Osteomyelitis is a serious bone infection characterized by inflammation of the bone/bone marrow that can prove fatal if not properly treated. Usually, when it is not properly treated, it is because a doctor has misdiagnosed the condition. This happens far more often than it should.
Osteomyelitis is caused by bacterial or fungal infections. If caught early, the condition is treatable with antibiotics and, sometimes, surgery. However, if left untreated because of misdiagnosis, the infection can spread to other parts of the body. If bone death occurs, amputation may be the only option to prevent the spread of infection. We are focusing our attention on humans, obviously. But osteomyelitis is not limited to humans. Elephants, in particular, are prone to this condition, which is often misdiagnosed and leads to their death.
If you have a potential osteomyelitis medical malpractice claim in Maryland, call us at 800-553-8082 or visit our website for a free online consultation.
What Causes Osteomyelitis?
As with any infection, the spread of germs to a vulnerable area is usually the culprit for causing osteomyelitis. A patient may contract osteomyelitis during orthopedic surgery, especially if the hardware is used to fix a fractured bone. Osteomyelitis can also occur if bacteria from major local infections such as cellulitis or necrotizing fasciitis enter the bloodstream. Perhaps unsurprisingly, one of the most common sources of osteomyelitis is staphylococcus aureus, which are bacteria commonly found on skin and mucous membranes. If an injury results in broken or punctured skin, staphylococcus aureus has a direct pathway into the body. This means that deep puncture wounds like dog bites can lead to osteomyelitis if not properly treated.
Once the bone is infected, white blood cells are attracted to the infected area. In an attempt to kill the infection, these cells (called leukocytes) release enzymes that attempt to destroy the bone. Since bones are highly vascular, pus from the immediate infection disrupts the blood flow to local vessels causing bone death. Luckily, the human immune system fights bone death by sending osteoblasts to repair the damaged bone.
These cells create new bony structures that are very visible as bone deformities on diagnostic tests such as x-rays. This is a classic way of distinguishing between chronic and acute osteomyelitis, as chronic osteomyelitis creates more deformities.
Who is at Higher Risk for Contracting Osteomyelitis?
Those who have experienced the following are at a higher risk of contracting osteomyelitis:
- Recent trauma or fracture to a bone
- Recent orthopedic surgery (especially open reduction internal fixation of bone with hardware)
- Recent major skin infection (especially cellulitis or necrotizing fasciitis)
- Recent skin ulcerations or open wounds
- Peripheral vascular disease
- History of diabetes
- Individuals with compromised immune systems
What are the Signs and Symptoms of Osteomyelitis?
Signs and symptoms of osteomyelitis include:
- Pain in the area of the infection
- Fever or chills
- Irritability or lethargy in children
- Swelling, warmth, and redness in the area of the infection
- It is important to note that sometimes there are no direct signs of immediate infection.
How is Osteomyelitis Diagnosed?
Osteomyelitis is commonly diagnosed by blood tests, diagnostic imaging, and bone biopsy.
By far the most common way to diagnose osteomyelitis is through a CBC blood test. If an infection is occurring, the test will likely reveal an elevated white blood cell count (WBC).
White blood cells fight off most infections in the body. Normal levels range from 4,500 – 10,000 white blood cells per microliter. Any number above this may be indicative of an infection
X-rays are a very effective tool for diagnosing osteomyelitis. Generally speaking, it is cheaper to get an x-ray considering nearly every healthcare facility has an x-ray machine nearby. Moreover, despite their limitations in revealing damage to soft tissue, x-rays are very good at visualizing bony structures. However, damage may not be visible until osteomyelitis has been present for several weeks.
More expensive tests can also provide detailed images. Computerized Tomography (CT scans) and Magnetic Resonance Imaging (MRI) can provide detailed images of the bone and the surrounding soft tissue.
A bone biopsy can reveal what particular organism is causing osteomyelitis and is another important tool for determining what antibiotics should be used for treatment.
How Is Osteomyelitis Treated?
Osteomyelitis is usually treated with antibiotics and surgery. Hospitalization and a course of IV antibiotics for around ten weeks are required. If a large area of the bone has died, or the infection has spread, surgery may be required to drain the infected area, remove diseased bone and tissue, and restore blood flow. There have also been instances when a surgeon was required to amputate the infected area to stop the infection from spreading.
When is the Failure to Diagnose or Treat Osteomyelitis Medical Malpractice?
Medical malpractice typically occurs when a physician cannot recognize or respond to the signs and symptoms of osteomyelitis. On many occasions, a simple reading of a patient’s medical records can reveal if they are at higher risk for osteomyelitis. A patient with a recent history of trauma, infection, or orthopedic surgery would fall into this category.
Commonly, the patient presents with symptoms of severe pain, redness, and swelling in the infection’s location. Medical malpractice may occur if the physician cannot diagnose osteomyelitis by performing the appropriate diagnostic testing or cannot treat the condition by prescribing the appropriate antibiotics. Surgery can be avoided with the timely administration of IV antibiotics, making it essential for the physician to pay close attention to the patient’s symptoms.
Sample Settlements and Verdicts
To give you an idea of how juries rule in osteomyelitis cases, we pulled some plaintiff’s verdicts at random. These are a fairly mixed-bag of cases and facts, so you should not consider these as the ultimate arbiter of your case’s worth. Still, consider this one tool to use when evaluating the value of your case.
