Infectious Disease Physician Discharges Patient; Results in Amputation

This case takes place in Ohio and involves a diabetic male who presented to the hospital with complaints of left foot pain. The patient had an extensive history of diabetes, hyperlipidemia, and hypertension, and he was also a pack-per-day smoker. The patient had injured his left toe after stepping on a nail and was treated by an infectious disease physician. The physician prescribed an antibiotic regimen and discharged the patient. The physician told the patient to follow up with his primary care physician to set up further wound care and treatment of his foot infection. Several weeks later, the patient failed to follow up with his primary care physician, and was readmitted to the hospital for amputation of his right toe due to an aggressive infection.

Question(s) For Expert Witness

Expert Witness Response E-002755

Diabetic foot disease causes more amputations than any other lower limb disease. The most common risk factors for ulceration and resulting amputation are infection, neuropathy, and ischemia. Although amputations are not always inevitable, many patients with this disease result in amputation because of improper detection and/or inappropriate treatment of foot ulcers. A systematic approach to the treatment regimen, patient education, screening, and intervention can improve end results in this disease. With the advent of Diabetic foot clinics, general practitioners, and physicians alike can facilitate appropriate treatment and prevention of further complications.

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