Daniel E. Holloway
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Northside Hospital-Cherokee complaint alleges a delayed hip diagnosis and a reduction fracture before avascular necrosis

The complaint alleges that emergency-department providers delayed treating a dislocated hip in a 14-year-old patient. A STAT hip X-ray ordered at 8:41 p.m. was not performed until after midnight, more than three hours later. A physician then attempted a closed reduction of the hip and fractured the patient’s femoral head. The patient was later transferred for pediatric orthopedic evaluation and taken urgently to surgery. His surgeon noted the prolonged dislocation likely compromised blood flow to the femoral head. He developed avascular necrosis, required a vascular bone-grafting procedure, and underwent a complete hip replacement about a year later.

System
Northside Hospital, Inc.
Facility
Northside Hospital-Cherokee
Providers involved
Northside Hospital, Inc. / Envision Physician Services, LLC / Jonathon C. Allen, M.D. / Kyle R. Schneider, PA
Pattern
Alleged delayed diagnosis and treatment of a dislocated hip that fractured during a closed reduction
Harm
Alleged avascular necrosis, additional surgeries, and a hip replacement in a teenager

Overview

This page concerns a public complaint alleging that emergency-department providers delayed treating a dislocated hip and fractured it during a reduction attempt.

Chronology

The complaint alleges as follows:

  1. The patient, 14, arrived at the Northside Hospital-Cherokee ER around 8:10 p.m. on October 24, 2022, after a baseball injury.
  2. A STAT hip X-ray was ordered at 8:41 p.m., and a physician assistant examined him at 10:24 p.m. and diagnosed a dislocation.
  3. The X-ray was not performed until about 12:21 a.m., more than three hours after it was ordered, and showed dislocation with no definite fracture.
  4. A physician attempted a closed reduction around 1:24 a.m. on October 25, 2022, and fractured the patient’s femoral head while doing so.
  5. A post-reduction X-ray showed a severely displaced femoral head and neck fracture with a persistent dislocation.
  6. The patient was transferred to a children’s hospital for pediatric orthopedic evaluation and underwent urgent surgery. His surgeon noted the dislocation had begun more than 12 hours earlier.
  7. His surgeon noted the prolonged dislocation likely compromised blood flow, and the patient later developed avascular necrosis and underwent a hip replacement.

Alleged failures

The complaint alleges the following failures:

  • The physician assistant did not promptly evaluate or diagnose the dislocated hip despite a clinical presentation calling for high suspicion.
  • The physician fractured the patient’s femoral head while attempting a closed reduction. He then did not ensure a timely specialty consult or transfer to a higher level of care.
  • Northside Hospital, Inc. and Envision Physician Services, LLC are each vicariously liable for the physician’s and assistant’s acts, the complaint alleges.
  • The complaint pleads medical malpractice, gross negligence, negligence per se, and vicarious liability against the defendants, with an expert affidavit under O.C.G.A. § 9-11-9.1.

Entities and tags

Northside Hospital, Inc.Northside Hospital-CherokeeEnvision Physician Services, LLCJonathon C. Allen, M.D.Kyle R. Schneider, PAHip dislocationFemoral head fractureAvascular necrosisCherokee CountyDelayed or missed diagnosisEmergency department careDelayed treatmentPost-operative complicationsEmergency medicineOrthopedic surgeryPediatric orthopedics