The plaintiff went to her primary care physician’s office in September 2003 and was seen by the defendant nurse practitioner. She told the defendant that she had been struck by an automobile in a parking lot a few days earlier. The defendant noted that the plaintiff had a large abrasion on her left leg with some purulent drainage and a large bruise on her back. The plaintiff also informed the defendant that her left leg felt cooler to the touch than her right leg. The plaintiff was told to go to the emergency room for any worsening pain, numbness or tingling.

Two days later the plaintiff was again seen by the defendant nurse practitioner. The plaintiff again complained of coolness in the left leg and also claimed that the leg got progressively colder toward her foot and toes. She also told the nurse practitioner that her toes were slightly discolored. The plaintiff was given an appointment to see the primary care physician the next week. When the plaintiff was examined by the primary care physician the plaintiffs left lower leg showed some swelling and her left great toe and second toe had a dusky color. She had palpable, but diminished pulses on the left leg compared with the right. The plaintiff was given an appointment to see a surgeon.

The next day the defendant surgeon examined the plaintiff and noted that the toes on her left foot were bluish in color and felt cold. The defendant noted that the plaintiff had faintly palpable bilateral femoral pulses, but no palpable pulses in the popliteal or posterior tibial or dorsalis pedal area. A Doppler ultrasound was performed and the plaintiff was noted to have intact posterior tibial pulses bilaterally but no dorsalis pedal pulse on the left. The surgeon developed the plan to set up another ultrasound of the left leg in two weeks. The surgeon also told the plaintiff that it was fine to go on vacation the next day.

The following day the plaintiff felt that her foot was worsening and she went to another surgeon with severe left foot pain and discoloration of the foot. The plaintiff was immediately admitted to a hospital and taken for an angiogram. She was noted to have a thrombus in the proximal superficial femoral artery with a complete occlusion of the popliteal artery above the knee. She was taken to surgery twice over the next two days in an attempt to restore meaningful blood flow to her leg. The surgeries were unsuccessful and she was transferred to another hospital for possible leg salvage. The attempts there were unsuccessful and she underwent amputation of her left leg above the knee.

The plaintiff alleged negligence by the nurse practitioner in failing to immediately hospitalize her when she complained of a cool leg and foot. The plaintiff also alleged negligence by the surgeon in failing to immediately hospitalize her when she had an obvious lack of blood flow to the leg and foot. The plaintiff claimed that the foot and leg could have been saved if she had undergone surgery at any time before the day she was hospitalized.

The defendants denied any negligence and claimed that the clots in the leg were in the small vessels, which made saving the leg impossible once the clots occurred.

A $2 million settlement was reached.

With permission from Medical Malpractice Verdicts, Settlements & Experts; Lewis Laska, Editor, 901 Church St., Nashville, TN 37203-3411, 1-800-298-6288.