Question

part 4

THE CASE OF JACOB AND THE DISEASED LEG

Jacob is an outstanding quarterback on his high school football team who

has been offered a college scholarship when he graduates. Unfortunately,

Jacob was injured during a late summer practice just before his senior

year. He suffered a compound fracture of the fibula bone in his lower leg.

Since the fracture broke through his skin, he required a surgical repair to

align or set the bone and close the skin. Dr. M., an orthopedic surgeon,

kept Jacob in the hospital for three days and ordered intravenous

antibiotics to be administered. When he was discharged from the hospital,

Jacob was told to come in for an office visit once a week for six weeks.

At six weeks Jacob’s parents took him in to the surgeon’s office for his cast

removal, and except for a slightly inflamed and draining area around his

stitches, Jacob’s broken bone seemed to be healing. After his cast was

removed, Jacob was told to wait for a few minutes while the surgeon went

across the hall to check on another patient. Dr. M. removed his gloves,

washed his hands in Jacob’s exam room, and then went across the hall to

examine another patient, Sarah K. The doors between the exam rooms

were left open and Jacob’s parents could see and hear Dr. M. examine

Sarah’s infected leg. They could tell that Dr. M. did not replace his gloves.

He told Sarah that he was glad to see that her osteomyelitis (a serious

bone infection) was almost better, and he told her to come back in another

week. Dr. M. then came back into Jacob’s room, still without gloves, and

examined Jacob’s leg more carefully. He was concerned about the

inflammation around the incision site and told the parents to keep the area

clean and dry. He wrote Jacob a prescription for an oral antibiotic and said

he could start to put a little weight on his leg. When Jacob came back the

following week, his leg was grossly infected with a large abscess. Jacob

had to have further surgery to drain the abscess. The pathology report of

tissue specimens from Jacob’s leg determined that he had developed

osteomyelitis. This infection took several months to heal. The delay in his

recovery meant that Jacob was unable to play football that fall and lost his

chance at a college scholarship. Jacob’s parents asked Dr. M. to provide

them with the results of the tissue test. They then sued Dr. M. for

negligence.

Case Questions

4. What could all of the involved parties have done to prevent this situation

from occurring?

Please explain your choice(s).

Answer 1

4. The doctor must have practiced strict aseptic techniques in order to prevent the infection being spread from one patient to another. The doctor did not washed his hands or put on gloves after examining an infected patient and he probably contracted the infection to Jacob.

Jacob and his parents have witnessed the doctor checking another patient's infected leg as well as their conversation. They saw the doctor coming to Jacob without washing hands. They must have reminded doctor to wash hands before examining the leg.

If any one of the involved parties have taken a proper step, the health care concern must not have progressed to such complications. It is clearly the responsibility of the doctor to maintain aseptic precautions, but self care is also an essential for healthy life.