Case details

Loosening component a known risk of knee surgery: defense





Result type

Not present

pain, right knee
On Aug. 29, 2012, plaintiff Michael Murphy, 58, a recently retired automotive technician, underwent a total right knee replacement by Dr. Paramjeet Gill, an orthopedic surgeon. The surgery was without apparent complications. However, in the late spring 2013, Murphy began to experience pain in his right knee. He was subsequently re-evaluated in the early summer, and it was determined that there was a possible loosening of the femoral component of the subject knee replacement. As a result, a knee replacement revision was scheduled for Sept. 16, 2013. During the September 2013 revision surgery, Gill noted that the cement on the femoral side did not seem to penetrate Murphy’s femur. As a result, the femoral component was replaced with a longer prosthesis that was anchored higher up in the femur bone. The revision surgery was without complication, and Murphy seemed to do well in the months after the surgery. However, in the spring of 2014, Murphy again complained of pain in his right knee. Murphy sued Gill, alleging that Gill failed to properly perform the initial knee replacement and failed to diagnose his condition after the second surgery. Murphy also alleged that Gill’s failures constituted medical malpractice. Murphy claimed that Gill failed to adequately cement the femoral component during the original August 2012 surgery and that this failure was a breach of the standard of care and the reason for the revision surgery a year later. He also claimed that Gill misread X-rays taken in the early spring of 2014, which Murphy claimed revealed a loosening of the femoral component. The plaintiff’s expert orthopedic surgeon opined that the loosening of the cement was caused by improper mixing at the time of the first surgery. He also opined that Gill should have realized the prosthesis was loosening sooner and performed the revision surgery sooner. Gill alleged he met the standard of care during both surgeries. He claimed that he adequately cemented the femoral component during the first surgery, but that the loosening of the components was a rare, but well-known, risk in knee replacement surgery. Gill also claimed that the X-rays taken in the spring of 2014, coupled with Murphy’s reports about his condition at that time, did not suggest a need for another replacement surgery at that time. He alleged that the X-ray findings were equivocal and that Murphy reported that he was working two jobs at 16 hours per day, so it seemed that Murphy was doing well under the circumstances. The defense’s expert orthopedic surgeon agreed with Gill and opined that in March 2014, surgery was not indicated. Defense argued that the March 2014 X-ray films did not reveal any dramatic changes. In addition, counsel noted that Murphy was seen by other orthopedic surgeons, all of whom did not recommend any additional surgery and that one subsequent treating physician took X-rays in 2016 that revealed the knee replacement components were all in good position., Murphy claimed he suffers from pain to his right knee as a result of a loosening of the femoral component following the second surgery. He claimed that he can walk without assistance, but that his ability to ambulate has been curtailed from his pre-surgery condition. He alleged that as a result, he can no longer enjoy the activities of daily living that he was once accustomed. Murphy initially claimed he could no longer perform his vocation as an automotive mechanic, but later dropped his wage-loss claim. Murphy has not undergone any additional repair on his right knee, and his current, treating doctor did not recommend any surgery. The plaintiff’s life care planning expert opined that Murphy would need extensive care for the rest of his life. Thus, Murphy sought recovery of approximately $2 million in medical costs, the bulk of which was set forth in a life care plan prepared by the plaintiff’s expert life care planner. Defense counsel argued that Murphy was in better condition after the knee replacement surgeries than he was when he arrived at Gill’s office in 2012. Counsel also noted that Murphy claimed that medications helped his knee and that Murphy’s wife testified that her husband was taking fewer medications than he used to take.
Superior Court of Fresno County, Fresno, CA

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