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Author Topic: SURGICAL DISASTER  (Read 5936 times)

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Offline dave t

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SURGICAL DISASTER
« on: August 07, 2008, 07:17:35 PM »
After going in for a half knee replacement that would supposedly last around an hour and a half, i came round after 4 and a half hours. I was told my knee was worse than expected and that a full knee replacement was carried out.

When the nurses changed shifts later i heard them saying i'd had a full knee replacement and surgery to mend a severed medial knee ligament.

When i questioned the surgeon the next morning as to what had happened to my medial ligament he nonchalantly said he had accidently severed the ligament at the start of the half knee op so had to repair that and carry out the full knee op from the other side and this was the first time in 30 years he'd ever made this mistake.

The physio grimmaced when i told him the state of my knee and the fact that the ligament was severed and not torn was very serious when it comes to the long term strength of the knee. Plus the fact that the 2 operrations overlap in healing time was a problem.

I am needless to say quite distraught at the minute after waiting so long for this operation, and i really need to know the long term prognosis and the level of seriosness involved with a severed medial ligament.

I was assured pre op that a half knee replacement if not satisfactory still left the possibility of a full knee op to correct anything, that cushion has now gone i was also told i'd be walking un aided after 2 weeks, i now have no idea for how long i will be layed up. Needless to say i will be takiing legal action against the surgeon and any advice people have on that front is very welcome.

thank you

Offline maryc

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Re: SURGICAL DISASTER
« Reply #1 on: August 07, 2008, 07:30:54 PM »
Sorry about all this.  I wish I could offer something else besides healing rays for a speedy recovery.
8/4/07 fell
8/5 diagnosed TPF
8/6 surgery plate and 6 screws
8/12 out of hospital NWM
8/21 staples removed
9/18 OS appt - WBAT with crutches
10/10 - WBAT with cane
10/27 - back to work w/cane
12/26 - no cane, slight limp when tired
1/25/08 - released from PT, no limp
2/3/09 - Released by OS

Offline MartinsGirl

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Re: SURGICAL DISASTER
« Reply #2 on: August 07, 2008, 10:09:31 PM »
I'm so sorry Dave,

Like Mary, I can't offer any advice or help. I'm just very sorry and will have you in my thoughts.  I also think you should re-post in the "Emergency-crisis room thread". that's where you go to post about surgery complications, mistakes, etc. I'm sure a LOT more people will see it there, okay? Right now you're in the general question room. WHat you're going through is definitely more of an emergency/complication. Post here:

http://www.kneeguru.co.uk/KNEEtalk/index.php?board=5.0

Good luck. So sorry.....
~Nevella
-July '07-soccer injury
- microfracture of the tibial plateau
- arthroscopy in Oct. '07 (remove torn cartilage and repair microfracture)
-developed AF but beat it (avoided surgery)
[img width=200 height=136]http://dl6.glitter-graphics.net/pub/504/504056crsfyif

Offline FormerlyActive

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Re: SURGICAL DISASTER
« Reply #3 on: August 08, 2008, 05:36:21 AM »
Hi
So sorry to hear your story. First thing I would do is write down everything you remember the nurses said also the doctor and the dates, times, all to the best of your recollection. Type it up and sign it.
Next get a copy of the surgical report and if they made a tape, a copy of the tape.
I would try to find out if something like this is fairly common, if it is his first one in 30 years I would guess not.
I would file the appropriate documentation with the hospital's ombudsman or whatever they are called where you live of the incident.
You have some choices and you should find out what they are. In some states in US now if they make a major mistake they won't bill your insurance or it will be a reduced bill. I'm sure its more expensive for a full than a partial.
Good luck and let us know.   
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together

Offline jathib

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Re: SURGICAL DISASTER
« Reply #4 on: August 08, 2008, 01:38:01 PM »
I'm kind of confused as to why he even repaired the ligament. Last I knew, when they did a total replacement they removed all four ligaments anyway. It might have been an issue if you had a partial replacement because they don't cut any of the ligaments for that.

