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The response to the question below was authored by Marc Mitnick DPM

My doctor did the wrong procedure

I had requested and consented to an Austin type bunionectomy. My DPM had not written in his notes clearly that I wanted a this procedure. He had that I wanted a lapidus procedure. The consent that I signed in the pre-op area clearly showed only the incisions for the Austin procedure with two screws. I knew this was correct and signed the form. After I was sedated and being wheeled to the OR, my doc felt that he, in error, had omitted the fusion in the arch with two additional screws, and changed the form and asked me if I was ok with him doing so. I have no recollection of that conversation because I was already sedated.

The procedure was done. It was not until my first post-op visit that the confusion was realized on my part. The incision was so long that I questioned him. He explained his error on the consent form and stated that he talked to me about it. I then explained to him that he did the wrong procedure. His records were incorrect and he admitted that he had not documented my request appropriately on our first appointment.
Now, that is done. I have requested physical therapy because I did not feel that my scar tissue and toe were healing as well as they could due to the fact I did not take as much time off from work as I would have if I had known

about the different procedure. My job requires alot of walking and standing.

My question is this--would this be considered malpractice since my chart was changed post being sedated? I am not looking to sue my doc--especially since I do believe that he truly thought he was following my wishes--he just did not believe that I paid attention to what I was signing pre-op (typical). The physical therapy is quite a large out-of-pocket expense for me--should he cover that cost?

Above all, I just want my foot to heal and get back to the activity level that I was pre-surgery. My arch is higher now, and really the only source of pain and discomfort. I am 10 wks post-op now.

Thank you for your time-

pdrx

Hi pdrx,

I do not really want to get in the middle of this but you cannot ask a patient to change consent once he or she has been sedated.
Having said that, the criteria for doing an Austin vs. a Lapidus procedure is different, so if your foot actually required a Lapidus based on pre-operative criteria, then the Austin bunionectomy alone would not have adequately corrected the bunion deformity, so even though you are left with a longer scar, assuming everything was done properly, in the long run you will be much happier with the results.

Marc Mitnick DPM

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Drugs.com

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Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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My doctor did the wrong procedure

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