Physical Therapist Medical Malpractice Lawsuit

This is a physical therapy medical malpractice lawsuit filed by a woman in Prince George's County. This case is the 67^th medical malpractice case filed in Maryland Health Claims Arbitration in Maryland in 2017 and was filed on February 7, 2017.

Plaintiff becomes a patient at defendant Sports Pro Physical Therapy in Prince George's County due to injuries she sustained in a car accident to her right foot/ankle and her lower back. She receives services on a continual basis for three months and then has a right total ankle arthroplasty done at Georgetown University Hospital.

A month after the procedure, she returns to the defendant physical therapist for rehabilitation of her right ankle. About three months later, the doctor who performed the procedure determines that she has a sustained non-displaced medial malleolar fracture in her right ankle due to the actions of defendant therapist who treated her with a balance board "against medical advice."

The surgeon has to perform an open reduction internal fixation of a medial malleolar fracture. This requires a lengthy period of rehabilitation and therapy. Despite this, the condition of the woman's right ankle further deteriorates, and she has a permanent disability.

How This Case Is Won or Lost

Like many malpractice lawsuits, this one is built around a series of decisions that, in hindsight, may have contributed to a preventable outcome. The plaintiff’s theory is straightforward: that the orthopedist missed clear signs of a worsening ulcer, failed to adjust the treatment plan accordingly, and waited too long to refer the patient to a specialist. According to the plaintiff, these delays ultimately led to an amputation that could have been avoided with more attentive care.

We do not know yet what the full medical record will show. The defense will almost certainly argue that this was a medically complex patient from the beginning. Neuropathy, anemia, and a history of cancer treatment are serious factors that affect healing. The defense may also claim the ulcer developed despite reasonable care and that its progression was unavoidable given the plaintiff’s overall condition.

But even when a patient has complicating health issues, that does not excuse a failure to act. If a doctor knows a patient is high risk, that should trigger closer follow-up and a lower threshold for involving wound care specialists or ordering further testing. The allegations here suggest that the patient’s foot was visibly worsening despite repeated assurances that things were improving. If the cast was not being adjusted to offload pressure properly or if the ulcer was not thoroughly evaluated when new symptoms appeared, those are serious concerns.

What is also potentially significant is the role the plaintiff’s primary care physician played. That doctor saw something the orthopedist allegedly missed and made the referral to a wound care expert. By that time, the injury had already advanced to the point that surgical removal of bone was necessary. If the jury finds that the signs of infection or tissue breakdown were clear enough to warrant an earlier intervention, that could form the foundation of a strong liability case.

At the same time, we recognize that medical decisions are not always black and white. The court will hear from experts on both sides, and this will likely turn on whether the care provided met the standard for managing a high-risk foot injury. That is what medical malpractice cases ultimately come down to: whether the doctor did what a reasonably careful physician would have done under the same circumstances.

You do not often see medical malpractice lawsuits filed against physical therapists, at least not compared to doctors, surgeons, or hospitals. That is not because physical therapists never make mistakes. They do. But there are several reasons why claims against them are relatively uncommon—and why many lawyers decline to pursue them unless the facts are especially strong.

First, most injuries that occur during physical therapy are not catastrophic. A strained muscle, a setback in recovery, or even a re-injury during rehab might be painful and frustrating, but it rarely rises to the level of significant, lasting harm that justifies the cost and risk of a malpractice case, at least from the malpractice lawyer's perspective. Medical malpractice litigation is wildly expensive, expert-driven, and time-intensive. For a case to make economic sense, there generally needs to be a serious and permanent injury, like paralysis, loss of limb function, or the need for surgery that could have been avoided. Those outcomes are far less common in the PT setting.

Second, proving negligence in a physical therapy case can be more difficult than it appears. A lot of what happens in therapy involves some level of discomfort or risk. Patients are often pushed to their limits to regain strength or mobility. So when something goes wrong, the defense can argue that the event was a known and acceptable risk of the rehabilitation process, not a deviation from the standard of care. That gray area often makes these cases harder to win.

Third, many physical therapy injuries are attributed, often fairly, to pre-existing conditions or the underlying injury being treated. In other words, the defense argument is often that the patient was already at risk for the outcome they suffered, and that physical therapy simply did not help as much as they hoped. That creates a challenge in establishing clear causation, which is a requirement in any malpractice claim.

Finally, there is the insurance issue. Some physical therapists carry lower policy limits, and many work under the umbrella of larger medical groups or rehabilitation clinics where the employer’s liability might be limited. That can affect the potential recovery in the case and discourage attorneys from taking claims that are unlikely to yield a meaningful settlement or verdict.

That said, physical therapy malpractice claims do happen and our lawyers have seen it. When a therapist ignores a clear contraindication, fails to properly monitor a high-risk patient, or uses unsafe equipment or techniques, and a patient suffers a serious injury as a result, a claim may very well be appropriate. But those cases tend to be the exception, not the rule.

• This Complaint has more questions than answers. First, is it a breach of the standard of care to use a balance board to rehabilitate this injury?
• The Complaint quotes the doctor as treating the victim with a "multiaxial balance board against medical advice. How as the use of this board against medical advice? Did the orthopedic doctor specifically say not to use a balance board? Were there oral or written instructions? It would seem odd that the doctor would have instructed the physical therapist not to use a balance board?
• Was it an acute injury or something the doctor figured out? The Complaint is very awkwardly worded. Did the patient know there was an injury the moment it happened?
• The victim claims a permanent ankle injury. Trying to thin slice which injury is from the car accident and which is from the malpractice may be a challenge.
• Plaintiff has a real chance of winning this case if the treating orthopedic doctor is fully on board with the allegations in the Complaint. If not, it will be an uphill battle.
• This is yet another medical malpractice lawsuit filed on the eve of the statute of limitations without a report from a medical expert.

• Prince George's County

• Sports Pro Physical Therapy, LLC
• A physical therapist

• Georgetown University Hospital

• Failure to properly administer physical therapy to rehabilitate the plaintiff's right ankle arthroplasty
• Failure to follow instructions and prescription from treating physician
• Causing harm and injury to plaintiff from a balance board
• Failure to properly instruct plaintiff during physical therapy

• Medical Malpractice

• None at this time

If you have sustained a severe injury due to the negligence of a doctor or nursing staff, our firm can help you. You may be entitled to compensation and justice for the harm you have endured. Call Miller & Zois today at (800) 553-8082 or get a free online case review.

• Take a look at the potential value of your medical malpractice case
  • Information about ankle and foot injuries and their value
• The other medical malpractice cases filed in 2017 in Maryland
• Medical malpractice lawsuits against physical therapist are relatively rare. Here are the statistics.
• Here is another lawsuit against physical therapists. This case involved a nursing home patient who fell while being assisted by two physical therapists. So it really does not go to the core of the PT's care and treatment of the patient.