Offline ATsoccergirl

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Re: SURGICAL DISASTER
« Reply #5 on: August 08, 2008, 02:27:56 PM »
Most surgeons will retain all four ligaments, although some less skilled surgeons will remove the posterior cruciate ligament.  In order for a total knee replacement to be sucessfull the four knee ligaments must be balanced to allow for proper biomechanics of the joint.  This is the hardest part of the surgery.  From the biomechanical changes associated with osteoarthritis the ligaments can become contracted.  Balancing the ligaments involves releasing the contractions and attempting to restore the knee to it's pre-arthritic level of alignment.  Without proper balancing the knee replacement can feel, in some cases, too tight, or more commonly, too loose.  The resulting instability, and looseness feeling, is the most common cause for a revision arthroplasty.   

The removal of the PCL is more of a convience factor for the surgeon, as it is technically more demanding to properly balance the PCL than any of the other ligaments.  Although study after study has shown that patients have a much better outcome with a drastically lower rate of revision if the PCL is retained and balanced. 
1999 LR, 2002 ACL/PLC recon, reversal of LR, 2004 ACL revision, 2006 Car accident torn PCL and small fractures resulting in bone chips in my knee.  Torn MCL 3 times.  Wicked screws under IT band and Pes Anserine.  June 2008-Hip Arthroscopy.

Offline mark1e

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Re: SURGICAL DISASTER
« Reply #6 on: August 10, 2008, 12:34:52 PM »
Amazing. Surgeon makes a major mistake, then proceeds with a major and unplanned surgery and nobody screams bloody murder?
I mean, if the surgeon went from half-knee to total knee replacement he achieved several important factual differences:
  • he performed an operation that will require longer time to recover from, resulting in more discomfort, trauma and worse health outcome for the patient
  • he destroyed various natural tissues, limiting patient's options in the future and introducing additional risks
I think that the patient should press charges against the surgeon. It's much more than only which insurance covers the cost of TKR operation: it's both the physical and physiological damages done to the patient, plus the cost of the future risk (increased insurance premium, treatment costs, lost income due to future problems, pain & suffering).

Offline UK Girl !

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Re: SURGICAL DISASTER
« Reply #7 on: August 10, 2008, 01:51:33 PM »
bravo to your surgeon I say !

i would have been gutted if he had opened me up and then sewn it all up again  to wake me to say i needed a total and would reschedule it another time when i had signed the relevant forms - did he discuss the possibility of a tkr?  was this ligament going to be removed for the pkr but needed for the tkr and subsequently replaced. I had my ligaments removed for my tkr. All depends on the prosthesis used - he may not have had the right one for how he would have like to have proceded and had to change plan. - you need to ask him !

I absolutely detest all these shouts of sueing the surgeon - ya think they do these things on purpose - why the hell would it be in their interest to mess up your surgery and their reputation !

I think you have to ask your surgeon these questions and take it from there and certainly dont waste your life worrying about what you would have liked to have been a pkr cos u got a whole new one which it appears is often better than having stages  of replacement.

Good luck with it - and remember that your OS has a LOT more knowledg of what he is doing than the physio - you wouldnt let your physio do the op would you !
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline mark1e

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Re: SURGICAL DISASTER
« Reply #8 on: August 10, 2008, 02:53:51 PM »
UK Girl: If I were to accidentally crash my car into yours, would you sue me for damages?
Starting legal action is OK if any kind damage is done. That's how conflicts are resolved.

Offline jathib

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Re: SURGICAL DISASTER
« Reply #9 on: August 10, 2008, 02:57:53 PM »
I think that the patient should press charges against the surgeon. It's much more than only which insurance covers the cost of TKR operation: it's both the physical and physiological damages done to the patient, plus the cost of the future risk (increased insurance premium, treatment costs, lost income due to future problems, pain & suffering).

Press charges? Geesh, if surgeons got arrested every time surgery didn't go as planned none of them would ever do surgery. There are risks associated with every surgery. We all sign a consent form beforehand and some of us even read them. I knew there could be a possibility of a TKR when I went in to my PKR. According to the original post the TKR was not carried out because a mistake was made but rather because the knee was far worse off than expected. This is not the surgeon's fault. I'm with UK Girl in that I'd be very upset if I came out of surgery only to find out nothing was done. I've come out of surgery on more than one occasion with more than I bargained for because I had more damage to my joint than expected. That is always a possibility going in and it's something we all should prepare ourselves for ahead of time. If you're not psychologically stable enough to accept the possibility that things may not go as planned then you shouldn't have surgery.

I also hate when someone's first reaction is to sue the doctor because things didn't go perfectly or because the doctor didn't tell them about the possibility of 'x' happening. They can't cover every possibility. We all go in knowing we could die on the table yet we still proceed.

