Malpractice suit: Witnesses differ on cause of Mitchell woman's wrist pain

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Two witnesses took the stand Thursday and gave differing opinions of the medical treatment given by a Mitchell doctor in the second day of a malpractice trial.

The claim is being made by Bette Thompson against Chris Krouse, an orthopedic surgeon who works at Avera Orthopedic Associates, and against Avera Queen of Peace Hospital in Mitchell.

Thompson testified Wednesday she had experienced excruciating pain following surgery performed by Krause to place a plate and screws in her left wrist after she fractured it in October 2007.

In Thompson’s complaint, filed with the Davison County Clerk of Courts on June 28, 2010, it states that she was in severe pain from the placement of the plate and screws because they were either too long or migrated, causing the screws to protrude into the joint.

According to the complaint, Thompson seeks to be reimbursed for all medical expenses and attorney’s fees, as well as damages for the loss of income, “pain and suffering,” “mental anguish,” and “loss of enjoyment of living” caused by the alleged malpractice.

Her lawyer, Casey N. Bridgman, began Thursday’s court proceedings by playing the jury a video of testimony of Charles R. Clark, a medical doctor specializing in orthopedic surgery based out of Iowa City.

Clark has testified in similar malpractice cases dating as far back as 1988.

His testimony was recorded before the trial began.

“If the screw is penetrating, it can cause damage to the joint,” Clark told the court. “It’s important to recognize that possibility, and the onus becomes that of the surgeon to make sure a screw is not in there.”

Clark said a shorter screw could have been used to prevent it from penetrating into Thompson’s joint.

“You certainly can see it, I noticed it right away,” Clark said upon examining several X-rays of Thompson’s wrist. “The post-op views that were printed … I believe required the surgeon to recognize it.”

Thompson had the plate and screws removed in May 2008 by orthopedic surgeon Blake Curd of Orthopedic Institute in Sioux Falls.

Curd testified on Wednesday that after examining a CT scan of Thompson’s wrist, he was concerned the screws may have been the cause of her pain.

Clark said screws can end up in places they were not originally placed because of how bone can move with respect to the hardware during the healing process.

The defense brought in orthopedic surgeon Ian D. Crabb, of Omaha, Neb., to offer a countering view.

Crabb testified pain was common during treatment of the type of injury Thompson sustained. “Nobody is happy six weeks from a distal radial fracture,” he said.

Crabb said no screws seemed to be penetrating Thompson’s joint following Krause’s surgery. “To me, that looks pretty good,” he said as he examined X-rays of Thompson’s wrist in court.

Crabb said it is common for screws to appear as if they are penetrating the joint in an X-ray when they actually are not because of the concavity of the wrist joint.

“I do a lot of these, and the screw appears to be protruding, but I know it’s OK,” he said. “The best time to tell where (the screw) is, is when you’re doing it.”

The day ended with testimony from Thompson’s occupational therapist, Kerri Muehler, who works at University Physical Therapy in Mitchell.

She testified that she had been giving Thompson therapy since November 2007 for wrist and shoulder pain.

“She was frustrated with the amount of pain,” Muehler said. “She didn’t feel she was progressing as she should.”

She said she had contacted Krause’s office in the early stages of Thompson’s therapy about the complaints.

“I just wanted him to be aware at that point,” she said.

Though she said Krause’s office had acknowledged the complaints and offered to see Thompson again, she also put Thompson in touch with Curd.

The trial will reconvene this morning and is expected to conclude by the end of the day.

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