Do I have a case?

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I've been through so much and this is a really complicated story. I wish I could post it as an attachment. I may have to spread this into more than one post. I'm wondering if I have a case against Dr. 1. I have undergone surgeries, suffered and spent a lot of money that I never should have had to because of his recommendations and surgical carelessness. Well, here goes...

October 1991 – Original injury occurred while riding a horse. I suffered a torn lateral meniscus, torn anterior cruciate ligament (ACL), and a torn medial collateral ligament (MCL) of the left knee.
December 1991 – Surgery # 1, Arthroscopic Partial Meniscectomy, performed by Dr. A in Norristown, PA. I had just turned 18.
Surgical details:
Dr. Puleo performed a partial lateral meniscectomy.
He decided that the ACL was healing well enough that it did not need to be reconstructed at that time.
The MCL was almost completely healed by the time of the surgery, so that was left alone as well.
Recovery was uneventful and I was shortly back to riding and even took up daily jogging.
September 2002 – Began seeing Dr. 1, of the ___________-- Charlottesville, VA 22903. My main complaint was pain in the left knee along the lateral joint line. Dr. 1 performed various tests upon physical examination and multiple x-rays of my left knee were taken. Dr. 1 decided that the pain was being caused by a torn/dysfunctional ACL and recommended a surgical ACL reconstruction. Surgery was scheduled for later that month.
September 2002 – Surgery #2, Arthroscopic Partial Meniscectomy and Debridement, performed by Dr. 1 at the _____________________.
Surgical details:
I was scheduled to have an arthroscopic ACL reconstruction, using my own patellar tendon to rebuild the ACL.
Dr. 1 decided that the ACL was not the problem and did not perform a reconstruction. He removed meniscal debris from the lateral joint compartment.
He informed me after surgery that the cause of my pain was the lateral meniscus remnants (the remainder after my partial meniscectomy in 1991). The remaining piece of meniscus had torn into multiple segments and he told me that I would need a meniscus transplant in order to function without the constant pain and get back to my previous level of activity.
Surgical recovery was uneventful, but constant was still a problem and was getting worse.
October 2002 – Began making plans with Dr. 1 for a meniscal allograft procedure, during which a lateral meniscus from a cadaver (donor), attached to a block of bone from the tibial plateau of the donor, would be inserted into my lateral joint space after gouging out a tunnel in my tibial plateau to fit the donor bone block and drilling a hole through my femur below the knee through which to pass an anchoring suture. Dr. 1 explained to me that the procedure would be done on an out-patient basis, that I would be nonweightbearing for about 6 weeks, and full recovery would be reached after 1 year. He said that I was an excellent candidate for this surgery and that I had every reason to believe that it was the answer to my problem. I explained that it was very important to me to be able to ride my horse, keep up with my young daughter, enjoy training my dog and engage in various physical activities with my husband. He assured me that I would be doing those things again shortly.
In preparation for the surgery, more x-rays were taken to size the meniscus that I would need.
The insurance company refused to pay for the surgery, so Dr. 1 and I each wrote letters explaining that the meniscus allograft was my only shot at escaping pain, arthritis and a sedentary existence. After an appeal of the initial decision we won the case and the insurance company was on board.