Offline UK Girl !

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Re: SURGICAL DISASTER
« Reply #10 on: August 10, 2008, 03:48:23 PM »
Hear Hear Jathib !

Thing is also - if a tkr was needed instead of pkr why would you sue !??!  I would be thanking my surgeon for sure !
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline Nettan

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Re: SURGICAL DISASTER
« Reply #11 on: August 10, 2008, 05:33:37 PM »
Everyone can make a mistake. But if mistakes are done, they should be reported by the surgeon that made the mistake.
Have you reported what happened or has the surgeon done that ?
In our system if a mistake is done you can get some payment for the damage or the suffering you have to go through.
Check that out before making legal action and have to pay out of your own pocket.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline UK Girl !

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Re: SURGICAL DISASTER
« Reply #12 on: August 10, 2008, 06:14:32 PM »
well all i can say is that is my opinion to which I am entitled just as anyone else is ! and anyone who doesnt like it doesnt have to take any notice ! We are all here to help each other - so the more angles we can get on things the better !

I dont know who you are referring to Luckygrandma6 referring to having peoples threads removed  and I understand you have had and are having a tough time of it, but I think that Dave T's case is somewhat different to yours.

Dave - what is the prognosis for your recovery - I assume you are braced and on crutches , doing controlled exercises to build up the quads - which is something that needs a lot of work for TKR as well.


anj
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)

Offline jathib

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Re: SURGICAL DISASTER
« Reply #13 on: August 10, 2008, 06:46:45 PM »
I disagree wholeheartidly that no matter how much a doctor screws up your life they should get away with it. You go into surgery trusting your doctor and what he tells you.
You'll have to point me to where anyone has said doctors should get away with screwing up your life. Nobody has even come close to suggesting that. Doctors are human, they make mistakes, even the great ones. Sounds like this doctor even admitted such. I don't think Dave's life has been screwed up at all. Rather he's going to have a longer rehab than expected. And he has a TKR instead of a PKR. That was going to happen anyway. Not the doctor's fault and not anywhere near close to malpractice. He would have had a TKR even if the doctor hadn't accidentally severed a ligament.

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In my case it wasn't what the surgeon did but what he did not do that has left me crippled.
Your case is not Dave's. Not even close.

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Why do you think doctors have malpractice insurance. To cover their butts that's why.
Hell yeah, they're covering their butts. And who could blame them when people are so quick to file lawsuits in this country. Doctors can be sued if a patient has an allergic reaction to medication even if the doctor was never told about it and even if the patient didn't know they were allergic to the medication. I'm sure you have liability insurance for your automobile in case you slam into someone. I know I have it even though, in 34 years of driving, I've never caused an accident. All doctors have malpractice insurance, even the great ones.

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There are bad doctors out there that need to be held accountable and it is too bad that the good ones have to suffer in the process, but that is life. Good people suffer becauseof bad people's mistakes.
Making a mistake does not make someone a bad person. It makes them human. Making a mistake does not make a doctor a bad person any more than you slamming your car into someone makes you a bad person.

Quote
I thnk the same person that screwed up my thread is trying to screw up this one. My advice would be to write to the Moderator and have them removed from your thread. We are here to help each other and we don't need people putting poisones venom into the mix.
I'm pretty sure you're talking about me. Since when is disagreeing equal to trying to screw up a thread and putting poisonous venom into the mix? Supporting people is great, but supporting them unconditionally is counterproductive.

Offline subail

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Re: SURGICAL DISASTER
« Reply #14 on: August 10, 2008, 08:34:57 PM »
All very well said, Jathib...you said quite eloquently what I wanted to say....
Dislocation of left patella and as a result left patellar tendon rupture in the medial section/torn at both ends.
3 Previous surgeries-semitendiosis tenodesis
Reconstruction surgery left knee October 10 '07
TKR right knee May 25 '10.....successful!
Limited ROM/TKR left knee May 25 2015...successful.

