Coming to grips with a decision to amputate a limb is a heartbreaking one that is all too often compounded when there is a medical mistake resulting in the amputation. Such medical negligence generally falls into one of five categories: (1) human error in removing the wrong limb; (2) mistakes made intra-operatively during a procedure for another reason; (3) failure to appropriately stop the spread of infection; (4) failure to recognize an adverse /allergic reaction to medications such as Heparin; and (5) human error in a pre-operative diagnosis.
Despite state-of-the-art advancements in how to appropriately document what part of the body is to be operated on pre-operatively, and then double and triple check that fact in the operating room with the patient prior to the operation, episodes of human error still occur. In short, the errors usually begin with the simple erroneous recordation of the limb to be removed (right vs. left). This information is then relayed to individuals in the operating room who mark the patient’s limb to be removed. Although patients are supposed to be part of the “limb identification” process, they are often mistakenly not asked to verify what the health care providers have assumed is accurate. A second cause of erroneous amputations occurs when health care providers are operating on a limb during an operation and make a mistake during that procedure that results in the need to amputate that limb (when that was never the plan all along). A third example of amputation error occurs when the physician is aware of the presence of an infection such as gangrene, attempts to remove the infected tissue or bone and stop the infection, but does so negligently, allowing for the continued spread of infection and ultimate need to amputate the limb. A fourth example occurs in the setting of a known patient allergy to a particular medication, i.e., a patient’s allergy to Heparin a blood thinner. A small percentage of patients who receive Heparin develop what is known as Heparin Induced Thrombocytopenia (“HIT”), a condition in which the patient’s blood will actually begin to clot immediately upon the introduction of Heparin into their bloodstream. The end result is the cessation of blood flow to the limb or limbs and the death of the surrounding tissue, leading to amputation or even worse, death. Finally, amputation errors can occur in the pre-operative setting, again due to human error. The most common type of error that our office sees in this setting is one in which the physician negligently diagnoses a patient with cancer in a limb and advises the removal of that limb. Post-operatively when the tissue from that limb is examined by a pathologist, it is discovered that the physician negligently diagnosed the patient with cancer, when in fact he/ she did not have cancer. In short, the procedure to remove the limb was unnecessary.