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  1. #1
    angushaid is offline Junior Member
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    Unhappy Mycobacterium Chelonae Infection due to foot surgery

    State of Oregon

    I had bunion surgery in September of 2004. Two weeks later the podiatrist removed the stitches. The next day I noticed the incision had come open at the base of my big toe. I called the podiatrist's office and was told to put butterfly bandages on the area until my next scheduled appointment a few days later. The podiatrist restitched that area of the incision and put me on oral antibiotics for two weeks as a precaution. I then saw the podiatrist on a weekly basis. After several weeks the doctor said my foot looked infected and prescribed Augmentin. Two days later my husband insisted on taking me to the emergency room and I was admitted to the hospital and put on IV Vancomycin immediately. The podiatrist then had to perform a second surgery the next day to remove all the hardware from my foot. Infectious disease doctors were called in to consult on my treatment. I was in the hospital for a week on a Vancomycin drip and then four weeks on home infusion Vancomycin. For seven weeks I was not allowed to be weight bearing on my foot.
    Then the culture taken from my foot showed that the infection was caused Mycobacterium Chelonae. This particular bacteria is resistent to most antibiotics. The infectious disease doctors changed my home infusion to 14 days of Tobramycin. I was also prescribed oral Biaxin. These two drugs are about the only ones effective against Mycobacterium Chelonae. Many cases of Mycobacterium Chelonae have been associated with non-sterile water or contaminated surgical instruments. The source of the infection appeared to be caused by a wire placed around my toe bone in the first surgery. Due to the infection my toe bone is not growing together where the hardware was removed. The podiatrist prescribed a bone stimulator which I have to wear at least three to six hours daily.

    In February my infecton flared up and nodules grew on my incision. The infectious disease doctors placed me on six more weeks of Tobramycin home infusion. Six weeks is the maximum time allowed as Tobramycin can result in hearing loss. I am still taking the Biaxin. It is now 6 months since the original surgery with countless trips to the doctor, two PICC lines and the bone is not healed and the infection is not gone.
    Can this be considered malpractice on the podiatrist's part for not recognizing the extent of the infection sooner or perhaps using unsterile insturments?
    Last edited by angushaid; 04-15-2005 at 08:46 PM. Reason: To clarify problem
  2. #2
    panzertanker is offline Senior Member
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    Quote Originally Posted by angushaid
    What is the name of your state?What is the name of your state?What is the name of your state? Oregon

    I had bunion surgery in September of 2004. Two weeks later the podiatrist removed the stitches. The next day I noticed the incision had come open at the base of my big toe. I called the podiatrist's office and was told to put butterfly bandages on the area until my next scheduled appointment a few days later. The podiatrist restitched that area of the incision and put me on oral antibiotics for two weeks. A month later my husband took me to the emergency room with a severe infection in my big toe and I was admitted to the hospital. The podiatrist then had to perform a second surgery to remove all the hardware from my foot. Infectious disease doctors were called in to consult on my treatment. I was in the hospital for a week on a Vancomycin drip and then four weeks on home infusion Vancomycin. For seven weeks I was not allowed to be weight bearing on my foot.
    Then the culture taken from my foot at the second surgery grew and the infection was discovered to be Mycobacterium Chelonae. This particular bacteria is resistent to most antibiotics. The infectious disease doctors changed my home infusion to 14 days of Tobramycin. I was also prescribed oral Biaxin. These two drugs about the only ones effective against Mycobacterium Chelonae. Many cases if Mycobacterium Chelonae have been associated the non-sterile water or contaminated surgical instruments. Due to the infection my toe bone is not growing together where the hardware was removed. The podiatrist prescribed a bone stimulator which I have to wear at least three to six hours daily.