Offline TIBBAR

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Re: SURGICAL DISASTER
« Reply #15 on: August 10, 2008, 10:42:40 PM »
I have been around long enough on this board to have seen poisonous posts appear. As I see it in the first few posts everyone was just expressing an opinion. No poison there till........ No one was pointing fingers of making fun of another poster till.......... I am not sure who was the supposed  poison one was?  Deleting a persons post because they don't agree with the poster would be defeting the purpose of the board. When one starts pointing fingers or making fun of  another poster that and that only should be looked at. That just wasn't happening in the beginning of this thread till........
As for the TKR vs PKR ( or anything else that was to be done) I just bet that the poster and his OS had already discussed that possibility. I even bet it was on the papers that were signed pre op. A TKR might take place.
The severed tendon was by far a very unfortunate event. Like some said tho some OS would even remove them instead of bothering with them. I very much understand that it has caused a lot of pain and other things. In a court of law the TKR thing would be thrown out as that probably was signed off on buy the patient. The only thing left to prosecute would be the severed tendon and I bet it would be hard to impossible to find anyone to take that to court. As bad as it was! I agree with Nettan that it should be first be brought up before the Hospital Review Board or the DR's Review board. I bet that that would bring more to the poster than a court of law. It really does have to be a blatant error on the dr's part than a mistake to get anything from the courts.
As for the doc. I give him a few points for admitting a mistake. Almost all the time the doc will put the patient off and tell them there is nothing wrong and the pain is in their head rather than admit he errored. If you search the boards here you will find numerous posters who only find out that their knee is trashed by their 2nd or 3td opinions and then so much time has gone by that the fix is complicated or nonexistent. At least this posted knows what is causing the pain right off.
Everyone is different.... no two ops or problems are exactly the same.........lets be a little more tolerant of each other and not jump on someone who has a differing opinion.        TIBBAR

Offline subail

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Re: SURGICAL DISASTER
« Reply #16 on: August 10, 2008, 10:50:54 PM »
You make some very intriguing statements. Since I don't agree with you I must be among the evil people out there. Well, I have an opinion as well. I don't see that having a dissenting opinion is 'playing God'...I wouldn't know how to do that, Lucky...

Doctors are human. My injury was not diagnosed for 10 months which left me frustrated and depressed for awhile. It was also quite debilitating. Much more damage occurred as a result. However, the doctor who initially misdiagnosed the problem simply did not have the skills to solve my problem. I am not about to sue him for lack of knowledge! It just took me some time and a great deal of patience to find the right surgeon.

You have my empathy for the problems you have suffered. That does not mean I will patronize you by agreeing with you all the time. Nor will I be condescending and nasty....

And no, I am not married to a doctor either.....
Dislocation of left patella and as a result left patellar tendon rupture in the medial section/torn at both ends.
3 Previous surgeries-semitendiosis tenodesis
Reconstruction surgery left knee October 10 '07
TKR right knee May 25 '10.....successful!
Limited ROM/TKR left knee May 25 2015...successful.

Gary064

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Re: SURGICAL DISASTER
« Reply #17 on: August 10, 2008, 11:10:41 PM »
I was misdiagnosed for 14 years but never even thought about taking action against the doctor.

The thing i have always liked about these boards is the freedom of speech, everyones opinions, and the help and guidance we all give each other to help each other through our darkest times or maybe just advice.

Lets keep it friendly, we are all friends on here..... I hope!!

Gary

Offline FormerlyActive

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Re: SURGICAL DISASTER
« Reply #18 on: August 11, 2008, 01:19:50 AM »
I wasn't necessarily suggesting legal action, but when things are different than planned, a starting step is always to get all the facts, and get them as soon after the incident as possible. The longer it lapses the hard it is to remember things you were told.

Facts can lead to understanding, better understanding of ones condition at least. Its always so hard when you hear things verbally as we all hear them differently. There can be such a communication challenge between patients and doctors. I myself have this, I'm tongue tied around them, and intimidated, then forget my most critical questions.  The surgical report will say what they did and what he found.

Its funny here in the US there have been alot of articles about how if the hospital or doctor apologizes then there is less likelihood of lawsuit. So the latest thing is, they are apologizing for major mistakes.

Here in Mpls about a month ago a patient had the wrong (non cancerous) kidney removed at one of the major, well respected hospitals.
I had a minor Obgyn procedure last Friday not even in hospital in doctor office
and they told me they have a new protocol where they go over the risks and bunch of other stuff (what happens if you don't have the procedure) and then they verify again your name and birthday and what you are having done.
Spoke with someone at a picnic today who told me his brother had a knee replacement and the wrong type of knee was put in (apparently there are some for people with the patella or not).
I haven't had surgery in 19 years on my knee and now really wish I had all those records (I do have my surgical tape thank God).