I was placed on a list of recipients waiting for a meniscus, and in May of 2003 my prayers were answered and I received a phone call telling me that the right meniscus was available and I could undergo surgery at anytime.
May 12, 2003 – Surgery # 3, Left Lateral Meniscal Allograft, performed by Dr. 1 at __________.
Surgical details:
During the procedure, the donor bone block to which the meniscus was attached was fractured through and through.
The meniscus was also damaged and needed repair before the procedure was finished.
The meniscus was such a tight fit that, according to Dr. 1, he had to wrench the joint space open to implant the new tissue. Because of the added pain that this was caused, I was admitted to the _____________ Hospital and kept overnight.
I discovered only upon reading the surgical report myself that the ACL was indeed torn at the time of this surgery, 8 months after # 2, with no incident or injury in between...
At the hospital:
Upon arrival at the hospital I found that the nurses were not expecting me, didn't know who I was and had no orders for my care.
In SEVERE pain, I waited over an hour before receiving any medication or attention from medical personnel.
I was released the following day, in TERRIBLE pain, and proceeded to pass out and then vomit while UNCONSCIOUS later that evening after my first trip to the bathroom. The pain was just too intense and I feel that I was either released too soon or not sent home with the proper medication, instructions or supervision.
The recovery:
Because of the fractured bone block, I was nonweightbearing, with a toddler to care for, for more than 8 weeks.
I was not prescribed physical therapy right away, so by the time I did start formal PT I had severe difficulties with extension and flexion of my knee and my patella (knee cap) had adhered in place due to the built up scar tissue and lack of motion. Dr. 1 kept telling me that everything was going fine and that it was all very "encouraging".
Dr. 1 did not prescribe a wheelchair, so I had to pay to rent one myself. I simply could not care for myself or my family without one.
Dr. 1 kept assuring me that all was going well even though I had a nagging feeling that it was not.
August/September 2003 – Shortly after beginning to bear weight on my left leg I began to experience terrible, sharp pain along the lateral joint line, worse than ever before.
An MRI was performed to see what was going on.
The new meniscus had torn and Dr. 1 recommended repairing it arthroscopically.
October 2003 – Surgery # 4 – Arthroscopic Meniscus Repair, performed by Dr. 1 at _______________.
Surgical details:
Dr. 1 trimmed away some of the meniscus and repaired a tear in the "salvageable" part. Of course, with each "trimming away", starting with the original transplant procedure, my chances for a pain free existence were dwindling.
The recovery:
The severe pain started almost right away again.
December 2003 – Another MRI to rule out a recurrent meniscus tear.
The meniscus was torn AGAIN. This time there was a also a floating "body" or a completely dislodged chunk of meniscus.
Dr. 1 again recommended an arthroscopic meniscus repair. I asked him if it wasn't time for a serious reevaluation of the success or failure of the transplant, and at that time he conceded the transplant had been a failure and that he no longer felt comfortable trying to "fix" the problem. He referred me to Dr. 2, of ____________ for a revision transplant of the left lateral meniscus.
TO BE CONTINUED....

