Woman loses medical negligence claim over partially amputated leg

A woman who alleged doctors unnecessarily amputated her lower left leg has lost her medical negligence claim against the Hunter New England Local Health District (HNELHD).

During a two-week Supreme Court civil hearing in May, Vesna Zvicer alleged medical negligence, claiming psychological and physical injury.

She was admitted to John Hunter Hospital in Newcastle on November 11, 2020 and amputation was recommended when her condition — sepsis — worsened.

The procedure was carried out in January 2021 at Macquarie University Hospital but Ms Zvicer argued her leg was "salvageable" and sought damages on behalf of herself and her children.

On Wednesday New South Wales Supreme Court Justice Edward Muston dismissed her claim.

"I have concluded that HNELHD did not breach the duty of care it owed to Ms Zvicer," he said.

"For the same reasons as I have given in reaching that conclusion, I am not satisfied that HNELHD breached any duty of care it owed to Ms Zvicer’s children."

Sepsis and necrosis in left leg

The court heard Ms Zvicer had extreme generalised sepsis and acute compartment syndrome in her lower left leg.

The court heard surgeons "prodded and poked" the leg muscle and determined the leg was dead and unviable. They feared Ms Zvicer's heel could become gangrenous.

But Ms Zvicer's barrister Adam Casselden SC said doctors could not have been certain her leg was necrotic without performing a fasciotomy.

"Just looking at the skin and poking it doesn't answer the question [of] is this necrotic and how severe it is," Mr Casselden said.

He said the procedure should have been done, opening the muscle up and relieved compartment pressure.

Fasciotomies were performed on Ms Zvicer's right leg and left and right thighs, but not her left leg.

Justice Muston said clinicians weighed the risks when deciding to proceed with amputation.

"The chance, if any, of salvaging Ms Zvicer’s left leg had to be weighed against the risks associated with performing a fasciotomy on that limb," he said.

"The first of those risks lay in the fact that Ms Zvicer was critically unwell when the surgery was performed."

Ms Zvicer's legal team told the court Ms Zvicer was well enough to undergo fasciotomy surgery, but it was ruled out.

Fear of death without amputation

The court heard when the amputation was scheduled in January 2021, she discharged herself from John Hunter Hospital only to return after becoming unwell.

Ms Zvicer was ultimately transferred to Macquarie University Hospital, where the amputation was carried out on January 16, 2021.

HNELHD argued the operating surgeon "acted in a manner which, at the time, would have been widely accepted in Australia by peer professional opinion as competent professional practice".

Justice Muston ultimately accepted the surgeon's fears she could die without an amputation.

"The tissue breakdown associated with muscle death causes the release of chemicals from within the cells that make up that tissue," he said.

"If pressure in a dead compartment was released — these chemicals wash out into the patient’s bloodstream and can cause major cardiovascular collapse and, potentially, death."

Ms Zvicer's legal team was steadfast in their belief the lower left leg was not dead.

Justice Muston dismissed Ms Zvicer's claim and claims on behalf of her children and ordered her to pay the health service's costs.