I'm wishing the best for you. Let us know how you go.
3/82 - Medial Synovial Plica removal both knees
9/89 - Lateral Release both knees
3/08 - Reinjury left knee hiking Asia Pac
5/08 - Miserable Malalignment diagnosis
4/08 - 9/08 Five doctors diff. opinions
7/08 - 02/09 - In PT, no chg.
4/09 - Dr. 6 opinion femur & tibia derotation together

Offline Nettan

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Re: SURGICAL DISASTER
« Reply #19 on: August 11, 2008, 07:12:47 AM »
Luckygrandma..maybe noone really knoews what's wrong with you ??
That happened to me before got my RSD/CRPS confirmed.
I think we should go back to the mainreason in this thread and try to help this person instead of accusing each other.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline Nettan

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Re: SURGICAL DISASTER
« Reply #20 on: August 11, 2008, 01:50:51 PM »
Luckygrandma, I haven't said that you haven't something going on with your knee..they just haven't figured out what is going on with your knee. And if one doc doesn't know, it's his/her duty to send you somewhere else.
I have seen that program and know what you talk about.
Surgery 6 times left knee torn meniscus, RSDS,chondromalacia, nervdamage cause constant nervpain,chronic inflamm.
Spinaldamage wheeler 100%.
Right knee damaged aug-06, use brace surgery 4/9-07.LCL tear.

Offline luckygrandma6

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Re: SURGICAL DISASTER
« Reply #21 on: August 11, 2008, 04:56:34 PM »
Thanks Nettan. That is what has me fruistrated. First the doctor has to admit he hasn't a clue, but this doc has been playing guessing games with me. I have much more respect for  a doctor that either admits his mistake or scratches his head and says I really don't know.
I just got back from getting my knee brace repaired and the man that did this at Orthodics Posthesis said if he wasn't told he would thank I didn't have a knee cap the way my knee is flat.I told him I've never been happy with the looks of it. It does not look like I have a knee cap but PT says I do and the doc insisted he put one in, but he even thinks it could be that they didn't do my knee cap right. Nevertheless I wil find out. Rest assured.
We haven't forgotten you Dave. I only used my situation to let you know that you are not alone in docs screwing up. I will contiinue talking about my problem on my thread so you can catch me there
Right knee (arthroscopy) 2004
Right knee (PKR)) April 5, 2005
Right elbow (Bursectomy)1998
TRKR 2006 Failed)
Left knee (arthroscopy)
Left knee (arthroscopy)
THR 1992
2 back surgeries (Feb 2007 & March 2007
Right knee spacer exchange (Failed) 2008
TRK (Hinged Prosthesis) Jan 2009

Offline bella287

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Re: SURGICAL DISASTER
« Reply #22 on: August 11, 2008, 10:18:57 PM »
One other thing to point out is most lawyers wont take orth cases because of the inherent problems that could arise once they open you up. I was thought to have a torn meniscus and once in found a 6cm lesion. My ex os did not want to do a tkr because of my age so suggested carticle implant instead. well it turns out carticle implant is not indicted for arthritis damage and the dr,s office did not order a cpm because they assumed insurence would,nt cover it. according to genzyme the makers of carticle the cpm is 1 of the most necessary parts of rehab from the carticle implant. I have talked to lawyers about the carticle surgery even being done and was asked if i signed the forms and i said yes but i didnt know that carticle implant didnt work well in arthritis patients. not to mention the fact that I didnt get the cpm because of the dr,s office neglect. I would think I had a case. so here i am going on my 7th surgery(with a new os thank god) and hoping my new os is much more knowledgable. So I guess what i am saying even with clear neglect most attorney,s wont even talk to us so we just keep pushing on and hoping to finally find a dr that can really help.  good luck to you all and wish me luck on the 20th    bella
11/06 meniscus repair, microfracture, 3/7/07 medial femoral chrondyle carticle implant. 8/27/07 arthroscope dedride overgrowth, 1/14/08 T.K.R., Current R.O.M. extension 9, flexion 90 5/5/08 M.u.a. 8/20/08 tkr revision, loose implant,patalla to large and heavy scar tissue removed

