Orthopedic surgery expert witness advises on total hip replacement infections

An orthopedic surgery expert witness advises on a total hip replacement patient who suffered repeated infections and additional surgeries. The plaintiff was scheduled for a hip replacement. During the procedure, the surgeon removed an abscess. The doctor did not complete the implantation of the Biomet prosthesis. The plaintiff was then transferred to another facility, where the replacement was completed, despite the infection.

The plaintiff alleges the first doctor and surgical staff were negligent in removing the abscess and the second doctor and staff were negligent in performing the hip replacement. The plaintiff suffered multiple infections that necessitated the repeated removal and replacement of his hip prosthetic.

Question(s) For Expert Witness

1. What is the standard of care?

2. Was it breached?

3. What was the result?

Expert Witness Response

The standard of care for an elective surgery is that if anything compromises the integrity of the surgical site, the operation should be deferred. No surgery can be performed. The surgeon must wait until the area of compromise is completely healed with normal skin and subcutaneous structure.

The defendant doctor breached the standard of care by proceeding with the elective hip replacement surgery even though he was aware that a furuncle had compromised the integrity of the surgical site four days prior. These failings were substantial factors in causing or contributing to the plaintiff’s subsequent infections. The negligent care was a substantial factor in causing the plaintiff to develop the infection in his right hip that required the removal and replacement of the hip prosthesis.

If the doctor had installed an antibiotic spacer and started infectious disease treatment and waited to ensure that the plaintiff did not have an infection, the long-term infection would have been avoided.

The expert is an orthopedic surgeon who performs and teaches total hip replacements.