The rest...

March 2003 – I traveled to Cincinnati, OH to meet with Dr. 2. Dr. 2 ordered more x-rays, gave me an exhaustive physical exam and came up with the following, very troubling conclusions:
Dr. 1 never should have recommended the meniscus transplant, as I was NOT a good candidate for that procedure.
He explained that my left leg was curved inward, a condition called a valgus deformity, and that the joint space was completely closed because of this and that anything placed in that joint space would ultimately be crushed to bits.
He said that it was evident on physical exam that my ACL was completely dysfunctional.
He informed me from looking at MRI's and x-rays that my articular cartilage is very worn.
He said that I have a gait abnormality typical of patients with chronic knee pain and that I would need to learn again how to walk correctly.
He pointed out on one of my x-rays an area of abnormal bone density, indicative of insufficient healing, in the area of the fractured bone block.
Dr. 2 told me that the fact that my patella was adhered down in place was very bad. Dr. 1 had told me it was no big deal. Dr. 2 said that because my patella was allowed to adhere to the underlying bone with scar tissue my patellar tendon had permanently shortened and because the patella must slide around for the knee to bend normally, my knee will never again reach full flexion. This condition is commonly called Patella Baja. This condition also puts my quadriceps at an unusual risk for tearing.
He explained that I will NEVER be able to run again, let alone enjoy sports and that MAYBE I will be able to ride my horse. My passion is show jumping (over fences) and that may never be possible again. I LOVE to dance. I won't be dancing anymore.
He explained that I will eventually need a knee replacement, but that we need to avoid that for as long as possible since I am so young.
He suggested the following course of action as a plan to decrease my pain as much as possible and put off my knee replacement until I reach an acceptable age for the procedure:
Arthroscopic debridement procedure – Dr. 2 felt that an absolutely necessary first step would be for me to have excess scar tissue removed from under my knee cap to help free it up and avoid further damage to my patellar tendon. The Patella Baja is irreversible, but he wanted to try to keep it from getting worse. He thought this surgery would also allow him to get a good look at what was really going on in my knee joint.
Distal Femoral Opening Wedge Osteotomy – A procedure during which the surgeon uses a bone saw to saw into the femur just above the knee to create a wedge, lengthening the outside of the femur and opening the lateral joint space. Bone from the patient or a cadaver is then placed in the open wedge, the partial fracture is plated and a long process of recovery begins.
Revision Meniscal Allograft Transplant – To provide necessary joint cushioning. This procedure will be complicated for me because I've already had one and will have a diminished chance for success for the same reason.
ACL reconstruction – This surgery will be more complicated than usual because we CANNOT use my patellar tendon to rebuild the ACL, as is the common practice. My patellar tendon was damaged as a result of the physical therapy delay after the first meniscal allograft procedure, performed by Dr. 1. Tissue from a cadaver will be necessary and will add considerably to the risks and expense of the surgery and detract, again, from the chances for a successful outcome.
This visit with Dr. 2 was not covered by my insurance. $$$$$$$$$$$$$$ ($1,200)
We learned that my insurance also would not cover any surgery performed by Dr. 2.
Dr. 2 said that it was imperative that he perform the first step, the arthroscopic debridement, but he suggested that I have Dr. 1 do the osteotomy after that. He encouraged me to go back to Dr. 1 and assured me that Dr. 1 is a good surgeon. Dr. 2 is THE national expert on meniscus transplantation and the only way he would do my eventual transplantation procedure was if he did this first step himself to see what he had to work with. A meniscus transplant is a necessity for me if I am to avoid a knee replacement at this time, and I am too young for that just yet.
May 2004 – Surgery # 5 – Arthroscopic debridement, performed by Dr. 2 at ________, Cincinnati, OH, PAID FOR OUT OF POCKET!!! (~$10,000, not including travel expenses)
Surgery details:
Dr. 2 found that my articular is 50% worn away, meaning that I am not a candidate for any procedures to repair articular cartilage. I have and always will have osteoarthritis of my left knee.
He removed an extremely large amount of scar tissue from under my patella.
He found that my ACL is partially torn and completely stretched out, similar to old elastic. He explained that it MUST be repaired.
What was left of the meniscus was folded over on itself and moving around in the joint space.
The recovery:
Uneventful, but the sharp pains continued.
June 2004 – Saw Dr. 1 for a post surgical follow up and to discuss the osteotomy. Dr. 1 said that he could perform the osteotomy six weeks after the surgery that Dr. Noyes had done. X-rays were taken and plans were made. Wanting to get such a painful event behind me, I went ahead and scheduled the procedure. Dr. 1 repeatedly warned me that the surgery would be painful, but said that I would only be nonweightbearing for 6 weeks. I would have 1 small plate and would not need a cast. He said I would stay in the hospital for one night following surgery.
July 2004 – Surgery # 6 – Opening Wedge Distal Femoral Osteotomy, performed by Dr. 1 at ____________.
Surgical details:
During the surgery the sawed fracture was accidentally extended all the way through my femur.
An extra, unexpected incision was made in my inner thigh area and 2 staples were placed in the medial (inside) aspect of my femur to try to stabilize the fracture.
Needless to say, this would add considerably to the pain and the healing time.
AGAIN I was neglected upon arriving in the hospital. None of the medical personnel knew who I was. They had no orders for me and I laid in horrific pain and waited for help for over an hour. The horrors of my hospital were numerous. I had to beg to stay 2 nights. I was in way too much pain to go home. My family would not have been able to care for me. I feel they released me too early even after 2 nights. The pain was INTENSE!

TO BE CONTINUED....

The end...

