Majetich v. Westin

from an adverse judgment in a malpractice action. The malpractice was alleged to cover all of the treatment, surgical and post-operative, but the court submitted to the jury only the single issue of the alleged failure of defendant Dr. Westin to perform post-operative care of plaintiff-patient according to the standard of care prevailing in the community. Except as is necessary in discussing a jury instruction claimed to be in part erroneous, we confine the statement of facts to the period after surgery.

The injury is claimed to be nerve damage, necrosis of tissue, and muscular atrophy of plaintiff’s left' leg caused by a postoperative infection which developed in the surgical site. The surgery was one to correct a foot-drop condition in the left leg of an 8-year-old girl. She had formerly successfully undergone a similar operation to her right foot and leg, and this prior operation is but most tangentially within the evidence in the instant case, the result having been all that anyone hoped for.

The second surgery was performed by Dr. Westin on May 31, 1963. Other doctors assisted, but both the operation itself and the post-operative care of the patient were primarily the obligation of Dr. Westin. On June 6, six days after the operation, Dr. Westin suspected infection of the leg and examined it, taking.a culture of the discharge from one of the surgical incisions. He ordered a “broad spectrum” of antibiotics. The following day, June 7, gross puss was noted, and the wound was opened for drainage. The infection was determined to be “staphylococcus aureus coagulase positive, hemolytic.” Ultimately, the infection subsided, but, as the defendant’s brief succinctly states, “the surgery of May 31 was rendered unsuccessful by this gross infection and the underlying severe necrosis. ’ ’

The testimony of defendant’s medical experts was generally to the effect that the procedures and diagnoses during the post-operative period were proper and that the unfortunate result was not due to malpractice. To contravene this evidence, plaintiff offered the testimony of her own expert, Dr. Arthur Simon.

Dr. Simon testified that he examined plaintiff the first day of the trial, noted the marked left foot drop, barely percepti

[218]

Me dorsiflexion. of the left foot, and anasthesia of part of the left foot. His opinion was that her condition was permanent. His qualifications were presented with respect to rendering an opinion as to the nature and standard of post-operative care in the type of surgery involved in such a case. He then testified that defendant Westin had not met that standard: “Q. You stated, Doctor, that it was your opinion that the defendant, Dr. Westin, fell below the standard of postoperative care, skill and diligence ordinarily possessed by an orthopedic surgeon in this community in by objection which was overruled] What did you base your opinion on Doctor? A. I based my opinion on having reviewed the records and on my knowledge that there are- certain standards required in the treatment of postoperative wound infections which I feel were not followed. Q. Now, wha.t were those, Doctor ? A. This patient had a wound infection which resulted in necrosis, which means that it was infection was of a severe enough nature to have destroyed muscle tissue and skin. And it is incumbent upon the doctor in charge of the patient to recognize the infection early enough to start antibiotic therapy and also to establish drainage. And my review of the records shows that this wasn’t done until about the sixth day postoperatively. It is also very possible that as a result of comparing the' hematocrits, that there was more blood loss than what was stated. ... It’s very possible that this patient had a hematomathat even though there was a small amount of blood stain in the cast, there still could have been a large collection of blood beneath the skin, subcutaneously, that could have caused pressure necrosis of the tissues involved.”