Carla was 50 years old at the time. She had difficulty with her left knee and consulted an orthopedic surgeon who recommended a total knee replacement. She failed to seek a second opinion. She subsequently learned that a total knee was unnecessary. Unbeknownst to her, the surgeon placed a non-FDA approved prosthesis, and according to a second orthopedist who she subsequently consulted he misaligned the prosthesis.

Carla's Xrays
Xrays of Carla’s knee: Left her first repair, Right the second repair

Following the placement of her total knee she experienced continual severe pain requiring strong narcotic pain medications, oxycodone and oxycontin. These medicines precipitated a severe depression and a suicidal attempt. She was unable to work and suffered financial hardship.

6 months after placement of the first prosthesis she had to undergo a second major operation to replace the prosthesis. Her pain continued and she sought legal recourse, however given her fragile mental state she was unable to tolerate the emotional stress of litigation and withdrew her claim.

After a 1 1/2 years she discontinued her pain medications and thanks to her deep abiding faith she was able to overcome her disability and pain. She transformed herself from a victim to a survivor, and now is a successful realtor.

As her father had warned her as a child “Life is not always fair.”

But shouldn’t Carla have received financial assistance during this difficult period of pain and mental anguish?  Her injury was not her fault, and I suspect the surgeon installed this new prosthesis expecting a superior result. Unfortunately his lack of familiarity with the prosthesis led to misalignment and Carla’s poor outcome. What would have happened if he had acknowledged his mistake, sincerely apologized, explained his plans to prevent this outcome from happening to other patients and contacted his insurance company to fairly compensate Carla during the period she was unable to work? Carla would have felt validated and in all likelihood would have recovered more quickly. She and her physician could have maintained a positive relationship, and Carla’s distrust of the healthcare system would have been alleviated.

Oregon now is considering a legislative act entitled: RESOLUTION OF ADVERSE HEALTH CARE INCIDENTS that will encourage this much more effective approach to patient injury. Our legal system has failed in making injured patients whole, <25% of those with preventable medical injuries receive a legal settlement and when they do 2/3rds of the award goes to their lawyers. Litigation creates an adversarial relationship between caregivers and patients and prevents both groups from communicating. This lack of communication makes emotional closure nearly impossible and stokes the fire of destructive anger. Patients need to devote their emotional energy to recovery rather than toward blame and anger. Bills like the one in Oregon have the potential to help transform victims of medical errors into survivors.