    In February my infecton flared up and nodules grew on my incision. The infectious disease doctors placed me on six more weeks of Tobramycin home infusion. Six weeks is the maximum time allowed as Tobramycin can result in hearing loss. I am still taking the oral Biaxin. It is now 6 months since the original surgery with countless trips to the doctor, two PICC lines and the bone is not healed and the infection is not gone.
    Can this be considered malpractice on the podiatrist's part for not recognizing the extent of the infection sooner?
    You state you went to the podiatrist, got a 2 week rx for antibiotics and then one month later went to ER. That reads to me that you went to podiatrist and did not seek any type of follow up care for one whole month until going to ER.
    Is that correct?

    If so, then I can see no reason to blame the podiatrist.
    Also, many cases of Mycobacterium Chelonae are caused by non-sterile H2O and equip, but it is hard to prove that is what caused your infection unless you can show a pattern of high infection rate, for example.

    You ask: Is it malpractice to not recognize an infection sooner?

    If you never went back after the initial antibiotic visit, no. How can he diagnose/treat what he hasn't seen in one month?
    If the situation is not the way you wrote it, clarify it for me and I will try to help.
    I have noticed that even intelligent people ask assinine questions every now and again.
    Disclaimer: I know a few lawyers. None of them is named panzertanker.
  3. #3
    angushaid is offline Junior Member
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    Mycobacterium Chelonae

    State of Oregon. I did continue with follow up care after the two week course of antibiotics. I saw my podiatrist every week. I saw the podiatrist on a Friday and he said my incision looked infected and prescribed Augmentin. After looking at my foot, my husband insisted on taking me to the emergency room first thing Monday morning. My husband thinks the podiatrist should have sent me straight to the hospital that Friday for IV antibiotics when he realized the extent my foot was infected. The podiatrist admitted we did the right thing by going to the hospital.
    Last edited by angushaid; 04-15-2005 at 08:17 PM.
  4. #4
    panzertanker is offline Senior Member
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    Quote Originally Posted by angushaid
    State of Oregon. After the two week course of antibiotics, I saw my podiatrist every two weeks. I saw the podiatrist on a Friday and he said my incision looked infected and prescribed Augmentin. After looking at my foot, my husband insisted on taking me to the emergency room first thing Monday morning. My husgand thinks the podiatrist should have sent me straight to the hospital for IV antibiotics when he realized the extent my foot was infected. The podiatrist admitted we did the right thing by going to the hospital.
    Using your original post and your subsequent response, I see no case for malpractice.
    You state the podiatrist saw you every 2 weeks when he recognized infection, and appropriately gave you 2 rounds of antibiotics, different ones when he saw you failed on the first round. That is meeting the standard of care.
    A malpractice claim would have to show that he either deviated from standard care, provided grossly substandard care or was grossly negligent in the care he provided. Accordiing to your post, he did none of these thiings.

    Wounds, either surgical or accidental, DO get infected. The fact that you eventually required IV antibiotics, and subsequent surgical debridement, do not necessarily mean malpractice has occured.
    I understand your frustration, but do not believe there was any gross negligence performed by your podiatrist. Do contact a med/mal attorney for a free consultation for your own piece of mind.
    Good luck.
    I have noticed that even intelligent people ask assinine questions every now and again.
    Disclaimer: I know a few lawyers. None of them is named panzertanker.
  5. #5
    pulse is offline Junior Member
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    I agree, Bunion surgery has a high rate of infection. Although unfortunate this was no caused by the podiatrist. If your tissues healed well (as they should) your wound wound never have been infected initially and the subsequest problems with resistant organisms would not have been seen.

    Hope things turned out OK

    Cheers
    Pulse
  6. #6
    angushaid is offline Junior Member
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    Unhappy

    Thanks for your help. It is extremely frustrating to have such a rare infection that is so hard to treat.
  7. #7
    panzertanker is offline Senior Member
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    Quote Originally Posted by angushaid
    Thanks for your help. It is extremely frustrating to have such a rare infection that is so hard to treat.
    I can believe that statement. Try not to get too frustrated, it lowers your immune system...think good thoughts, all will heal in time.
    I have noticed that even intelligent people ask assinine questions every now and again.
    Disclaimer: I know a few lawyers. None of them is named panzertanker.

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