The recovery:
In a nutshell, a nightmare. What recovery?
September 2004 – Sought a second opinion from Dr. 3, Richmond, VA.
Dr. 1 was once again telling me everything was "encouraging" and I was in such pain and so debilitated that I knew he was wrong. I had to seek a second opinion. Dr. 2 would not discuss my situation over the phone for liability reasons and I couldn't afford the time or the expense of another trip to Ohio. Dr. 3 came highly recommended from a local orthopedic surgeon who claimed that my knee was "too complicated" so he didn't feel comfortable dealing with me.
Dr. 1's office faxed some paperwork to me on request that was supposed to be my medical records that I planned to take with me to my appointment with Dr. Wolfe. They also faxed me the medical records of a 17 year old young man.
The faxed records were inaccurate.
They made no mention of the broken bone block, the patella issues, the femur fracture being extended all the way through the bone or any of the other complications I've experienced over the years.
The records referred to me as "Mr. B" and "he" frequently. I am female.
The records stated that I'd had a "stable ligamentous exam" when I hadn't had any examination of the ligaments in my knee, let alone one showing that the ligaments were stable. We know beyond a doubt that my knee would never have a "stable" outcome from any ligamentous exam.
The records stated that I was "happy with the outcome" of my surgery, when everyone involved knows that nothing could be further from the truth.
Because the medical records from Dr. 1's office were inaccurate on many accounts, I picked up copies of the actual surgical reports from VASC. I took those and my recent x-rays to Dr. 3's office on the day of my appointment.
Dr. 3 disclosed the following to me after reviewing the operative reports, my x-rays, and after taking even more x-rays:
My fracture had barely healed at all. He cautioned me to be very careful in everything that I do. He said that I must caution my physical therapists (I undergo physical therapy three times a week) not to put undo stress on my leg. He made me very aware of that my leg is very fragile and could completely rebreak if I'm not extremely careful. He said that this finding is NOT "encouraging" at all.
He said a great deal of my pain and immobility was being caused by a tremendous amount of fibrosis (scar tissue) in my knee joint. Dr. 3 explained that my knee's mobility would be severely limited and the pain in the joint itself would not lessen until I have the fibrous tissue surgically removed. ANOTHER SURGERY HAS BEEN ADDED TO THE LIST!
Dr. 3 says the fibrosis cannot be dealt with until the fracture is healed because the bone alignment could easily be disrupted at this time.
Dr. 3 confirmed my suspicion that my patella was again adhered to the underlying bone with scar tissue. My Patella Baja is worsening. My patellar tendon is shortening more. I am losing more range of motion. This can only be fixed surgically and I can't have the necessary surgery until the fracture is healed.
Dr. 3 is going to x-ray my leg again and fit me with a bone stimulator at my next appointment on October 20. Insurance companies will only cover the stimulator three months post surgery.
The present
I am in worse shape than ever, I've spent over $30,000 out of my own pocket, my quality of life is lower than I ever could have imagined it would be and everyone around me, especially my family, is affected by this. I believe a lot of this financial and emotional pain could have been avoided if Dr. 1 had recognized my ACL problems and my valgus deformity before recommending a surgery that I was not a good candidate for. It complicates matters that he's made at least 2 MAJOR mistakes while operating on me – the broken bone block and the extended femur fracture.
Here's what's going on now...
The pain of the surgery was UNBELIEVEABLE and is still unbearable.
I STILL cannot comfortably bear weight on my left leg. Every step causes INTENSE PAIN and most of the time I still use crutches or a wheelchair. Unassisted walking is limited to around the house for short periods. It has been three months since the procedure.
I am in pain ALL THE TIME. SEVERE PAIN! I can't sleep, can't rest comfortably, can't do my usual tasks around the house, can't care for my family...
I'm irritable with loved ones because I'm ALWAYS hurting.
I'm depressed and saddened because I will NEVER live the active lifestyle that I once did.
My marriage is suffering because of all of the stress. My husband has missed a lot of work caring for me and we thought I'd be fully functional and working myself by now. I can't even do the grocery shopping or cooking anymore, let alone cleaning, laundry, etc.
We have the added expenses of a cleaning service, daycare, a wheelchair and various other things because I am basically crippled.
I used to do freelance writing and decorative painting as a second source of income for the family and I've had to put those things on hold.
My leg is extremely swollen and unattractive.
I fear that I will never be able to play actively with my daughter, enjoy my horse and other pets, enjoy walks with my husband (one of our favorite pastimes before all of this).
When I can get to sleep, only one position works for me.
I have back and neck pain from sleeping in one position constantly and using crutches for months on end.

This story is so long and involved and the impact on my life so great that I am probably leaving details out. Oh yeah, I have a rotten case of gastritis from stress and NSAIDS. Dr. 1 had me taking up to 2400mg. of Ibuprofen daily. I underwent an endoscopy in order to diagnose that and now take Prevacid at $135 per refill!!!

Thank you to anyone who muddled through this whole story and extra thanks to any who can offer help/guidance. I am normally not the litigious sort, but...ggheeeeeeesh!

There isn't really anything anyone here can offer you. Your medical records require expert review to determine if you are a victim of bad medical practice or bad luck.

Contact a medical malpractice attorney. They will consult with you at no charge to evaluate your case for legal merit.

Update

Just a quick update - I've spoken with an attorney. He thinks I most likely have a strong case for medical malpractice and I'll be meeting with him in person next Thursday.

mrsf said:

Just a quick update - I've spoken with an attorney. He thinks I most likely have a strong case for medical malpractice and I'll be meeting with him in person next Thursday.

Click to expand...

I wrote this before you had contacted an Attorney.

MN.

