Malpractice? Need some advice please

[mudman]

I'm 37 and lead a VERY active life, work a very physical job, and playing with cars is my only hobby that doesn't involve physical exertion.
August of 2013 I was playing volleyball and rolled my ankle. It swelled quickly and I was in some pretty big pain. Managed to drive myself home and my wife took me to our urgent care center.

They took xrays and said it is just a sprain. I don't remember even being offered pain meds or an anti inflammatory. They put one of those simple half casts on me and sent me on my way.

Fast forward to this spring and I see my PCP about my knee as it had really been bothering me, always stiff and sore, getting up from a chair or out of a car I needed a minute before I could walk at a normal pace. Dr does some xrays and says that it looks ok but go see a specialist as something isn't right. Meet with the specialist/surgeon and he does a quick look at my knee and then glances at my ankle and says "WTF is this!" He takes a few xrays and and a CT scan and tells me that:
1) I have a "huge chunk" of bone floating around in my ankle
2) one ligament is fully torn and another has been stretched to the point of not doing its thing
3) cartilage and bone have been eroded by the chunk of bone floating around
4) my knee pain was likely from misalignment of the tibia and fibula causing patella tracking issues

I had surgery in May to remove the bone and repair the ligaments and clean up some cartilage and smooth the rough area of bone where it has eroded. I did physical therapy as directed. My ankle bothers me now more than ever and my knee still sucks (but is a little better)

Dr says I'll probably need more surgery as he couldn't get to all of the cartilage during that first procedure.

This has cost me thousands. I'm never going to regrow that bone or cartilage. I can't do some of the things I love to do and more physical activities, even walking, causes pain.

My initial visit with the urgent care center should have caught this, right?
What do I do now?

[Linderpat]

Originally Posted by mudman

...My initial visit with the urgent care center should have caught this, right?
What do I do now?

Well for one thing, don't piss around on Pelican OT, instead call a lawyer. That statute of limitations aint gonna wait for us to chime in.

[Nickshu]

You had an injury doing a risky activity by your own choice.

Perhaps the first visit xrays showed normal findings as the bone had not separated yet. That said U/C's do often call everything a "sprain" at first from my experience. Doing MRI's and expensive imaging on every guy who walked in w/ an ankle sprain for palliative care is not practical.

Did you followup with your PCP thereafter for a real evaluation? Urgent care sort of doesn't count as a real evaluation IMO, that's basically just an emergency/get me out of pain until I can get to a real doctor sort of place to go.

What was the time interval between the time you saw your PCP and when you saw the specialist/orthopedic?

Life is risky, things happen, it was YOUR injury not the doctor's. Ask yourself are you looking to blame someone who was trying to help you for the result of YOUR injury vs taking ownership?

The human body is imperfect and in many instances has a limited capacity to repair itself even with the best healthcare/surgery.

Getting old sucks.

[mudman]

Time been injury and PCP visit was just over a year.
Time between PCP and specialist was less than two weeks.

UC made me feel like it was a waste of time for me to even be there. They showed no concern that it might be more serious nor did they tell me to follow up with anybody.

[bpu699]

When you are seen in prompt care, they do the initial eval to get the ball rolling. They aren't orthopedic doctors...

Sounds like they did an xray, which will NOT show ligament tears/tendon tears/etc... All an xray shows is fractures, which they reported you did not have (accurate, yes?).

You mention a "loose bone." That could be anything from a small chip - means little. to a complete fragment that was pulled off... Which is it?

Usually prompt care will tell you "if your symptoms aren't better see your primary doctor..."

Thats the legal way of covering yourself, in case the patient doesn't follow up and something is missed... Its SOP.

Sorry you had a bad ankle. Doesn't sound anywhere near malpractice... unless that original xray showed a clear fracture... Any problems that develped could also have occurred/worsened after the prompt care visit...

Focus on healing yourself... alluding to malpractice will take you down the wrong road...

(Simply an opinion/not medical advice or legal advice and shoudnt be misconstrued as such from a random stranger on the net...)

[Norm K]

Originally Posted by mudman

UC made me feel like it was a waste of time for me to even be there. They showed no concern that it might be more serious nor did they tell me to follow up with anybody.

It appears that you didn't either.

[mudman]

[mudman]

It was a fragment. Surgeon referred to it as "a huge chunk of bone"

[mudman]

Originally Posted by Norm K

It appears that you didn't either.

Why would I? I was seen by a doctor and told I was fine.

[Nickshu]

Were you completely asymptomatic during the year between the U/C visit and the PCP visit?

My wife went thru a similar deal, diagnosed as an ankle sprain, felt better after basic care for a couple weeks, but always was a bit sore, nothing that restricted her activities (was running 8-10 miles 2-3x per week on it), almost a year went by, started hurting again while training for a half marathon. Had an MRI, found a similar chunk of bone pulled off by a ligament. Orthopedic determined it was non-operable, wore a boot for 4 months and has been fine since. Unfortunately they don't do repeat MRI's to verify the bone reattached unless there is persistent symptoms.

