Verdicts & Settlements

RESULTS: $500,000 Settlement

COURT: Virginia Circuit Court

DATE: 2025

ATTORNEY: James P. St. Clair

STAFF: Kathryn B., Paralegal

CASE DESCRIPTION:

Medical malpractice against an orthopedic doctor for failure to diagnose and provide treatment of a right tibial fracture of the knee, resulting in complex extended surgery and the need for knee replacement.

WHAT HAPPENED:

Our client was a self-employed commercial cleaner when she fell from a six-foot ladder, injuring her right wrist, ankle, and lower leg. She presented to a local urgent care facility, which diagnosed her with a fracture of the right wrist radius and referred her to an orthopedic group.

The orthopedic group treated her broken wrist, x-rayed her ankle, and diagnosed her with an ankle sprain.  However, no knee X-rays were performed on her knee, despite multiple complaints of right leg and knee pain and swelling, according to our client.

Nine weeks after her initial injury, she underwent an open reduction and internal fixation of her tibial plateau knee fracture, which took two hours to complete and included surgical instrumentation. The surgery was not necessitated by malpractice.

She was eventually discharged from physical therapy and was noted to have a good result with minimal pain. However, the delay in the diagnosis of her fracture to the tibial plateau (just under the knee joint) contributed to her knee arthritis and the probability of our client needing a costly and complicated future knee replacement surgery. Ultimately, our client claimed past medical expenses of $25,000.00 with a potential future knee replacement at a cost of $100,000.00.

LEGAL STRATEGIES:

The orthopedic surgeon defended this medical negligence case by asserting that our client did not complain of knee pain during the initial examination. So, the key to unraveling this case and proving medical malpractice was to show that the surgeon, for whatever reason, failed to properly evaluate the knee or order X-rays or imaging of the knee joint during his initial orthopedic care.

During this litigation phase of the case, Attorney Jim St. Clair learned that one of the treating orthopedic nurses at the doctor’s office had left the practice. Mr. St. Clair tracked down this nurse and was able to confirm that our client had definitely made complaints to the orthopedic surgeon about her knee, contrary to the orthopedic surgeon’s recollection of those visits.

The X-ray done later shows tibial plateau  fracture

However, the nurse had been subsequently discharged from the orthopedic practice for unrelated reasons, so naturally, the orthopedic doctor and his attorney claimed she was unreliable, but she testified that she had heard our client complain to the surgeon about the knee to corroborate our client’s version of events.

Furthermore, while undergoing physical therapy for what the orthopedic doctor had initially diagnosed as only an ankle sprain, the physical therapist advised our client to have her knee reevaluated by the orthopedic group, as her pain was not improving. The second orthopedic doctor from the same group ordered both an X-ray and a CT scan of the knee area, which were performed six weeks after her fall. This confirmed a displaced, comminuted Schatzker 5 fracture of the tibial plateau, which was addressed and repaired, but much later than it should have been.

After tibial plateau surgery, showing surgical hardware

It is standard of care for an orthopedic surgeon to recognize a knee injury of this severity. A distracting second injury, such as a wrist fracture, should heighten the surgeon’s awareness of any other musculoskeletal complaint. This is part of a standard secondary survey by an orthopedic doctor, which must be done in the setting of a high-energy injury.

RESULTS: At a judicial settlement conference, a month before the jury trial was to begin, the case was settled for $500,000.00.