fatcats6

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Re: SURGICAL DISASTER
« Reply #23 on: August 11, 2008, 11:05:35 PM »
I would like to add my thoughts...you have a challenge ahead of you as you recovery from this unexpected result.  Did you sign a consent form agreeing to a total replacement as well as a partial, they usually get you to agree to Plan B.  All I wanted to say is that taking legal action isn't something to take lightly, there will be a heavy emotional and financial toll on you and you may not get the outcome you want and this can lead to alot of anger and frustration that is compounded by your physical condition. You will also have to hang on to the hurt for years as you go through the legal system, not good for your emotional state.  It's human nature to look for someone or something to blame as we struggle to understand a particular circumstance.  When I fell, I yelled at the Council for having an uneven footpath, I yelled at the stupid tree for dropping so much stupid blossom after a heavy rain, I yelled at my stupid shoes for not having enough grip, I yelled at my stupid self for not taking more care....in the end, all that yelling didn't help and neither would have money.  I'm sure everyone would agree that given the chance to give back the money and have no injury, we would all pick the no injury option.  Surgeon's make mistakes, they are after all human beings, or at least do a reasonable impression of being one, people skills are abit thin on the ground:)  Mistakes = insurance policy coverage, just like our car insurance, you hope you don't need it but you can't afford not to have it.  Investigate your options, write everything down, make sure you get the nurses names and the date, time you heard the conversation and also the conversation you had with your Surgeon post operatively.  If you do go the legal route, the best advice I can give you is detatch yourself emotionally and realise, it was not personal as far as the Surgeon is concerned, this is his job, it's how he earns money and he didn't intend to hurt you more than you were.  I admire and respect surgeons, for the most part they are amazingly skilled people, but when things go wrong, we have systems in place to deal with it.  There's nothing wrong in using those and that's the key, you suing the Surgeon is not personal on your part, it's being compensated for a human error that has had a negative impact on your life.  I wish things didn't have to become so hostile but it seems no matter what, it does.  There is no right or wrong answer to your dilema, only you know in your heart what you want to do, either way, it's a tough road ahead and I wish you nothing but good things.


Offline plantgeek58

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Re: SURGICAL DISASTER
« Reply #24 on: August 12, 2008, 02:39:47 AM »
Dave,
I can understand your frustration and anger at the circumstances in which you find yourself, but I have to say that I don't honestly think you would have a chance to win a legal case against the surgeon, for a couple of reasons. First of all, in making the decision to perform a TKR, the surgeon was acting in your best interest, because he felt that you wouldn't benefit from the partial and he didn't want you to have to go through all that pain and rehab only to have to come back in a year or two for another surgery. Unfortunately, it is a fact of surgery that you don't always have an accurate idea what you will find ahead of time and surgeons have to use their best judgment as to what will be the best option for the patient. It would have been unscrupulous of your OS to go ahead with the partial when your knee was in need of the total. In that respect, he made the most responsible decision he could.
The severed tendon is another issue entirely, but again I think it would be a difficult legal case to win. It was a major mistake, but the surgeon was able to repair it. Unless you end up with complications or a permanent disability because of it, I don't think a jury would find for you and you could be putting yourself through a long, drawn out process for nothing. I could be wrong, but that's my two cents. I also think it was commendable of your OS to admit his mistake and I think you should talk more to him about all of this. Let him know how you're feeling, especially your fears and worries, and see what he has to say before you proceed to legal action.
Terre
RK 7/04 part. m. menisc., plica resect., MF
    3/05 part. m. menisc., open OATS
    1/07 part l. menisc., MF, patellar chondroplasty
    9/08 MF
LK 11/04 & 8/06 part m. menisc.
     7/07 LR, patellar tendon debrid., part m. menisc.

Offline cwalukevich

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Re: SURGICAL DISASTER
« Reply #25 on: August 12, 2008, 05:22:39 AM »
Dave:
Get all the information in written form/tapes  that you can since you were just post-op, you want to be sure what you heard is correct. Get the doctor to give you copies of all the surgery records and a
statement written that he cut the ligament. Ask if there was any way he could have repaired
the ligament and still done the PKR or were there other contributing factors that led him to do the TKR. Get ALL your medical case records from him.

You need all of this so you can sit and read it when you are in less pain and make your own
evaluation as to legal issue. You also need all this in case you want a second opinion or if
you some day decide to get another OS.

