Outpatient Surgery Magazine

Patient Experience - June 2019 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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• Pre-op. Mr. Standley was not a candidate for TKA because of his multiple knee surgeries and history of osteomyelitis. • Intraop. Dr. Rech failed to provide appropriate perioperative antibiotics. • Post-op. Dr. Rech failed to properly manage the infection once it occurred. Additionally, Dr. Rech's records didn't include a complete history of Mr. Standley's previous surgeries or osteomyelitis — despite a report of such by another doctor who performed pre-op medical clearance — and no indication that a bone scan, MRI or CT was performed before surgery. The surgery, done in 2 stages over 3 months, included arthroscopy, meniscectomy, chondroplasty and removal of hardware. Complications accelerate Two weeks after the final surgery, Mr. Standley presented to Dr. Rech's office for post-op evaluation. The doctor ordered Keflex (cephalexin) for infection prophylaxis, which Mr. Standley's complaint alleged "indicates that infection was in Dr. Rech's thought process," court records show. Eleven days later, Mr. Standley went to an ER with complaints of severe left knee pain and drainage. An ER doctor noted that the surgi- cal site had surrounding erythema and warmth. Lab tests showed ele- vations in white blood cell count, sedimentation rate and C-reactive protein. Mr. Standley was admitted for cellulitis and "possible infected hardware." However, Dr. Rech visited the patient the next day and wrote a progress note that said there were no indications of infection and that the patient "may be treated on an outpatient basis," after which Mr. Standley was discharged. The next night, however, Mr. Standley was back in the ER, reporting knee pain and swelling. He was admitted with a diagnosis of infection J U N E 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 2 1

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