Medical Malpractice Newsletter
The Difficulties Associated With Establishing Podiatric Medical Negligence
Generally, a podiatrist is a limited-license practitioner who, depending on the scope of practice recognized by the podiatrist’s home state, can treat medical problems associated with the foot, ankle and/or leg. Depending on their training, podiatrists might perform any one of several medical services, ranging from the treatment of nail fungus and structural deformities to specialized surgery using advanced surgical techniques.
In a typical medical malpractice lawsuit, the injured patient must prove that their practicing physician departed from the accepted standard of medical care in order to establish negligence. However, the task of proving podiatric medical negligence can be a complicated one, due in part
to inconsistent state laws regulating the training of podiatrists and the scope of podiatric practice.
Inconsistencies Associated with Podiatric Medicine
There are several inconsistencies associated with podiatric medicine, both as it relates to other medical fields and inherent within podiatric practice itself. Perhaps the most significant disparity between podiatry and other medical fields is that podiatrists are held to different standards than traditional medical doctors. Specifically, there is no consistent board certification requirement to regulate the practice of podiatry. Instead, the American Podiatric Medical Association (APMA) allows several boards to certify podiatrists, recognizing only one board for certifying competency in ankle and foot surgery. In addition, podiatrists are not required to serve internships or residencies in many states.
The field of podiatry is further complicated by virtue of the widely diverse state training requirements that govern the podiatric practice itself. Even in those states that do impose residency requirements, residency training can be significantly different from one program to the next. For example, some residency programs focus on medical concerns, while others focus on non-surgical orthopedic concerns, and podiatrists might spend anywhere from one to three years in residency, depending on the program.
Podiatric Surgery
In addition to inconsistent training requirements, the scope of podiatric practice also varies from state to state. For example, some states allow podiatrists to practice medicine and perform surgery on the foot and leg, while other states limit podiatry to the feet. These variations in the scope of podiatric practice can become problematic when a podiatrist who received post-graduate training restricted to the foot relocates to a more liberal state, and is able to practice beyond the limits of his or her training.
Another potential basis for a medical malpractice claim related to podiatric surgery can arise when podiatrists perform surgeries in their offices, rather than in a hospital. This is because office surgeries increase the patient’s risks of infection and delayed treatment in the case of a medical emergency. Certain surgical errors might also expose a podiatrist to malpractice liability, including:
- Excess bone removal
- Improper placement of implants and fixation devices (i.e. pins or screws)
- Over or under correction of a bone deformity
Podiatrists performing foot surgery on diabetic patients are held to a higher standard of care, as diabetes can make healing and fighting infections more problematic. As such, undiagnosed and untreated foot ulcers can lead to severe infection and possibly gangrene in a diabetic patient, exposing the practicing podiatrist to potential medical malpractice liability.
Establishing Podiatric Medical Negligence
Because of the aforementioned inconsistencies associated with podiatric medicine and the wide range of potential bases for medical malpractice unique to podiatry, establishing a standard of care to prove podiatric medical negligence is often difficult and case-specific. Depending on the particular qualifications of the practicing podiatrist and the state-specific regulations of the field, some of the inquiries that might prove useful in establishing podiatric negligence include:
- Determining the podiatrist’s extent of training and experience
- Requesting copies of the surgical logs of podiatrists who have served on hospital staffs, to determine whether the podiatrist exceeded his or her hospital surgical privileges
- Researching the laws of the podiatrist’s home state and comparing them with the laws of the state in which the podiatrist was trained, to determine whether the podiatrist was inadequately trained
- Determining whether the podiatrist is certified by an APMA-approved board
- Determining whether the podiatrist is board-certified in surgery or in primary podiatric medicine, in cases where the podiatrist might not have been adequately board-certified to perform surgery
- Investigating whether the podiatrist followed adequate surgical procedures
Armed with an understanding of the underlying inconsistencies of podiatric medicine, an injured patient can approach a claim based on podiatric medical negligence with a more informed strategy for establishing the accepted standard of care.
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