CASE REPORT: FAILURE TO DIAGNOSE AND TREAT COMPARTMENT SYNDROME
This case comes to us from Illinois. The patient, 37 years old, collapsed while running. He was admitted to a hospital for several days and treated by an internist. He experienced severe pain, swelling, and tenderness in his lower legs while in the hospital.
One week after the collapse the patient was seen by another internist who immediately diagnosed the patient to be suffering from compartment syndrome in both legs and referred him to an orthopedic surgeon. The orthopedic surgeon performed an emergency fasciotomy on both legs. However, due to the delay in diagnosing the patient’s condition and receiving appropriate surgical care (the fasciotomy), the patient suffered nerve and muscle damage resulting in permanent bilateral foot drop.
Compartment syndrome is a painful condition that develops when swelling takes place within an enclosed area (compartment), in which muscles, nerves, blood vessels, and bones in the compartment have no room to expand. Pressure on arteries, veins, and nerves causes extreme pain, slows circulation to the muscles and nerves, and can cause permanent damage to these tissues.
The patient sued the first internist who saw him open his admission to the hospital, alleging the doctor failed to timely diagnose his compartment syndrome and refer him to the appropriate medical specialist for treatment. The jury awarded the patient $2 million and the case was settled later on appeal for approximately the same amount.