Legal issue:
I have been thru this with my dad in the early 1990's here in USA. He died during surgery for a routine pacemaker replacement at age 68. I got a referral to a malpractice attorney, phoned him,
signed a form to allow access to the records. My sister met with him ONE time on behalf
of our family. He hired a medical specialist to review the case notes to see if it was meritorious.
The suit was filed on behalf of dad's 5 kids and widow. The suit was resolved in 4 years
time with a settlement. One phone call, one office visit, one medical expert, one insurance
company, two more phone calls, 6 cashier's checks. Believe me, the attorney will tell
you right up front if it is a good case. Oh-and no expenses other than the phone calls
or the stamps. They work on contingency fee basis. Oh, and my dad had signed the
surgical consent form but the doctor was still deemed to have made a not reasonably
expectable error for the surgery.

Please understand that knowledge is power and you do not know what impact this
error the surgeon made will have on the rest of your life. Could this knee develop
complications that affect your ability to work in future? Knowledge is power AND
insurance for you. His insurance is malpractice insurance.

If you gather all the info, even if you do have a case, you are the one who decides whether or
not to move forward.

Concentrate on healing and best wishes.

C.

Offline jathib

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Re: SURGICAL DISASTER
« Reply #26 on: August 12, 2008, 10:12:42 PM »
One thing I meant to add to my first post for Dave. First and foremost, if you decide to take legal action you need to decide what you want. You have no case whatsoever as far as the TKR is concerned. The doctor's only options were to do nothing and sew you back up, do a PKR knowing it wouldn't be satisfactory, or do a TKR. I also believe he did what he thought best for the patient.

As far as the severed ligament goes, what do you want? He made a mistake, he admitted it, and he fixed it. What more do you want him to do? As others have suggested get the facts. Keep in mind that the inside of a knee is a jumbled mess of ligaments, tendons, muscles, etc. It doesn't look all pretty in there like it does in the pictures. There might be a logical reason why the ligament was severed. Maybe it wasn't where it was supposed to be, maybe something else wasn't where it was supposed to be, who knows. Get the facts and decide what you want before you do anything.

Offline dave t

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Re: SURGICAL DISASTER
« Reply #27 on: August 13, 2008, 08:57:56 PM »
Ok, From my point of view i was led to understand from watching ops on video in the consultation that immediately after coming round from the op that i should be bending my knee 70 percent and be exercising/physio the joint from then on and spending only a couple of weeks on crutches.

I have a 10 inch scar and find it hard to believe that an experienced surgeon could'nt see a big white ligament and managed to slice said perfectly good ligament.

I have no idea what people are talking about when they say some surgeons do away with ligaments, as i'm fairly sure they are precisely what is holding the knee together.

My leg is currently in a metal brace with no movement for 6 weeks, the brace is then altered 10 degrees for the next 2 weeks and then again 2 weeks later. Thereby the Knee joint is recieving no physio/movement for a minimum 10 weeks and i am getting no firm answer as to whether this affects the long term success of the knee replacement and no firm answer as regards the long term strength of the ligament as it was a clean cut and not a tear.

I have calmed down slightly and i am not as wound up by the fact this turned into a full knee op, although this was not down to the state of my knee but by the fact he messed up to start with and did the full knee as he had to operate from the otherside of the knee circumventing the possibility of a half knee.

I'm a builder and i have to work as i'm not retired yet, a minimum of 10 weeks out of action is a nightmare, and i can't emphasise that enough. I'd planned for 4 weeks out and then at least being in a position to drive and organise jobs.

I will emphasise he owned up to cutting the medial ligament accidently but there was no apology, and i really doubt he would have owned up if i had'nt phrased my question to him as "the nurses tell me" there was a problem with my mediall ligament.

In short i'm still furious, still have no idea how good my knee will be or how strong the ligament will heal and really really wish someone else had done the op.

fatcats6

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Re: SURGICAL DISASTER
« Reply #28 on: August 13, 2008, 10:49:33 PM »
The injury is bad enough, but when your liveihood is in jeopardy, there's a real sense of urgency.  Your anxiety level must be pretty high, totally understandable.  We'd all like to have 20/20 hindsight and would like a perfect outcome, in a set timeframe and for life to be disrupted as little as possible and that we are just like we were before the injury.  I don't think many people actually have it play out that way.  There are complications, sometimes more than one.  Healing takes longer, we have set backs, re-injury, mostly due to being a klutz, sometimes just bad luck.  Money worries have a really bad impact, as someone who does physical work, I can well imagine how nervous you are about getting back to it, how it will effect your client base/word of mouth etc.  You'll find driving a real challenge and it usually takes a few more weeks than the 6 weeks they say you can drive before you actually can.  You'll also underestimate how exhausted everything will make you.  This isn't a quick fix injury, it's brutal surgery and the damage you can see is a fraction of what's going on inside.  I must say, I'm surprised at how adaptable we are, I have limited ROM 6 months after the op and I am managing to do almost everything, just in different ways, bit like a three legged dog, know what I mean?

