Physical Therapist Discharges Vulnerable Patient Too Early


Physical Therapy Expert WitnessThis case takes place in New Jersey and involves a middle-aged male patient who was born with a mild form of a neurological disorder which made coordinated movement difficult. The patient had suffered a serious fracture on his right ankle while exercising, which required fairly extensive orthopedic surgery to repair. After undergoing a successful surgery, the man was placed in the care of a post-operative rehabilitation facility. While in the care of this facility, the patient participated in daily rehabilitation exercises designed to strengthen his ankle in anticipation of his eventual release. The patient was discharged by the rehabilitation facility weeks ahead of schedule. A few hours after being released for the rehabilitation facility the patient re-injured his ankle, making another surgery necessary. It was alleged that the post-operative rehabilitation facility was negligent in releasing the patient too soon.

Question(s) For Expert Witness

  • 1. Do you treat post op ankle surgery patients?
  • 2. Are you familiar with the guidelines for when a patient should be released?
  • 3. Given your experience in this setting, do you believe that you may be able to determine if this patient was released prematurely after a thorough record review?
  • 4. Please explain why you are qualified to review this case and if you have served as an expert witness on any similar cases.

Expert Witness Response O-007402

I have treated many patient’s who have had an ORIF to their ankle. I have treated these patients in multiple settings, including acute, rehab, SNF and outpatient. After reviewing the records, I am sure I could determine if the patient was safe enough for discharge home, or if he required further PT intervention. I have been a physical therapist for 18 years, working in a variety of settings during that time, I have worked as an expert witness reviewing thousands of pages of medical records and am very thorough. I have been deposed multiple times as an expert witness and have been to court recently, where in the opinion of the attorney, I was a vital component of the plaintiff winning his case. I have reviewed many cases involving patient falls. I have worked as the orthopedic team leader in a major acute care hospital where instructing patients after an orthopedic surgery for a safe discharge was my primary duty.

Expert Witness Response E-000326

I routinely treat post op ankle surgery patients. 15% of my cases are ankle cases and I am very familiar with ORIF procedures and their rehabilitation protocols. In order for this patient to be released, the patient should be a safe ambulator and have good balance / coordination, strength and ROM, prior to discharge. Typically, complications of CP include gait dysfunction and would put the patient at higher risk of re-injury, and must be considered in the rehab process. I can certainly help determine if this patient was released prematurely; I would need to review the patient’s PMH, the initial evaluation, daily notes, progress reports and the discharge summary, in order to determine if the plan of care was carried out properly. I feel especially qualified for this case because I’ve taken expert cases involving CP patients in the past. And lastly, I own and practice full-time in an outpatient facility.

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