- 2019, New Jersey: $2,500,000 Verdict—A 20-year-old woman underwent surgery on her right foot to correct a bunion. A podiatrist performed the procedure. She returned to the same podiatrist, days after the surgery, with concerns that her now blackened toe was infected and experienced decreased blood flow. The podiatrist’s partner found no infection signs but put her on antibiotics. Despite undergoing multiple antibiotic and surgical treatments for 18 months, her surgical wound never healed. She eventually underwent an MRI scan that revealed osteomyelitis. Following her diagnosis, she saw an orthopedic surgeon who removed a bone from her toe. Her wound finally closed, and she was declared infection-free. She sued the podiatrist for failing to provide standard of care and committing malpractice. The woman testified that she can no longer play soccer and wear certain footwear. The jury awarded her $2,500,000.
- 2019, Virginia: $4,500,000 Verdict— A 53-year-old man developed osteomyelitis after undergoing arthroscopic surgery to remove hardware in his left leg. The surgery was performed out of infection concerns. Following the surgery, part of his wound was left open and exposed bone. The wound was covered with gauze. The man eventually developed osteomyelitis, which necessitated a left leg amputation. He sued the surgeon for negligence and the hospital for vicarious liability. The man claimed the surgeon failed to stabilize the tibia and promptly cover exposed bone. He received a $4,500,000 jury verdict.
- 2019, Florida: $11,800,000 Verdict— A 53-year-old man consulted an osteopathic orthopedic surgeon for his knee pain. The surgeon performed a left knee arthroscopy, chondroplasty, meniscectomy, and hardware removal on him. He eventually performed a total knee replacement several months later. Two weeks after the surgery, the man was admitted to the hospital for a potential hardware infection and treatment for cellulitis. The surgeon examined him the following day and recommended outpatient treatment. The man visited the hospital two days later, where the staff diagnosed him with an E. coli infection and osteomyelitis. His left leg would eventually be amputated above-the-knee. He sued the surgeon for recommending a total knee replacement, despite the high infection risk. The jury awarded him $11,880,000.
- 2015, Virginia: $600,000 Settlement—After suffering from severe back pain, a 64-year-old man presents to the emergency room. He is diagnosed with a lumbar strain and told to take ibuprofen. Three days later, the man presents again, complaining of similar pain. No physical examination was given, and the patient is, once again, told to continue taking ibuprofen. He returns the following day, only to be diagnosed with several infections including osteomyelitis. He is eventually transferred to Johns Hopkins, where he is treated for various illnesses including encephalitis and other infections. Other doctors suggest that a CT scan and administration of IV antibiotics would have prevented the severe illnesses suffered by the plaintiff. As a result, he sues the original hospital, who settled the claim prior to trial.
- 2014, Pennsylvania: $3,500,000 Verdict—A man with a history of diabetes has to undergo surgery to treat his Cauda Equina Syndrome. After the surgery, the man develops pressure sores throughout his body, with the worst being on his feet. The man also develops sores on his coccyx from being left in a bedpan for a significant amount of time. After also developing MRSA and other infections, the patient undergoes 18 surgeries. He then develops osteomyelitis in his foot, causing him to undergo amputation surgery to further prevent the spread of infection. The man sues the hospital, claiming that negligent care caused the infections and subsequent surgeries. The defense drew attention to the man’s elevated risk of developing an infection, claiming that they did all that they could to prevent infection. The jury disagreed and awards a $3,500,000.
- 2013, Maryland: $869,082 Verdict—A 56-year-old man presents to the hospital emergency room. He had undergone neck surgery 10 years earlier, putting him at high risk for developing osteomyelitis. Over the first 4 days of hospitalization, he complained of persistent neck pain. However, no one examined his neck or performed an x-ray. He was simply given morphine. On the fifth day, a cardiologist performed a cardiac catheterization. Following the procedure, the man somehow fractured his neck and spent the next 41 days on life support until he passed away. An x-ray following the catheterization revealed that the man had been suffering from osteomyelitis. The Plaintiff contended that a simple x-ray would have led to a diagnosis prior to the catheterization. The Plaintiff also contended that once the diagnosis was made, the application of a soft collar would have guarded against a neck fracture. After deliberating for several hours, the jury returned a verdict of $869,082.
- 2006, Maryland: $1,000,000 Settlement–A woman goes to an orthopedist for a cervical laminectomy. Following the surgery, she returns to the orthopedist for treatment because the surgical incision was painful, red, and draining pus. The orthopedist cultures the fluid and finds evidence of Staphylococcus aureus. He prescribes an oral antibiotic, but the patient sees no improvement. The infection spreads and she eventually needs additional surgeries, including a total right hip replacement. The woman sues the orthopedist, contending that he was negligent in failing to consult with an infectious disease specialist at the time of the culture and that he should have prescribed IV antibiotics. The case settled prior to trial for $1,000,000.
- 2004, Maryland: $2,200,000 Settlement—In this tragic case, a 71-year-old man presents to the hospital with severe back pain. He sees an orthopedist that diagnoses him discitis and prescribes pain medications. 17 days later, the man is discharged. He follows up with the same orthopedist on two additional occasions over the next several weeks complaining of severe back pain, neck pain, and feeling sensations of electrical shocks down both arms. Each time the orthopedist fails to diagnose the condition. A few days later, he goes to the hospital. Within hours, the man loses the ability to move his arms and legs. An MRI revealed he had been suffering from osteomyelitis. Because of the orthopedist’s negligence in failing to diagnose and treat the condition, the man is permanently paralyzed. The case settled prior to trial for $2,200,000.
- Get more verdict information and more details on these cases.
Medical Malpractice Claims in Maryland: Getting Help
If you think you have a potential wrongful death malpractice claim for someone you loved because a doctor failed to diagnose osteomyelitis, call 800-553-8082, or get a free no obligation case evaluation.