Type of Action:
Plaintiff alleged defendant failed to timely diagnose, and then negligently treated his periprosthetic joint infection leading to a knee fusion. Plaintiff’s ad damnum and request to the jury was $4,000,000.
Culpeper Circuit Court
August 4, 2023
Verdict or settlement:
Attorneys for defendant:
Michael E. Olszewski and Tracie M. Dorfman
Description of Case:
Plaintiff underwent total knee arthroplasty in August 2016. Three weeks later, he returned to see the defendant due to wound drainage after a reported fall. The defendant recommended wound care and close follow-up. One week later, the wound had not improved so the defendant ordered irrigation, debridement and aspiration of fluid for cultures. The cultures returned gram-positive cocci, so the defendant recommended a polyethylene exchange. Prior to surgery, the lab verified sensitivities which revealed that the infection was methicillin-resistant staph aureus (“MRSA”). The defendant was not aware of this result prior to surgery. If he had been aware, he would not have proceeded with the polyethylene exchange. Following surgery, the plaintiff’s wound did not heal, and he was transferred to another facility where he underwent the first stage of a 2-stage revision. Unfortunately, the infection deteriorated the extensor mechanism, and the second stage of the knee revision could not be accomplished. The plaintiff elected to undergo knee fusion, rather than above knee amputation.
Plaintiff filed suit against the orthopaedic practice group on June 13, 2018. He alleged that the defendant failed to timely diagnose the infection, and that his operative plan was negligent because he did not wait to learn whether the patient had MRSA. Plaintiff alleged that a 2-stage revision should have been done instead of the polyethylene exchange because it had a higher success rate particularly in the setting of MRSA. Plaintiff alleged that if the defendant had performed a 2-stage revision, it would have been successful and would have avoided the knee fusion. Due to a COVID continuance, the case proceeded to trial on July 31, 2023, seven years after the events in the case.
At trial, the defense argued that the defendant acted reasonably by initially believing the drainage was from a recent fall and was not likely from an infection. Then, the defendant argued that it was reasonable to proceed to surgery without knowing the bacteria’s sensitivities to antibiotics and that a polyethylene exchange was a reasonable first-line treatment for periprosthetic joint infection. The defense argued that even if a 2-stage had been done, it is speculative to argue that it would have been successful.
On the fifth day of trial, the jury deliberated less than three hours and returned a unanimous defense verdict.