How did your OS miss the ligament....easy, it was an accident, just like, how could I have missed the hole I fell in when I broke my kneecap? It was bigger than Texas but I still managed to get myself into it...still wonder at that and still wish I could have those 2 seconds back.  I'm glad to hear that you have calmed down alittle.  Much better for you and for your family.  Hope something I've said has helped alittle.

Offline luckygrandma6

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Re: SURGICAL DISASTER
« Reply #29 on: August 14, 2008, 02:12:58 PM »
Dave, I still sympathize very much with your situation and agree the surgeon screwed up. I'm a perfect example of surgeon's screw ups. My surgeon is not even willing to make it right or fix the problem. I'm convinced he forgot to give me a kneecap when he took mine out. If you died while he was doing a TKR do you think your family would have sat by and said, OH!! He's only hunan and couldn't help it. People die from exploratory surgey that was supposed to be in and out patient surgery. I know one woman where the surgeon ruptured her bowels during exploratory surgey and her bowels were coming out through her stomach. When I was in the hospital for my PKR I met her in x-ray and she had alreay been in the hospital for three months. It wouldn't hurt to at least talk to a lawyer. Believe me he will not take the case unless he feels you have a case. 
Right knee (arthroscopy) 2004
Right knee (PKR)) April 5, 2005
Right elbow (Bursectomy)1998
TRKR 2006 Failed)
Left knee (arthroscopy)
Left knee (arthroscopy)
THR 1992
2 back surgeries (Feb 2007 & March 2007
Right knee spacer exchange (Failed) 2008
TRK (Hinged Prosthesis) Jan 2009

Offline jathib

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Re: SURGICAL DISASTER
« Reply #30 on: August 14, 2008, 02:15:28 PM »
Ok, From my point of view i was led to understand from watching ops on video in the consultation that immediately after coming round from the op that i should be bending my knee 70 percent and be exercising/physio the joint from then on and spending only a couple of weeks on crutches.
This might be due to the fact that your ligament now has to heal. I don't know the protocol for that sort of thing but I'm sure it has complicated matters.

Quote
I have a 10 inch scar and find it hard to believe that an experienced surgeon could'nt see a big white ligament and managed to slice said perfectly good ligament.
Again, it's not as pretty in there as it looks in the pictures. Ligaments aren't that big. I do urge you to ask the doctor how it happened.

Quote
I have no idea what people are talking about when they say some surgeons do away with ligaments, as i'm fairly sure they are precisely what is holding the knee together.
Here's a web page that will explain that. It all depends on what kind of prosthesis is used. In your case you might have been better off with a different type where you wouldn't need that ligament.

http://www.ehealthmd.com/library/totalkneereplacement/TKR_types.html

Quote
I have calmed down slightly and i am not as wound up by the fact this turned into a full knee op, although this was not down to the state of my knee but by the fact he messed up to start with and did the full knee as he had to operate from the otherside of the knee circumventing the possibility of a half knee.

Again, get the facts. Your first post said your knee was worse than expected. If that is the case you may well have needed a total knee anyway. I don't really see how cutting a ligament could change the state of your bones.

Quote
I'm a builder and i have to work as i'm not retired yet, a minimum of 10 weeks out of action is a nightmare, and i can't emphasise that enough. I'd planned for 4 weeks out and then at least being in a position to drive and organise jobs.
Hate to tell you, but if you're doing manual labor you likely couldn't have returned to work in four weeks even with a partial knee. I know I couldn't have based on experience. And my PKR went perfectly. It would have easily been three months before I could do any manual labor. And I still can't kneel after 18 months and I never will.  Joint replacements take at least a year to heal, even with a good outcome. These things rarely happen the way surgeons tell you they will. They usually give you the best case scenario.















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