Alleged Contgraindicated Levaquin Prescription
SPECIALTY: Internal Medicine
ALLEGATION: An 80-year-old female alleged ongoing Achilles-tendon injury after taking 500 mg of Levaquin for a urinary-tract infection in 2009. Plaintiff alleged, first, that the provider should not have prescribed any antibiotic for the patient’s confirmed urinary-tract infection; and second, that the provider failed to inform her of the risks associated with Levaquin and the alternatives to that medication. The patient claimed a myriad of ongoing symptoms and decreased mobility caused by the Levaquin.
PLAINTIFF ATTORNEY: John Walsh
PLAINTIFF EXPERT: Peggy Goldman, MD, Internal Medicine/Emergency Medicine, Seattle, WA
DEFENSE ATTORNEYS: Tim Ashcraft, Fain Anderson VanDerhoef Rosendahl O’Halloran Spillane, Seattle, WA
DEFENSE EXPERTS: Peter McGough, MD, Family Practice, Seattle, WA, T. Scott Woll, MD, Orthopedics, Vancouver, WA
RESULT: Defense Verdict
IMPROPER INTERPRETATION OF ANKLE X-RAY IN FAILURE TO DIAGNOSE TENDON INJURY
ALLEGATION: The patient presented to the Emergency Department with a complaint of moderate right-dorsal foot pain after stepping off a stool and landing awkwardly. The provider who conducted the exam noted a pink contusion and swelling crossing obliquely from the head of the third metatarsal to the first metatarsal, tender to palpation. A standard three-view X-ray suite was ordered.
The radiologist interpreted the X-rays that same day, and noted that the joints were normal with no significant arthritic disease or effusion. Ankle mortise was symmetric. Soft tissue appeared to be normal, and the overall impression was of a normal right foot. As a result of this interpretation, the patient was instructed on the use of crutches, ice, elevation, and rest, and was sent home to follow up with a primary care physician, or return if pain worsened.
A year later, the patient presented to the Emergency Department with complaints of foot pain. An X-ray was taken, which revealed a lateral subluxation at the base of the second metatarsal, suggestive of a Lisfranc ligament injury with no attendant fracture. In comparing this X-ray with the prior X-ray, the radiologist noted the possibility of a much smaller Lisfranc ligament injury on one view of the prior films.
Subsequently, the patient underwent a medial column stabilization surgery, which included a fusion of the first, second, and third tarsometatarsal joints, as well as medial-to-middle cuneiform and middle-to-lateral cuneiform joints, for ongoing complaints of pain and inability to bear weight.
It was alleged that had the radiologist identified and reported the Lisfranc tendon injury on the 2012 X-ray, surgery would have been avoided.
PLAINTIFF ATTORNEYS: Jeff Donchez and Mercedes Donchez
PLAINTIFF EXPERT: Glen Curda, DPM, Bellevue, WA
DEFENSE ATTORNEY: Chris Anderson
DEFENSE EXPERT: Jonathan Berlin, MD, Radiology, Chicago, IL
RESULT: Defense Verdict; Private Trial