Benzmiller v. Swanson

117 N.W.2d 281, 1962 N.D. LEXIS 90
CourtNorth Dakota Supreme Court
DecidedOctober 2, 1962
Docket7977
StatusPublished
Cited by30 cases

This text of 117 N.W.2d 281 (Benzmiller v. Swanson) is published on Counsel Stack Legal Research, covering North Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Benzmiller v. Swanson, 117 N.W.2d 281, 1962 N.D. LEXIS 90 (N.D. 1962).

Opinion

STRUTZ, Judge.

This is an appeal from an order granting a new trial. The complaint of the plaintiff against the defendant, an orthopedic physician and surgeon, charges the defendant with malpractice in the setting and treatment of a broken arm.

The plaintiff was involved in a farming accident on Saturday, July 12, 1958, when he fell from a hayrack while loading baled alfalfa. The field where the accident occurred had been fertilized with manure. The plaintiff was immediately taken to a local doctor in a nearby town but, on examination of the plaintiff’s injury, the local doctor determined that the plaintiff had suffered a compound comminuted fracture; that the injury was potentially very dangerous and constituted a medical emergency which should not be treated by a general practitioner. The plaintiff thereupon was advised to go immediately to Fargo for treatment.

On arriving at the St. John’s Hospital emergency room, X-rays were taken of the *284 plaintiff’s injury and these disclosed to the intern on duty that the plaintiff had suffered a compound comminuted fracture. The plaintiff requested that the defendant he called, and he was called by the intern on duty. The defendant thereupon directed the intern to admit the plaintiff to the hospital and stated that he would see the patient in the morning. The intern also informed the defendant that he believed the plaintiff had suffered a compound com-minuted fracture, and, according to the testimony of the intern, that the bone could be seen through the opening of the skin. The defendant did not order the administering of antibiotic drugs to avoid or control infection, but did order the cleansing of the plaintiff’s arm and wound and the administering of a pain-killing drug and a tetanus antitoxin. Plaintiff was not prepared for surgery, although the intern testified that, in his opinion, the injury constituted a surgical emergency.

The defendant made no attempt to see the plaintiff that evening. Later, on the same day, he was contacted by a registered nurse employed at the hospital, giving defendant further information regarding the plaintiff’s injury. This nurse was the plaintiff’s sister-in-law. The defendant, however, made no attempt to see the plaintiff until approximately five o’clock on the following day, after again having been called by the hospital. His examination of the plaintiff’s injury on this occasion was very superficial. Later that evening, plaintiff’s arm was cleansed, shaved, and prepared for surgery, which the defendant had announced he would perform the following morning. This preparation for surgery was made by persons other than the defendant, and presumably at the defendant’s direction.

The operation was performed on the following day, the 14th of July. After the operation, a cast was applied. Sometime thereafter, the arm began to bother the plaintiff and the defendant ordered a “window” cut in the cast for purposes of observing the injury. By July 17, an infection had set in and some of the stitches were removed from the infected parts of the wound. On the visit of July 17, and on subsequent visits, the defendant removed tissue from, the wound. On July 21, one week after the operation and nine days after the plaintiff had suffered the injury, the defendant removed more dead tissue and then informed' the plaintiff that he was quitting the case. He gave as a reason for his action the “interference” of the plaintiff’s sister-in-law. Defendant thereupon presented to-the plaintiff a release which he requested the plaintiff to sign, which the plaintiff did execute. The release purports to absolve-the defendant of all responsibility for treatment of the gas gangrene which had developed in plaintiff’s wound.

Prior to the giving of such release, when-it became apparent that the plaintiff had infection, other medical doctors were called1 into the case at the request of the plaintiff and, on the defendant’s withdrawing from-the case, a Doctor Murray examined the-plaintiff and found the arm badly swollen,, the skin brown and discolored, and skin-stitches removed. Doctor Murray instituted a vigorous debridement of the wound,, including the removal of dead, devitalized,, and necrotic tissue, and skin, muscle, and' bone fragments. At that time the plate-which had been inserted by the defendant at the time of the operation fell out.

By August 9, the plaintiff’s condition-was such that it was felt that he could be discharged from the hospital to await developments. The gas gangrene had been controlled, but much of the tissue and muscle on plaintiff’s arm had been removed. During the time between such discharge and the plaintiff’s return to the hospital, on September’ 6, he was treated at a clinic. By the time of his return to the hospital, there had been further tissue loss and much-of the muscle and many of the nerves of the forearm had been removed, and the evidence shows that plaintiff’s arm had become-useless. On September 6, when the plaintiff was readmitted to the hospital, his arm was amputated.

*285 The record shows that amputation was necessary because of osteomyelitis, or bone infection, which the plaintiff’s witnesses testified was due to loss of tissue and muscle damaged by infection, which loss of tissue and muscle exposed the bone and caused it, in turn, to become infected.

Dr. Paul Johnson, a qualified orthopedic surgeon, testified as an expert for the plaintiff. He stated that good surgical practice requires a doctor to assume that all compound fractures are potentially contaminated and infected; that all compound fractures should be treated as surgical emergencies, and that this is especially true where the injury occurs in rural areas where the ground is more likely to be contaminated by animal refuse. Doctor Johnson further testified that, in cases of compound fracture, the wounds should be cleansed to eliminate all foreign matter at the earliest possible moment and, in any event, within six to eight hours of the time of injury, and that this should be done by a physician or surgeon sufficiently qualified to adequately appreciate the seriousness of the situation; that antibiotic drugs should be administered to control infection; and that such treatments should be started on the day of the injury and as soon as possible after the injury.

Doctor Murray, a general surgeon, whose experience included two years of army service where his practice involved treatment of bone injuries and whose private practice as a general surgeon in Fargo for a period of four years also embraced treatment of bone injuries, corroborated the testimony of Doctor Johnson on all major points. A portion of Doctor Murray’s testimony, to the effect that he felt the operation on plaintiff’s arm should have been performed as soon as possible after the injury, instead of two days later, was stricken by the trial court.

The defendant testified that he was not certain that the plaintiff had suffered a compound comminuted fracture until he performed the surgery on the second day following the accident; that he did not diagnose the plaintiff’s injury as a compound fracture from the X-rays; and that, although the intern had told him that plaintiff had suffered a compound fracture, he had asked the intern whether the bone was protruding and was informed that it was not.

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Bluebook (online)
117 N.W.2d 281, 1962 N.D. LEXIS 90, Counsel Stack Legal Research, https://law.counselstack.com/opinion/benzmiller-v-swanson-nd-1962.