(Please note: the names and locations of all parties have been changed to protect the confidentiality of the proceedings.)
2. FAILURE TO REFER TO A SPECIALIST:
After having tried to close the open wound for six months, or perhaps even a year, the standard of care would require Dr. X. to send Mr. Smith to a wound specialist or a plastic surgeon. As the months and years went by, Dr. X. failed to refer Mr. Smith to an appropriate wound specialist or plastic surgeon.
It was critical to plainitff’s health that the open wound be closed by plastic surgery if necessary. This is because the skin acts as a barrier to infection. When the skin is broken, bacteria can enter. Dr. X. testified on page 44, lines 8 through 11:
“Q. So when the skin is broken, there’s always a risk of infection?
A. There’s a risk of infection when the skin is broken.”
3. STEROID INJECTION: “THE WRONG THING TO DO”
In the hospital Mr. Smith was confirmed with an MRSA infection in his wound. Dr. X. had injected this infected wound with Kenalog, a powerful steroid, on March 11 and March 19, 2002. Dr. X. testified on page 71, lines 14 through page 72 line 25:
“Q. Right. And would you agree that injecting an infected wound with a steroid such as Kenalog would be the wrong thing to do?
A. I would agree that injecting an infected wound with Kenalog would be the wrong thing to do.
Q. Why would it be the wrong thing to do?
A. Kenalog can interfere with the healing process and with the immune process.
Q. And tell me what you mean by that.
A. It can – – Kenalog can slow down the growth of fibroblasts which make new tissue and can slow down the growth of and thin the epidermis, the skin, and it can also slow down the – – reduce the effectiveness of the body’s inflammatory cells.
Q. So injecting an infected wound with Kenalog makes it harder for the body to fight the infection?
A. It could.
Q. And Kenalog is also an anti-inflammatory, true?
A. Kenalog is a corticosteroid which is an anti-inflammatory, yes.
Q. So injecting a wound with Kenalog would – – could makes the seriousness of the infection by reducing inflammation?
A. It would reduce the inflammation. Generally speaking if there’s a significant infection there you’ll see it despite the injection of a steroid into the wound.
Q. So injecting an infected wound with Kenalog would both make it harder for the body to fight the infection a make it less obvious to medical providers that it was infected?
A. That has that potential.
Q. Now, can the same be said of systemic steroids?
A. The same could be said of systemic steroids.
Q. And you prescribed a systemic steroid for Mr. Fideldy, did you not?
A. I did.”
The result of injecting an infected wound with Kenalog has been described by plaintiff’s consultant as like “throwing gasoline on a fire.”
The end result of Dr. X’s two-year care of William Smith was to send him into sepsis and then quadriplegia. He ignored the possibility of infection, he refused to refer him out for better care, and he injected the wound with Kenalog. (See Part 14 of 23.)
For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.