Physical therapy expert witness reviews a case involving hip dislocation caused by a student physical therapist

A physical therapy expert witness opines on a case that involves an eighty-one-year-old male patient with a past medical history of osteoarthritis. She previously underwent radiofrequency ablation for her joint paint, but underwent bilateral total hip replacement surgery on the recommendation of an orthopedic surgeon. Around three months following surgery, once the surgical wounds had healed, the patient began physical therapy. During his first session the physical therapist introduced the patient to a physical therapy student who he said was to be in charge of his therapy. The physical therapist left the room and the physical therapy student was unsupervised throughout the entire session. According to the patient, the PT student manipulated the patient’s right leg in an aggressive manner until the patient heard a loud pop followed by immediate excruciating pain. The patient was taken to the emergency room via ambulance. An x-ray revealed that the patient had suffered a dislocation of the hip joint. The patient had to undergo a hip revision procedure as a result.

Question(s) For Expert Witness

Comment regarding the standard of care for the student in causing the dislocation as well the supervision by the owner/therapist, as well as the likelihood of needing a second operation due to the injuries incurred from the PT.

Expert Witness Response

With the patient in this case being eight-one years-old, I imagine he may have been a Medicare recipient. If that is the case, Medicare has some very strict rules on supervision of therapy students. Either way, in no event would a student ever be "in charge" of a patient's therapy. The responsibility for a patient’s care rests with the licensed physical therapist. Standard of care regarding student supervision is less clear cut than Medicare rules. However leaving a student completely unsupervised constitutes poor judgment even if it is not a clear deviation from the standard of care. A thorough review of the clinical data would be help gain a clearer understanding of exactly what happened to the patient’s hip when left under the care of the physical therapy student i.e. surgical history, medical diagnosis resulting in repeat surgical procedure and therapy history leading up to the incident of injury. Given the history of the presenting complaint it is almost certain that this patient’s injury was caused as a direct result of the “care” he received at the hands of the student.