Case Archive
 
Internal Medicine

Mismanagement of Plantar Ulcers Leads to Amputations
$355,000 Florida Settlement

A 62-year-old woman with a well-established diagnosis of diabetes was seen in a local HMO clinic for complaints related to calluses on the plantar surface of the left foot. During the next nine months she was seen 25 times by family medicine, gynecology and podiatry practitioners for various problems, including continued complaints concerning the calluses. An ulcer appeared on the plantar surface. In 69 visits over the next year ulcers developed on the right foot. The following treatment was repeated in most of the visits: debridement, foot soaks, and occasional antibiotics. On the last visit a podiatrist instructed the woman to return in two weeks. Two days later she was admitted by an internist (not previously involved in her treatment) for a fourth digit amputation, followed several days later by a partial first ray amputation of the right foot. Two years later, she underwent a transmetatarsal amputation of the remaining toes. A medQuest expert in internal medicine and infectious diseases testified by video deposition that management of the patient negligently failed to account for the fundamental precept that continued weight-bearing prevents healing of plantar ulcers in a diabetic patient. The negligence of all the practitioners, including the podiatry residents at the clinic, led to the amputations. The defendant parent "holding company," the subsidiary health insurer, the subsidiary HMO, the HMO-owned clinic, the board-certified podiatrist, and two podiatry residents each settled. Terms of the individual settlements, which totaled $355,000, were confidential.

Attorney for the Plaintiff:
Kenneth J. Kavanaugh, Esq.
Fort Lauderdale, FL




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