Lisa Zenzen Baker, 1961-2003


Sunday, May 01, 2011

Another missed diagnosis

Lawsuit alleges Albany
hospital caused leg injury

By David Baker
Posted May 1, 2011

A woman who went to Albany Memorial Hospital after falling from a stepladder has filed a lawsuit in which she alleges that she has been left with permanent injuries after nurses failed to follow a doctor’s orders to check for a dangerous build up of pressure in her leg.

This, according to legal papers, is what happened:

An emergency room physician found two fractures in Karen Rogers’ right leg. In an emergency department report, the physician noted that the patient should be evaluated for compartment syndrome, a condition in which fluids are trapped in tissues that surround muscles.

Without immediate treatment, compartment syndrome can cause serious injury to muscles, nerves and blood vessels.

The next day Rogers underwent surgery for the two fractures, after which the surgeon issued orders for the pain medication Demerol, and for an elastic stocking and a compression boot to be placed on the left leg, the one that had not been broken.

But, according to the suit, the stocking and the boot were put on the right, injured leg.

Later that day, Rogers complained of pain in the leg. Contacted by telephone by nursing staff, Jessica Newson, a physician’s assistant in the orthopedic surgeon’s office, ordered the same dose of Demerol switched from intermuscular shots to an IV. But less than an hour later Rogers told an nurse that the pain was increasing to “20 out of 10.” After a nurse again contacted the surgeon’s service, Newson, without examining Rogers, ordered a different IV medication, Dilaudid.

But Rogers continued to be in what she descried as “unbearable pain.” According to the complaint, she then was told that no further pain medications were authorized and “she would have to make do with the pain medication that had already been prescribed.”

Extreme pain that is not alleviated by medication is a prime symptom of compartment syndrome, according to a listing on the Internet site WebMD.

By the early hours of the next day, Rogers began losing sensation, first in the toes, then in the foot and later in the calf. The calf also was swollen and began to feel cold.

Swelling and loss of feeling is another symptom of compartment syndrome, according to numerous Internet medical sites.

But according to the lawsuit, the hospital staff took no action in response to the symptoms.

“Despite the Plaintiff’s continuing complaints of extreme pain that were disproportionate to her condition, and which were not relieved by the administration of seven total doses of three different narcotic pain medications, and other signs and symptoms of compartment syndrome, the nurses of Defendant, Albany Memorial, did not contact … anyone from the orthopedic group, or any other physician to evaluate the Plaintiff,” the suit says.

The lawsuit also says that the surgeon had ordered nursing staff to perform neurovascular checks every hour, and that Memorial Hospital’s own protocol for a patient such as Rogers calls for the checks to be done every four hours, but that no check was done on Rogers between 11 p.m. and 8 o’clock the following morning.

The alleged failure to perform the checks as require by the hospital’s own protocol – “Care Pathway #55” – resulted in the state Health Department issuing a ‘statement of deficiencies’ against the hospital, according to the lawsuit.

At 9 a.m., the surgeon who had treated Rogers the day before examined her and immediately performed surgery to open four compartments and relieve the pressure. This surgery required four incisions, each about 8 inches long.

The incisions were left open until further surgery was done to close them. Also, necrotic – dead – tissue – was removed and later a skin graft operation was performed

Rogers also had lost blood and needed a transfusion.

“The Plaintiff is now permanently left with grotesque scarring, deformity, tissue loss, muscle loss, atrophy, loss of sensation, numbness , tingling, burning, pain, loss of motor function, nerve damage, vascular compromise, constant swelling and edema, the need to wear a compression stocking, destabilization of the right extremity, bone loss, decreased coordination and agility, and a diminished physical capacity, along with further physical compromise and related emotional distress as a result of the compartment syndrome and the delay in diagnosing that condition,” the suit says.

The lawsuit seeks an unspecified amount in damages.

A search of the archives of the Times Union produced no indication that the lawsuit was reported by the paper.

Representing Rogers is the Albany law firm Lynch, Schwab.

The defendants are represented by D’Agostinio, Krackeler, McGuire & Cardona of Menands; Thuillez, Ford, Butler & Young; Napierski, Vandenburgh, Napierski & O’Connor; and Thorn, Gershonm, Tymann, Bonnani, all of Albany.

UPDATE:  The case was settled in January 2013, four years after it was filed and five weeks before a scheduled trial.


Once again, nursing staff ignore instructions