Case details

Patient: Immediate fasciotomy should have been performed

SUMMARY

$300000

Amount

Verdict-Mixed

Result type

Not present

Ruling
KEYWORDS
compartment syndrome, decreased range of motion, foot, foot drop, heel
FACTS
On April 7, 2009, plaintiff Eric Ikonne, 21, a defensive lineman for San Diego State, collapsed on the field during a team workout and was admitted to Sharp Memorial Hospital in San Diego, where he was placed under the care of Dr. Kenneth Roth. Ikonne was treated for rhabdomyolysis, which is the breakdown of muscle fibers that can be caused by any condition that damages skeletal muscle, especially injury. The condition leads to the release of muscle fiber contents into the bloodstream, which is harmful to the kidney and often causes kidney damage. As a result, Ikonne was treated for kidney problems by a nephrologist, who treated him with an increased amount of hydration to the kidneys to wash out the toxic enzymes, until April 14. Ikonne then returned to school on April 22, but he could not lift his legs to ambulate. The school subsequently referred him to an orthopedic surgeon, who diagnosed him with bilateral compartment syndrome. Ikonne sued Roth, his medical office and the hospital’s operator, Sharp Healthcare. He alleged that the defendants failed to appropriately treat his condition and that this failure constituted medical malpractice. Plaintiff’s counsel noted that Ikonne had the sickle cell trait, which the coaching staff was not aware of, and that those with this sickle cell trait are believed to be at increased risk for developing rhabdomyolysis and compartment syndrome, which can lead to permanent muscle damage. Thus, plaintiff’s counsel contended that though Roth appropriately treated Ikonne for the kidney problems, he did not treat Ikonne properly for the complications of the condition, including compartment syndrome. Counsel argued that Roth should have performed tests on Ikonne’s legs and consulted with an orthopedic surgeon. Counsel further argued that a fasciotomy could have then been immediately performed, which would have released pressure on the legs and would have relieved the nerve injury completely. In addition, plaintiff’s counsel contended that the hospital failed to notify Roth about Ikonne’s difficulty walking. The plaintiff’s orthopedic surgeon testified that the standard of care required an immediate fasciotomy within 24 to 48 hours. Thus, the expert opined that had an orthopedic surgeon been brought in, Ikonne would not have suffered any residuals. The plaintiff’s expert hospitalist testified that the failures of Roth and the nurses to diagnose, treat and refer Ikonne to an orthopedic surgeon were below the standard of care. Roth claimed that compartment syndrome is a very rare occurrence, and that he treated Ikonne properly and within the standard of care. Roth’s expert in orthopedic surgery opined that Ikonne had an excellent recovery and that a fasciotomy would not have made a difference. Sharp Healthcare claimed that it treated Ikonne well and that its nurses did everything they were told to do. Thus, it claimed that the hospital’s staff acted within the standard of care. The hospital’s expert in emergency room medicine opined that the hospital did everything proper and that there were no standard of care issues., Ikonne spent a week in the hospital, but had trouble walking upon his release as a result of bilateral compartment syndrome. He claimed he now suffers from nerve damage and foot drop in both legs as a result of his treatment at the hospital. After being referred to an orthopedic surgeon, Ikonne wore orthotics for five months and started rehabilitation, which included one year of physical therapy. Ikonne previously started played in 10 football games in 2008 and started in two of them. However, after developing compartment syndrome, he never played football again. Ikonne, now 24, is pursuing a master’s degree at the University of Texas, but he claimed he still cannot lift the big toe on his right foot and continues to have residual pain as a result of the compartment syndrome.
COURT
Superior Court of San Diego County, San Diego, CA

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