(13) A tourniquet was reapplied to the left arm to prevent the possibility of the broken catheter's flowing through the blood stream and causing further complications.
(14) X-rays were taken of the left arm which located, in a two-dimensional plane, the presence of the section of catheter in the forearm of the dorsal aspect.
(15) Dr. Lucchino made a transverse incision in the dorsum of the left arm in an attempt to locate the catheter that had shown up in the x-ray. This incision was made approximately one hour after the severed tube had been discovered.
(16) Failing to locate the catheter, Dr. Lucchino made two more transverse incisions in areas farther up the dorsum of the left arm. Investigations in these areas having proved unsuccessful, Dr. Lucchino again probed the initial incision and located and removed the broken piece of catheter from the subcutaneous tissues.
(17) The three incisions were then closed with 4-0 cotton, after a cut down was placed in a suitable vein on the dorsum of the hand. The wounds were dressed and an ace bandage was applied.
(18) The patient was then prepared for his gall bladder operation, which was performed without incident. The patient left the operating room at 1:15 P.M.
(19) When the patient was returned to his room, his left arm was elevated by placing it on a pillow. Ice bags were applied to the left hand and forearm to reduce the swelling.
(20) The day after the operation, October 22, the patient complained of pain in his left arm. Ice bags were applied and his arm remained elevated on the pillow. His hand color was "good" and his dressings were dry.
(21) On October 24, the nurse's notes observe that the patient's arm was "red and [the] hand was quite puffy."
(22) On October 26, the nurse noted that there was "serous sanguinous drainage" from the plaintiff's left arm and warm soaks were applied.
(23) Again, on October 28, there was "seeping serous material" from each of the incisions on his left forearm and continuous warm soaks were applied.
(24) On October 28, Dr. William S. Klein, Chief of Staff at the Veteran's Administration Hospital, reported that no further action was indicated regarding the plaintiff's left arm.
(25) On October 29, the nurse's notes tell of a "yellow seepage from incisions on [the] arm". Warm compresses were continually applied in an attempt to stop the seepage. Dr. Cohen reported the patient "doing well" and recommended his discharge.
(26) Between October 22 and October 29, the patient was visited daily by Dr. Lucchino.
(27) On October 30, 1964, the plaintiff was released from the hospital by Dr. Edward Whelan, a member of the hospital's staff. The plaintiff was scheduled to return on November 3, 1964 for a check-up.
(28) On November 3, 1964, Dr. Whelan examined the plaintiff and discharged him. Although the left arm was swollen and "ooze" was flowing from the incisions, Dr. Whelan did not consider these symptoms significant enough to note on the hospital's medical records.
(29) For approximately one month after discharge from the hospital, the drainage from the incisions on the left arm continued. The plaintiff's left arm and hand were swollen during this period and, as instructed by the medical staff at the hospital, he applied warm soaks. The drainage ceased when the incisions healed within 5 to 6 weeks after the operation.
(30) Two or three months following his surgery, the plaintiff began to complain of numbness in his fingers, associated with burning and continued weakness of function. He attempted to alleviate this malady with aspirins.
(31) Due to the limited use of his hand, the plaintiff was unable to resume work at his previous employ as an industrial painter. This job required the use of both hands in that a painter must climb ladders with one hand and grasp his painting utensils in the other, as well as requiring strength and agility in working on scaffolds above the ground.
(32) The plaintiff worked for four to five days at a trucking firm unloading parcels, but his weakened arm and lack of work prevented continued employment.
(33) During his extended recuperative stage, the plaintiff spent much time at a used car lot with friends. He normally just "killed time" there but also performed errands which garnered him about $5.00 a week. He sought no other employment.
(34) During this period, the plaintiff's family was supported by contributions from his mother-in-law, as well as from earnings from his wife and children.
(35) On the advice of his attorney, the plaintiff went to see Dr. James M. Hunter, a hand specialist, on January 6, 1966, which was approximately 14 months after the plaintiff was discharged from the Veteran's Administration Hospital. Although the plaintiff could have sought the assistance of the Veteran's Administration Hospital, he did not return to their clinic after being discharged on November 3, 1964.
(36) Examination showed that the power of plaintiff's left hand was decreased by approximately 50% when compared with his right hand. Sensory testing showed that the median nerve was damaged. Dr. Hunter concluded that the plaintiff was suffering from a severe "median nerve compression syndrone" (carpal tunnel syndrome) and recommended operative treatment in the near future.
(37) On the basis of the plaintiff's statements and his own examination, Dr. Hunter opined that the 6-8 weeks of inflammatory edema, which the plaintiff experienced after the incisions in his arm were made, caused the thickening and adhesions of soft tissues which resulted in compression of the median nerve.
(38) The plaintiff was admitted to the Jefferson Medical College Hospital on March 22, 1966. On March 24, Dr. Hunter performed an operation which ressected the adhesions and constrictions of the epineurium around the median nerve.
(39) Post-operative treatment proceeded without complications, and the plaintiff was discharged from the hospital on March 26, 1966.
(40) The first week after the operation, the burning sensation in the plaintiff's arm subsided.
(41) The plaintiff had several follow-up visits with Dr. Hunter, and approximately 12 weeks after the operation, his left arm and hand were functioning normally.
(42) The total cost of the carpal tunnel operation was $726.15. Itemized, the charges were:
Jefferson Hospital $281.15
Initial exam 35.00
Follow-up exams 60.00
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