With over 5 million orthopedic surgeries in the United States each year and Americans getting older thanks to advances in modern medicine, it is important to know what should happen after an orthopedic surgery, and where mistakes are often made.
Likely, if you or a loved one needs an orthopedic surgery because of an acute (sudden) injury such as a hip, leg, ankle fracture, or chronic condition (long term) that leads to a knee or hip replacement, the following healthcare providers will be involved:
- Orthopedic Surgeon
- Physician Assistant to Orthopedic Surgeon
- Office staff of orthopedic surgeon
- Anesthesiologist
- Cardiologist for surgery clearance
- Post Op PACU staff
- Hospitalist if surgery occurs inpatient
- Physical Therapists
- Occupational Therapists
- Wound care nurses
- Home Health or Rehab Staff
The list goes on. And when you have numerous providers each handling one aspect of care, mistakes in communication are bound to happen. And with 5 million surgeries a year, it is likely you or your loved one is just one of many patients being operated on at your surgical site in a day, and receiving post operative care.
So, what could go wrong? The following is a list of the more typical mistakes that are made before, during or after an orthopedic surgery:
- Negligence that causes fracture – such as fall or improper transfer in a nursing home or hospital
- Wrong site surgery (yes – this still happens)
- Improper anesthesia (Not all orthopedic surgeries require general anesthesia and many can/should be handled with regional blocks)
- Negligent pre-op evaluation which could include failing to appreciate a heart condition or other condition which would place the patient at risk during surgery
- Failing to stop blood thinning medication pre-operatively
- Incorrect orthopedic device (wrong size rod, screw, etc)
- Nerve damage during placement of device (yes, there are nerves in your lower limbs that need to be protected during surgery)
- Inadequate DVT prevention post op (failing to order medication or use foot pumps)
- Excessive DVT medication that could cause internal bleeding (Xarelto, Coumadin and Lovenox are often used post operatively and all three come with significant risk and complications)
- Failure of therapists to follow physician orders re: weight bearing, non-weight bearing
- Failure of therapists to quickly initiate proper therapy
- Transfer mistakes leading to patient falls, additional orthopedic injuries
- Infection of surgical sites
- Failure to diagnose or treat infections post operatively
- Foreign bodies left in patient (gauze, sponges)
- Medication errors post operatively (mistakes in writing orders or administering medication)
Sadly – when you are dealing with so many providers, the list of possible mistakes could go on.
While not all mistakes are preventable, and not all are negligence under Virginia law, our office can quickly help your family determine if the complications you experienced before, during or after an orthopedic surgery rise to the level of malpractice under Virginia law.
No surgery is risk free – but one thing we advise all families to do is be your own best advocate. Take notes while speaking to doctors. Write down orders to make sure you understand the plan and question when it changes.
This week I am helping a loved one after a hip fracture and repair, and have already needed to clarify physician orders on three separate issues (who is doing wound dressing changes, when is the patient to receive rehab, and who is to remove wound staples). The MD orders state one thing, yet home health claims another. When in doubt – call. Be an advocate. Ask questions. And call our office if you have further concerns about orthopedic surgery in Virginia – 540-520-4582.