The standard of care expert also criticized the clinic staff for how they carried out the physician’s order for a referral and for not acting in a more urgent manner. Plaintiff’s experts testified the patient’s residual pain and weakness were caused by the performance of the sur­gical repair greater than three weeks after injury.

Standard of care experts for the defense supported the care by the physician assis­tant, occupational medicine physician, and the clinic employees. The defense causation expert testified that the patient’s outcome was a not a consequence of any delay in surgery. The defense’s physician experts all disputed the existence of a three-week window of opportunity to successfully re­pair the tendon rupture. After one hour of deliberations, the jury found in favor of the defendant.

[17-T-099]

Type of action: Medical Malpractice

Injuries alleged: Ongoing pain, loss of range of motion, and weakness

Court: Washington County Circuit Court

Tried before: Jury

Date resolved: Jan. 12, 2017

Special damages: $35,000 in lost wages and $68,000 in medical expenses

Demand: $2,050,000 ad damnum

Verdict or settlement: Defense verdict

Attorneys for defendant: Neal H. Lewis and Brandy Burnette Balding, Johnson City, TN

Plaintiff’s experts: David Chesler, M.D. (internal medicine) and Gregory Degnan, M.D. (orthopedic surgery)