A 50-year-old man sustained a rope-burn injury to his left hand during a fishing trip in early August 2004. He subsequently presented to an orthopedic facility with complaints of a hand infection and was eventually referred to orthopedic surgeon Dr. W.
One week later, Dr. W administered a steroid injection, which caused the infection to worsen. The patient claimed that the steroid injection was contraindicated by the underlying infection. Dr. W referred the patient to Dr. C for infectious disease management.
In November 2004, Dr. W performed an incision and drainage procedure, and specimens were sent for pathology study and cultures. The pathology results were sent to both Dr. W and Dr. C, but the culture results were sent only to Dr. W. Other specimens were sent for culture in November 2004 and January 2005.
The results from the first culture, received by Dr. W in three reports, indicated “Mycobacterium,” “rare presumptive Mycobacterium marinum,” and “Myocbacterium marinum.” Dr. W did not forward these results to Dr. C and allegedly did not review the last report. Dr. C treated the plaintiff for a fungal infection based on the results of the second culture. After the third specimen in January 2005 grew acid-fast bacilli, Dr. C was informed that the patient likely had an infection caused by M. marinum.
The patient alleged that the 44-day delay in diagnosis and treatment of the M. marinum infection allowed the infection to worsen. The patient was hospitalized for one week at a major clinic and underwent three debridement surgeries to his left hand. He subsequently underwent five months of physical therapy and received long-term intravenous antibiotics for the infection.
The patient lacks full range of motion in his hand and is unable to fully open the fingers or make a tight fist. He has a trigger finger, surgical scars, and painful nodules. The hand is also extremely intolerant to temperature. The plaintiff claimed that the debridement surgeries would have been unnecessary if the initial culture reports had been acted upon in a timely manner.
The defendants claimed Dr. W saw no evidence of infection at the first office visit and that there was no sign of infection when the steroid injection was administered. The defendants claimed that the hand’s condition did not worsen after the injection and that the plaintiff was referred to Dr. C when a second fishing trip led to a flare-up that eluded diagnosis. Dr. W maintained that, during the procedure that produced the first cultures, he instructed the circulating nurse to have all lab results sent to both himself and Dr. C. Dr. W believed that Dr. C had been sent the results when he saw both their names on the pathology reports.
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