Orthopedic surgeon fails to rule out serious infection in his knee-replacement patient.
- Case Name: Brun v. Kaiser
- Court and Case Number: Arbitration No. 16503
- Date of Verdict or Judgment: Monday, April 19, 2021
- Date of Arbitration Award : Monday, April 19, 2021
- Date Action was Filed: Friday, January 24, 2020
- Type of Case: Medical Malpractice
- Judge or Arbitrator(s): Thomas D. Weaver
Plaintiffs: Claimant Brun, 73, male, retiredClaimant Brun, wife of patient
Defendants: Kaiser (Southern California Permanente Medical Group)
- Type of Result: Arbitration Award
- Gross Verdict or Award: $532,521
- Net Verdict or Award: $532,521 less MICRA deduction
- Trial or Arbitration Time: 4 days
Attorney for the Plaintiff:
Walkon Law Firm by Bradley J. Walkon, San Juan Capistrano.
Attorney for the Defendant:
LaFollette, Johnson, DeHaas, Fesler & Ames by Brian M. Meadows, Santa Ana
Plaintiff’s Medical Expert(s):
Stuart M. Gold, M.D., orthopedic surgery, Torrance.
Patrick Joseph, M.D., infectious diseases, San Ramon.
Defendant's Medical Expert(s):
Frederic G. Nicola, M.D., orthopedic surgery, Marina del Rey.
Howard Pitchon, M.D., infectious diseases, Beverly Hills.
Facts and Background
Facts and Background:
Claimant underwent a left total knee replacement at Kaiser on April 1, 2019. On April 8, 2019, he presented to Kaiser with symptoms of infection at the left knee. It was diagnosed as cellulitis and he was sent home.
On April 9, 2019, claimant presented to Kaiser's Emergency Department and was admitted. On April 10, 2019, he was evaluated by his orthopedic surgeon, who continued to feel his patient merely had cellulitis. On April 12, 2019, claimant underwent an Irrigation and Debridement surgery and was diagnosed with necrotizing fasciitis. On April 20, 2019, claimant underwent a left above-the-knee amputation.
As to standard of care: That when plaintiff presented to Kaiser on April 8 his symptoms were consistent with a left knee infection.
Necrotizing infections are life and/or limb-threatening. Accordingly, if a patient has signs and symptoms consistent with a potentially necrotizing infection, the standard of care requires that a reasonable orthopedic surgeon take action to rule out that disease. Here, the standard of care required that Kaiser's orthopedic surgeon rule out a potentially necrotizing infection on April 10, 2019. Had this been done, claimant's necrotizing infection would have been diagnosed and controlled such that he not require an amputation.
As to causation: As claimant's infection was not adequately controlled before April 12, 2019, it gained momentum and became extremely difficult to control, necessitated numerous surgeries, and culminated in the need for above-the-knee amputation. Timely control over this infection, if obtained on or before April 10, 2019, would have halted the momentum of the infection and prevented amputation.
As to standard of care: It was reasonable to conclude that claimant merely had a left knee cellulitis and the standard of care did not require action to rule out a potentially necrotizing infection until April 12, 2019.
Causation: Given the type of necrotizing infection that afflicted claimant, nothing could have been done at any point to prevent him from requiring an amputation.
Injuries and Other Damages
Physical Injuries claimed by Plaintiff:
Claimant suffered the amputation of his left leg, above the knee.
Claimant's spouse maintained a loss of consortium claim.
- Special Damages Claimed - Future Medical: $32,521
Demands and Offers
- Plaintiff Final Demand before Trial: $275,000
- Defendant Final Offer before Trial: $0