One operation that can be performed to repair a fractured ankle is an ORIF, an open reduction internal fixation, in which the bone is realigned and held together with hardware such as plates and screws. It is a common, well-established orthopedic procedure.
Sometimes, however, surgical wounds get infected. The typical standard of care, when it comes to wound infections, starts with diligence by physicians to open and clean the wound, as well as administering antibiotics. If infected wounds are not taken care of quickly, it can spread and cause other problems.
In this case, instead of following proper wound management protocols, our client’s physician failed to provide appropriate post-operative antibiotics, and when clear signs of infection appeared, he neglected to remove the infected hardware, a critical step when an implant becomes infected.
The infection was allowed to take hold and spread. She developed severe MRSA and Pseudomonas infections, osteomyelitis (an infection of the bone), and acute kidney injury caused by the prolonged antibiotic treatment her worsening condition eventually required.
The Townsley Law Firm fought for our client and recovered a settlement of over $650,000.
Two Failures That Let an Infection Take Over
The negligence in this case was not the infection itself. Infections are a known risk of any surgery. The negligence was in how the infection was handled once it appeared.
Failing to provide appropriate antibiotics. Managing surgical wounds includes watching for infection and treating it promptly and appropriately when it develops. Antibiotics are a first line of defense. When a patient shows signs of a surgical wound infection and appropriate antibiotics are not provided, the infection is given room to grow and spread rather than being controlled early, when control is easiest.
Failing to remove infected hardware. When hardware implanted during surgery becomes infected, the metal itself becomes a surface where bacteria form a biofilm, a protective layer that shields them from both the immune system and antibiotics. Once that happens, antibiotics alone often cannot clear the infection. The standard of care frequently requires removing the infected hardware to eliminate the source. Leaving it in place, despite clear signs of infection, allows the infection to persist and worsen no matter what else is done.
Together, these failures let a controllable problem become a limb- and health-threatening one.
How the Infection Cascaded
Once the infection was allowed to establish itself, the consequences compounded.
MRSA and Pseudomonas. These are serious, aggressive bacterial infections. MRSA is resistant to many common antibiotics, which makes early, appropriate treatment and source control all the more important. Allowing these organisms to take hold in a surgical site sets up a difficult and prolonged fight.
Osteomyelitis. When infection reaches the bone, it becomes osteomyelitis, one of the most stubborn infections in medicine. Bone infections are notoriously hard to eradicate, often requiring extended IV antibiotics and repeated surgeries to remove infected tissue and hardware.
Acute kidney injury. The very treatment her worsening infection demanded carried its own harm. Prolonged, aggressive antibiotic therapy can damage the kidneys, and she developed acute kidney injury as a result. This is a cruel feature of delayed infection control: the longer an infection is allowed to progress, the more aggressive the treatment required, and the more collateral damage that treatment can cause.
Tendon contracture. The prolonged course of infection and repeated surgeries left her with a tendon contracture, a tightening that restricts movement, requiring yet another surgical correction.
Due to poor decision making by her physicians, our client endured multiple surgeries, long-term IV antibiotics, and a tendon contracture that required additional surgical correction. Each of these originating from an infection that appropriate early treatment and timely hardware removal could have controlled.
