Daniel E. Holloway
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Northside Atlanta complaint alleges missed popliteal artery injury from a knee dislocation before leg amputation

The complaint alleges that emergency-department providers did not diagnose a popliteal artery injury after a trampoline accident. The patient had dislocated her right knee and fractured her tibial plateau and fibula. The providers did not adequately communicate with paramedics to learn about the numbness and poor circulation in her leg. They did not order a CT angiogram or an ankle-brachial index test, and they discharged her despite an x-ray showing an extensive fracture. The next day an orthopedic provider found no pulse in her leg and sent her back for an emergency fasciotomy. Her popliteal artery had been transected, and after failed efforts to save the leg she underwent a below-knee amputation.

System
Northside Hospital
Facility
Northside Atlanta Hospital
Providers involved
Northside Hospital, Inc. / Northside Emergency Associates, P.C. / Joshua Rothstein, M.D. / David Hocevar, P.A. / American Medical Response of Georgia, Inc. / American Medical Response, Inc.
Pattern
Alleged failure to diagnose a popliteal artery injury after a knee dislocation
Harm
Alleged right leg amputation from a delayed arterial diagnosis

Overview

This page concerns a public complaint alleging that emergency-department providers did not diagnose a transected popliteal artery after a knee dislocation. The delay allegedly led to a leg amputation.

Chronology

The complaint alleges as follows:

  1. On July 17, 2022, the patient dislocated her right knee and fractured her tibial plateau and fibula jumping on a trampoline.
  2. Paramedics documented numbness, poor circulation, and no sensation in her foot, and noted a suspected fracture-dislocation before transporting her to the hospital’s emergency department.
  3. A physician assistant examined her, ordered x-rays showing an extensive knee fracture, and discharged her with an orthopedic referral.
  4. The next day an orthopedic provider found no pulse in her leg and sent her back by ambulance for suspected vascular injury.
  5. Imaging confirmed the popliteal artery was occluded.
  6. The orthopedic provider noted it had also been transected, and she underwent an emergency fasciotomy and external fixation to try to save her leg.
  7. On August 25, 2022, after efforts to restore circulation failed, she underwent a below-knee amputation of her right leg.

Alleged failures

The complaint alleges the following failures:

  • The providers did not adequately communicate with paramedics to learn that the patient had numbness, poor circulation, and a suspected fracture-dislocation in her leg.
  • They did not suspect or rule out an arterial injury given her posterior knee dislocation and fracture pattern.
  • They did not order a CT angiogram or an ankle-brachial index test to check for reduced blood flow in her leg.
  • They discharged her rather than keeping her for observation to watch for neurovascular changes from an arterial injury.
  • The complaint alleges the defendants’ combined failures amounted to gross negligence that caused the loss of her leg.
  • The complaint pleads professional negligence, ordinary negligence, and punitive damages, with an expert affidavit under O.C.G.A. § 9-11-9.1.

Entities and tags

Northside Hospital, Inc.Northside Atlanta HospitalNorthside Emergency Associates, P.C.American Medical Response of Georgia, Inc.Popliteal artery injuryFasciotomyBelow-knee amputationDeKalb CountyDelayed or missed diagnosisEmergency department carePremature dischargeAmputationEmergency medicineOrthopedic surgeryEmergency medical services