Based on this and your story I think the ankle may tend to lack symptoms despite major problems sometimes??

[mudman]

Originally Posted by Nickshu

Were you completely asymptomatic during the year between the U/C visit and the PCP visit?

My wife went thru a similar deal, diagnosed as an ankle sprain, felt better after basic care for a couple weeks, but always was a bit sore, nothing that restricted her activities (was running 8-10 miles 2-3x per week on it), almost a year went by, started hurting again while training for a half marathon. Had an MRI, found a similar chunk of bone pulled off by a ligament. Orthopedic determined it was non-operable, wore a boot for 4 months and has been fine since. Unfortunately they don't do repeat MRI's to verify the bone reattached unless there is persistent symptoms.

Based on this and your story I think the ankle may tend to lack symptoms despite major problems sometimes??

Yes! My knee was what brought me to my PCP. My ankle might bother me for a week and then be fine for a while.

I had nothing other than the initial extreme swelling and bruising to make me think it was broken.

[Nickshu]

Well then it's tough to make a case for any malpractice. Given that you had no symptoms there was no real reason to have imaging of the ankle done and if the initial xrays were read by a radiologist who found no problems then the urgent care had no reason to think anything was wrong beyond a sprain. Tough break.

[Norm K]

I'd be quite surprised to learn that the paperwork the UC clinic sent you home with doesn't explicitly recommend a follow up visit with your PCP.

[gacook]

Originally Posted by mudman

I'm 37 and lead a VERY active life, work a very physical job, and playing with cars is my only hobby that doesn't involve physical exertion.
August of 2013 I was playing volleyball and rolled my ankle. It swelled quickly and I was in some pretty big pain. Managed to drive myself home and my wife took me to our urgent care center (McLaren Medical).

They took xrays and said it is just a sprain. I don't remember even being offered pain meds or an anti inflammatory. They put one of those simple half casts on me and sent me on my way.

Fast forward to this spring and I see my PCP about my knee as it had really been bothering me, always stiff and sore, getting up from a chair or out of a car I needed a minute before I could walk at a normal pace. Dr does some xrays and says that it looks ok but go see a specialist as something isn't right. Meet with the specialist/surgeon and he does a quick look at my knee and then glances at my ankle and says "WTF is this!" He takes a few xrays and and a CT scan and tells me that:
1) I have a "huge chunk" of bone floating around in my ankle
2) one ligament is fully torn and another has been stretched to the point of not doing its thing
3) cartilage and bone have been eroded by the chunk of bone floating around
4) my knee pain was likely from misalignment of the tibia and fibula causing patella tracking issues

I had surgery in May to remove the bone and repair the ligaments and clean up some cartilage and smooth the rough area of bone where it has eroded. I did physical therapy as directed. My ankle bothers me now more than ever and my knee still sucks (but is a little better)

Dr says I'll probably need more surgery as he couldn't get to all of the cartilage during that first procedure.

This has cost me thousands. I'm never going to regrow that bone or cartilage. I can't do some of the things I love to do and more physical activities, even walking, causes pain.

My initial visit with the urgent care center should have caught this, right?
What do I do now?

If you truly love your active lifestyle, you learn to deal with the pain. I had very similar ankle issue (still have a chunk of bone floating around the doc couldn't get to). It's been around 15 years now; I still play volleyball/softball/tennis/basketball...some days just hurt more than others.

Just wait till that ankle starts developing arthritis...

[sammyg2]

[HardDrive]

I've got two blown disks in my back and a tweaked shoulder. The disks in my back were misdiagnosed for close to 10 years. If you've been active your whole life, you start to accumulate broken bits. I'm 45, and I recall my late thirties well. You need to start being a bit more careful, stay flexible, keep your core strength up....and buy a 5 gallon bucket of ibuprofen from Costco.

I don't think suing it worth your time. Move on.

[McLovin]

The practical analysis is:

1. Are you willing to pay a lawyer $300/hour out of your pocket to pursue a claim?

2. Can you find a lawyer who will take the risk himself (i.e., contingency fee)?

I suspect the answer to both is "no."

[JavaBrewer]

Originally Posted by nickshu

well then it's tough to make a case for any malpractice. Given that you had no symptoms there was no real reason to have imaging of the ankle done and if the initial xrays were read by a radiologist who found no problems then the urgent care had no reason to think anything was wrong beyond a sprain. Tough break.

+1

[wdfifteen]

Originally Posted by mudman

UC made me feel like it was a waste of time for me to even be there. They showed no concern that it might be more serious nor did they tell me to follow up with anybody.

Hmm. Every time I've been to an ER or Urgent Care they give me a paper to sign saying I will make an appointment with my regular doc. They didn't do that?

How are you going to prove the stuff that was wrong with your ankle didn't happen in the year between your UC visit and the time you saw your doc?

[GeorgeK]

Having a valid case will also rest on the initial XRay showing an anomaly that the emergency physician missed. Is that the case?