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Delayed Treatment Causes Partial Loss of Hand Function | Debary Malpractice Attorney

Delayed Treatment Causes Partial Loss of Hand Function

When a patient being treated for an injury continues to complain of increasing pain, medical professionals should take this as a warning sign that their treatment plan needs to be re-considered.

Unfortunately for a restaurant worker who received an accidental deep knife wound to his hand, the possibility of infection was not considered early enough to prevent a partial loss of functioning in his hand.

This man, a 35-year-old restaurant worker, visited the emergency room with a deep cut in his hand. He was examined by a physician’s assistant, then sent to the surgery department. Then a nurse practitioner irrigated, sutured and dressed his wound. The patient was instructed on wound care and signs and symptoms of infection.

The man called the next day complaining of extreme pain. The treating nurse practitioner prescribed Tylenol with Codeine. The man called back about five hours later, stating the medication was ineffective and he was now having chills.

The nurse practitioner advised him to take an anti-inflammatory agent. He called the center later that same day, this time reporting a fever. He was seen that night by the physician’s assistant who had performed his initial exam.

Upon re-examination, the physician’s assistant found the man’s hand wound to be swollen, reddened and hot. Also noted was a red streaking that extended just to his elbow, indicating that his lymphatic system was also involved in the infection. The man had a fever of 100 degrees even after several ibuprofen doses. The physician’s assistant diagnosed abscess formation, lymphangitis and cellulitis, which is a skin infection.

After consulting with the covering surgeon, the physician’s assistant removed six of the nine sutures and observed spontaneous discharge from the wound, including old non-clotted blood. The wound was cultured, irrigated with peroxide and saline, and dressed. The cellulitis and lymphangitis were delineated. Subsequently, the complete blood count test revealed a white blood count of 17,000, which is higher than the norm (which indicates infection), and he tested positive for streptococcal and staphylococcus infection.

The man was given antibiotics intravenously and discharged home on oral dicloxacillin with a follow-up appointment set for the next morning. However, he lost partial function of his hand as a result of the delay in his diagnosis and treatment.

This case was settled for $100,000 against the covering physician, the physician’s assistant and the nurse practitioner for improper supervision, improper care, and unqualified personnel providing care.

It was a successful claim based on the following factors:

The possibility of infection was not promptly addressed despite multiple calls from the man complaining of pain. Multiple patient complaints within a short time period should trigger further inquiry of other explanations, like infection in this case.

The man’s degree of pain was never ascertained by medical professionals and that misunderstanding ultimately affected his care. For thorough documentation and continuity of care, patients should be asked to rate their pain on a scale of 1 to 10. This helps provide a specific frame of reference for evaluating the pain over time.

The nurse practitioner negligently failed to prescribe an antibiotic when the wound was stitched.

For more on patient safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

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