Orthopedic surgeon to appeal $2M malpractice verdict involving overlapping surgeries

Orthopedic

Brett Greenky, MD, plans to appeal a $2 million malpractice verdict delivered on July 2 over an orthopedic surgery performed six years ago, syracuse.com reports.

A jury unanimously found Dr. Greenky and his practice, Syracuse (N.Y.) Orthopedic Specialists, negligent for their handling of a hip replacement surgery on patient Dorothy Murphy, 63.

The patient alleged that an operation Dr. Greenky performed left her permanently injured. She accused Dr. Greenky of removing too much bone and fracturing her femur during surgery. Dr. Greenky said the fracture did not happen during surgery and denied any wrongdoing.

Dr. Greenky was operating on patients for more than 14 hours on the day of Ms. Murphy's procedure. He performed multiple overlapping surgeries, which is safe and common, studies have shown.

Dr. Greenky would create an incision, implant a device, close part of the incision and move to another operating room, leaving a resident physician or physician assistant to close the first patient's wound and apply a dressing.

"It's very common, especially in surgery centers that do a lot of orthopedic surgery," said Dr. Greenky's attorney, James Lantier. "It's very efficient."

When compared to non-overlapping surgeries, most overlapping surgeries had no increase in death or complications, according to a study of 66,000 overlapping procedures published in the Journal of the American Medical Association earlier this year.

Mr. Lantier called the $2 million verdict "excessively high" and said Dr. Greenky will appeal the decision. Testimony about Dr. Greenky's use of multiple ORs should not have been allowed, Mr. Lantier said.

The patient said she was not made aware before surgery that someone other than Dr. Greenky would finish the operation, despite guidelines from the American College of Surgeons that instruct surgeons to inform patients about overlaps.

Operating for 14 hours in a day can cause physician fatigue and patient safety issues, said John Santa, MD, a former director of health ratings at Consumer Reports, who spoke to syracuse.com. Dr. Santa said high volumes can improve surgeons’ skills but hinder preoperative and postoperative care at a certain level.

But the plaintiff did not show how Dr. Greenky's schedule compared to the typical caseload among orthopedic surgeons, according to Mr. Lantier. The plaintiff also failed to prove the use of two ORs was negligent or caused the patient's injury, he said.

Dr. Greenky is "one of the most well-respected joint replacement surgeons in the country," Syracuse Orthopedic Specialists said in a prepared statement to syracuse.com.

More articles on orthopedics:
NY hospital earns Center of Excellence in Orthopedic Surgery
Dr. Dominic Thomas Kleinhenz joins spine surgery team at University Orthopedics
Joint venture acquires Indianapolis' medical office building — 3 insights 

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