Peripheral Vascular Disease and Acute Limb Ischemia: When Delayed Treatment Leads to Amputation

When blood flow to a limb becomes severely restricted or suddenly drops, the tissue of the affected limb begins to die even within hours. This is a condition known as acute limb ischemia. There is also advanced critical limb ischemia. Both are medical emergencies that require rapid diagnosis and treatment. If the circulation isn’t restored quickly, damage can become irreversible and may result in catastrophic consequences like infections, sepsis, and even amputations.

Medical professionals are required to hold themselves to a high regard when it comes to the standard of care they must follow for all patients. Failing to do so, especially in the case of delaying treatment in peripheral vascular disease and acute limb ischemia can be grounds for a lawsuit. Patients and family members can seek legal advice from a medical malpractice attorney prior to filing a claim.

What Happens During Acute Limb Ischemia?

Acute limb ischemia happens when a sudden blockage prevents blood from reaching a limb like a leg or foot. The blockage may be caused by one of the following issues:

• A blood clot (thrombosis)
• Severe progression of peripheral artery disease
• An embolism traveling from another part of the body
• Complications following vascular or cardiac procedures

Tissues begin to suffer from ischemia if they do not receive oxygen-rich blood. As such, the tissue is deprived of the oxygen and nutrients needed for survival. Tissue death can occur if the treatment for acute limb ischemia is delayed.

During this period of time, it can lead to:

• Muscle damage
• Tissue death
• Nerve injury
• Infection

The limb may no longer be salvageable if circulation is not restored quickly. That’s when amputation becomes the only option that can save the life of the patient. The result is preventable and the best way possible is treating acute limb ischemia quickly. Medical professionals that miss this treatment may face legal repercussions as a result.

Understanding Peripheral Artery Disease

Peripheral artery disease (PAD) is a condition which narrows the arteries causing a reduction of blood flow to the arms or legs. Plaque can build up over time causing the arteries to restrict circulation. A missed peripheral artery disease diagnosis can be devastating for a patient. If they experience warning signs early, medical treatment must be administered once the signs are reported. The common symptoms of PAD include:

• Leg pain while walking (claudication)
• Changes in skin color
• Coldness in the lower leg or foot
• Numbness or weakness
• Wounds on the feet or toes that heal slowly

Untreated PAD can develop into critical limb ischemia. This is considered to be the most severe stage of the disease. The sooner PAD is treated, the better the chances the patient can move on with life as normal. However, if medical professionals fail to treat the condition properly, this can lead to irreversible damage.

What Is Critical Limb Ischemia?

Critical limb ischemia occurs when blood flow is severely restricted. It gets to the point where tissues won’t be able to survive without immediate treatment. At this stage, the following may occur:

• Severe pain at rest
• Gangrene or tissue death
• Non-healing ulcers or wounds
• Loss of pulses in the affected limb

The risk for amputation is even greater if circulation cannot be restored. That is why medical professionals must take the necessary precautions for patients who may have PAD and treatment accordingly before things take a turn for the worse.

The Blocked Artery That Was Not Treated In Time

Let’s take a look at the following hypothetical situation: A patient arrived at the emergency room experiencing symptoms of sudden leg pain, numbness, coldness, and even weakness. These are clear signs of acute limb ischemia. The emergency doctor on duty had mistakenly diagnosed this for another nerve-related condition. However, days passed and the patient was awaiting testing or consultation and the symptoms worsened.

A CT angiography detected that a blocked artery was cutting off blood supply to the limb. However, the tissues had suffered irreversible damage by the time this was discovered. A surgeon confirmed this and decided that amputation was the best possible option. Nonetheless, what was mistakenly diagnosed for one thing turned out to be something serious.

The patient lost the leg and weeks later discovered that the amputation was the result of a misdiagnosis. They pursued a possible medical malpractice claim with the help of an attorney who was familiar with cases related to amputations that were the result of acute limb ischemia treatments being missed.

Typical Negligence in Vascular Emergency Cases

It’s important to note that vascular complications are not always the result of medical negligence. For this reason, it makes such cases complex. With an experienced medical malpractice attorney who has worked on numerous cases, they may be able to determine the events that were considered negligent on the part of the medical professionals. These common concerns in such cases may include:

• Failure to recognize signs of ischemia: These include the classic symptoms such as severe pain, coldness, numbness, and absent pulses. All of these prompt urgent evaluation.
• Delayed imaging: This requires tests such as Doppler ultrasound or CT angiography to confirm if an arterial blockage exists.
• Delayed vascular consult: If circulation programs are suspected, a vascular surgeon will need to be involved quickly. A delayed vascular consult reduces the chances of a treatment being successful. Thus, time is not on the side of the patient in this situation.
• Failure to start anticoagulation: Blood-thinning medications are important to help prevent clot progression in certain cases.
• Delay in transfer to a specialized facility: Some hospitals might not be able to perform the advanced procedures such as thrombectomy or bypass surgery. This means the patient needs a rapid transfer to a vascular center where it can be done.
• Failure to monitor pulses after procedures: Patients who undergo vascular or orthopedic procedures must be monitored closely so that the circulation remains intact.

None of these steps should ever be delayed in a vascular emergency situation. If medical personnel fail to act accordingly and quickly, the patient faces a worse case outcome including amputations. The medical facility or professionals involved may be subject to a medical malpractice claim that can not only be costly, but can also lead to reputational damage.

If you or a loved one has been a patient during a vascular emergency and treatment was delayed resulting in amputation, a malpractice claim may be the best option. That’s when you should consult with an attorney familiar with these cases as soon as possible. Depending on your jurisdiction, it is important to consider filing a medical malpractice claim within the statute of limitation in order for the case to be considered.

Final Thoughts

Peripheral vascular disease and acute limb ischemia are both in need of prompt treatment if symptoms appear. If delayed, the patient faces an amputation that didn’t need to happen. Such symptoms of peripheral vascular disease and acute limb ischemia need to be taken seriously. If you or a loved one had experienced symptoms of these vascular emergencies but have not received proper treatment leading to amputation, your best course of action is to consult with a medical malpractice attorney near you.