** I am so sorry that you have had all these problems and at such a
young age.* I must say before I get started here that your husband
must be an angel from above, as some guys would have already
vamoosed.
He must love you very much and that means that you are Blessed.
I had a similar thing happen to me with the medical profession and
another that just about took my life. Because I wished later that I had
pursued the first one into court I will give you my advice. I believe the
statute of limitations ran out for me. (The amount of time you have to
file suit.)
1. If I were you I would do this for the simple reason that you
have an entire lifetime of pain and things you will not be able to do AND/
OR Enjoy doing let alone the Normal Day-to-Day Necessary things that
Need to be done for you and your family from now on. The next 40+ years.
That is a LONG TIME. -------------------------
2. I suggest you do NOT go back to see Doctor 1. I don't know what kind
of coverage you have. Managed Care, HMO or what? I had an HMO gatekeeper that would not send me for tests or specialized care.* I fired 2 MD's and 2 Gastroenterologists and now have an Internal Medicine Special-
ist as my Primary Physician. By the time I received the last 2 diagnoses I
had already lost all of my teeth. The 2 diagnoses before that almost cost
me my life as a Gastro lied (minimized) about my condition.
1 of the 4 doctors was also my husband's doctor, which is why I no longer
have my husband. Because of a lack of Care on the part of the physician,
he has passed away at the age of retirement, 62. His Diabetes was never
addressed OR treated by this physician, or much else he had going on.
3. It is good that you got copies of your medical records. May I sugest that
you also request in writing (from the Doctor's you have seen out-of-town)
to also have All records, Doctor reports, x-ray reports and any OTHER
reports sent to you. You can call the clinic(s) and Hospital's you have been to & ask for the Records Dept. Ask them to send you a Release of Medical
Records Form & ask them how many pages there are & if there is a charge, how much?* When you fill them out just write in that they are for "SELF"***
An attorney will charge you for these & for their time in retrieving them.
Local clinics and Hospitals you can visit & they may give them to you at
no charge, but don't bet on it. I get copies of mine every few months as I learned my lesson when I had to get my Dad's after his death, they are not cheap. .92 per page in 1999. Had I Not gotten mine, I would not have
known what was being written in them was a whole different story from what I was being told. (Like You)
4. Even if you think (and we all want to) that things will get better, "it will
just take more time to heal," etc. Please pursue an attorney in this matter.
You may have to speak to a few and may need to go see more than 1 till
you are comfortable with one. (Only leave a copy of your records with
an attorney after your case has been started.) 1 copy may just dis-
appear somehow. (That would be my kind of luck.) Then too if you have
to get another Attorney you will still have a copy.
* Once things are damaged it doesn't matter what is done to attempt to
repair the damage, one fact will always remain. The damaged part will
NEVER work the same again. There have been times that a shoulder I had
repaired in 1990 was working pretty good, but I still have limited range of
motion and in the spring of 2004 I went to pull some grapevines out of my
front yard and felt it stretch pretty not good. Quit doing that immediately.
This is 14 years later!!
5. An Attorney will listen to see if they think you have a case over the
telephone. Remember though, while this part is free to you, once they
take your case, every call, even to you will come off the top of anything
recovered from the malpractice monies. I had an attorney stretch out con-
versations, saying a whole lot of nothing, repeating stuff already said, and
another charge an hour for a 20 minute phone call. SO.. keep track of all
contact and visit lengths in case of later dispute you can send a copy of
it to them, unless you like being overcharged. Know and write down exactly
how much an hour they charge and how much their paralegal charges So
You Know and keep this all in a FILE.
6. You are too young to have worked to be able to file for disability but
according to your household income/assets you may be eligible for SSI.
Have you applied? You can call the Social Security Offices to send you
forms for it at 1-800-772-1213 or check them out at http/www.socialsecurity.gov/
click on More Disability Information and then scroll down to Supplemental Security Income. Would Medicaid be of help to you? I don't know your
situation. I truly hope something here helps you. God Bless ~~ Mary~~

Thank You!

Mary,
Thank you so much for that heartfelt and helpful reply! I am truly grateful for the information you shared and your sympathetic nature. I am so terribly sorry that you lost your husband way too soon. And you're right. Mine is an angel sent from God. He is very down lately. I was just x-rayed again and still NO healing of my femur whatsoever.
I will do all of the things you suggested and I'm headed over to the SS website now. THANK YOU! THANK YOU!
M