Patient Requires Amputation After Botched Foot Surgery

This case involves a middle-aged male patient who was admitted for a surgical procedure on his right foot. A sterile compression dressing was applied post-operatively to the patient’s foot. While he was being monitored in the postoperative recovery room, he developed and exhibited signs of decreased blood flow to his foot, assumed to be caused by the compression dressing or some error. The patient developed ischemia to his left second toe, leading to necrosis requiring amputation. His injuries resulted in significant medical care and treatment and caused him pain, suffering, disability and disfigurement.

Question(s) For Expert Witness

1. Do you routinely treat patients similar to the one described in the case?

2. Have you ever had a patient develop the outcome described in the case?

3. What are common complications of applying a compression dressing on a patient, as done in this case?

4. What are the signs and symptoms of a lack of circulation?

5. What are the proper follow-up steps to mitigate any further damage to the patient?

Expert Witness Response E-022988

In my practice I routinely treat patients such as the one described. I have been fortunate to not have had a patient develop this outcome in my practice, but I have seen this complication during my training. Common complications of compression dressings can can range from mild skin problems to necrosis. The most common signs and symptoms of decreased circulation are a lack of capillary refill, skin changes and pain. The appropriate steps once its determined that circulation is decreased is to loosen or change the dressings and recheck circulation.