3523 Case Study: Failure to Diagnose Burn/Infection Resulting in Finger Amputations | Harry S. Cohen & Associates

Failure to Diagnose Burn/Infection Resulting in Finger Amputations

Filed under Misdiagnosis, Emergency Room

The Bakewell Case

Ms. Bakewell, a 50-year old woman, was working at a local restaurant when she burned her right index finger on a bagel toaster. Thereafter, she sought treatment at a local Hospital Emergency Department.

Although an emergency room physician was on duty that evening, Ms. Bakewell was only examined by a Physician’s Assistant (“PA”) who diagnosed her with a first degree burn. Ms. Bakewell was released with instructions to follow-up the next day with a workers’ compensation treatment facility.

The next day Ms. Bakewell treated with a workers’ compensation facility where the compensation doctor noticed the swelling and blistering and immediately cut the rings off of Ms. Bakewell’s right hand. He then diagnosed Ms. Bakewell with a second degree burn and prescribed antibiotics and pain medication. It should be noted however, that the treatment facility’s own written policies mandate that any patient diagnosed with a second degree burn on the hand be referred to a burn specialist, a burn center, or a hand surgeon. Carelessly, this compensation doctor did none of this, and instead released Ms. Bakewell back to work that same day.

Later that same day, Ms. Bakewell was forced to seek additional treatment back at the local Hospital Emergency Department. This time, Ms. Bakewell was admitted and diagnosed with a severe deep infection of the right hand, gangrene of the right index finger, and severe full thickness burn of the right index finger and middle finger with flexor tenosynovitis of the right hand, and thenar deep abscess which spread through her fingers and hand.

Ultimately, Ms. Bakewell had her right index and right middle fingers amputated. She also was required to undergo several more operations for debridement of the wounds and also underwent a skin graft operation. Ms. Bakewell has since been fitted with prosthetics fingers.

We brought suit against the Hospital (PA and ER physician) and also against the workers’ compensation facility (compensation doctor). After taking the Defendants’ depositions, we obtained expert reports from (1) an Emergency Room expert, (2) an Infectious Disease Expert, and (3) a Burn Specialist expert.

Our experts opined that the PA and ER physician breached the standard of care by failing to recognize Ms. Bakewell’s elevated temperature as a potential sign of infection and failing to administer any antibiotics. In fact, in his deposition, the PA admitted that he failed to recognize Ms. Baker’s elevated temperature and that had he noticed that, it might have led to a different assessment and different diagnosis.

Our experts also opined that the compensation doctor deviated from the standard of care by failing to start Ms. Bakewell on IV antibiotics and by failing to refer Ms. Bakewell to a burn specialist, a burn center, or a hand surgeon (as the facility’s own policies mandated).

These were both missed opportunities to salvage Ms. Bakewell’s right hand in its entirety because had Ms. Bakewell’s infection been properly diagnosed and treated, it would have reduced the extent of her infection and reduced the likelihood of her resulting amputations and subsequent surgeries.

The Defendants produced an Infectious Disease expert who advanced the opinion that it was “possible” that appropriate antibiotics “might not have prevented” the subsequent antibiotics.

Two weeks prior to trial, the parties agreed to mediate the case before a former Trial Judge; the case settled for a substantial sum.

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