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Postoperative Infection Case Result

Surgical Errors Cause Postoperative Infection

High six-figure recovery for complex ankle fracture in a middle-aged coal miner — This plaintiff fell from a tree and suffered a bad break of the ankle, which was also an "open" fracture, i.e., the bone was protruding through the skin. Open fractures are particularly prone to infection because the surface of the skin has been broken, and the wound is exposed to potential environmental contaminants. In this case, the man fell in an area full of grass and dirt. He went on to develop a very serious infection that required four to five major surgeries. It was our contention that the surgeon did not do a good job of debriding or cleaning the wound when he first saw him on the night of the injury. It is always important for a surgeon to completely and thoroughly debride a wound in order to give a patient the best chance of avoiding infection. In this case, the doctor argued that it is sometimes not possible to remove all debris, but our contention was that with an open fracture you have to be particularly careful to look in all of the "nooks and crannies" of the wound and make sure no debris is left behind. To prove he did not do that we showed that some five weeks later, when the patient went to a second orthopedic surgeon, that doctor found that there was still a small clump of grass in the wound near the site of the fracture.

In addition to not cleaning the wound properly, we also contended that the surgeon did not do the correct operation for a tib-fib fracture of this sort. Because these fractures often involve extensive soft tissue damage, we claimed that the doctor should have done a two-stage procedure in which he first simply applied an external fixator to the fracture and then waited two to four weeks to remove the temporary fixator before applying permanent plates and screws to the fracture. This two-stage procedure, we argued, gives the fracture a better chance of healing. The defense argued that almost all tib-fib fractures are prone to infection and problems regardless of the type of surgery that you do.

A postoperative infection is the major risk that every patient faces after any surgery. Therefore, merely because a patient has an infection after an operation does not mean that the doctor did something wrong. However, in this case we argued that the doctor did do something wrong because we know he left behind a small clump of grass near the fracture site. In most cases involving postoperative infection, you do not have that sort of "smoking gun."

As a result of his multiple surgeries, the plaintiff was still not able to walk properly more than three years after the injury. His ability to return to work as a coal miner had been eliminated. Although there was other work he might be able to do, those other jobs would not pay as much as the coal mining job. Therefore, in addition to the general claim for pain and suffering due to all of the surgeries and recovery time he endured, we also claimed wage loss and diminished earning capacity as a major part of our damages.


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