Staten Island Jury Finds Orthopedist Not Liable In Connection With Infected Knee Prosthesis

A 62 year-old married male, retired firefighter (9/11 first responder) underwent a unicompartmental left knee replacement by the defendant orthopedic surgeon on January 17, 2011. He was discharged on post-operative day number 3, but was readmitted the next day with an abscess and clot in his right arm at the site of his prior IV. The infection in the right arm was diagnosed and treated with intravenous and then oral antibiotics. Orthopedics was consulted out of concern for possible seeding of the arm infection to the knee prosthesis. The hospital’s radiologist interpreted a knee x-ray as demonstrating a large effusion, for which the radiologist recommended an aspiration and culture of the aspirated fluid. The attending hospitalist, and other providers, diagnosed cellulitis in the knee wound. The defendant orthopedist determined that the knee appeared normal for its post-op stage, and an aspiration was not performed. Six weeks later, plaintiff was readmitted and diagnosed (on aspiration) with a knee infection. The organism cultured from the knee was of the same type that was cultured from the right arm (Oxacillin Sensitive Staph Aureus, resistant to clindamycin). The defendant orthopedist had performed an aspiration and wash out of the knee in February when plaintiff developed a hematoma secondary to anticoagulants he was on for thrombosis in the arm. Cultures during that admission were negative, but defendants conceded that it was possible the antibiotics the plaintiff was taking for the arm suppressed their growth.

Plaintiff’s experts in orthopedics and infectious disease contended that an aspiration was warranted as recommended by the radiologist on January 21, and that appropriate treatment with intravenous antibiotics and a wash out at that time would have prevented the need for a total knee replacement, which was eventually performed by another surgeon at another institution. Plaintiffs contended that the defendant negligently failed to diagnose an infection, and negligently failed to prescribe intravenous antibiotics at the time of plaintiff’s readmission in February. Defendant called an expert in total joint replacement, and Chief at Mt. Sinai. The jury took less than 90 minutes to return a verdict in favor of the defendant on all four departure questions.