37 year old woman with long history of surgeries in right foot which started with ankle surgery at age 17 for osseochondritis dissecans. It was complicated by a loose body (instrument) left in ankle joint by surgeon. Further surgery by a different surgeon to remove the fragment resulted in pain and stiffness of joint. She presented to subject podiatrist at age 23 with these symptoms. The care and treatment by this podiatrist continued from May, 2006 to June, 2019. During that time, the podiatrist performed 17 surgeries on the patient’s foot and ankle including 4 ORIF and over 50 injections. The patient’s condition was complicated by two car accidents which resulted in injuries to her foot and ankle. Further, during the course of treatment the patient developed RSD. In December, 2018, the podiatrist performed a Total Talar Replacement with Implant. Three days after the surgery, the podiatrist notes new X–rays confirm slightly displaced position of device in ankle mortice (anteriorly displaced). In January, 2019 podiatrist performed Neuroplasty of superficial peroneal nerve and in March, 2019 an open reduction internal fixation of ankle subluxation, lateral ligament stabilization with mini-C Arm. Due to the inability to walk and severe pain, in September, 2019 the patient had a below knee amputation by a foot surgeon.
Should the podiatrist have continued to treat this patient for 13 years and perform 17 surgeries on her foot and ankle? Is a podiatrist licensed to perform a total talar replacement with implant in NYS? Did the fact that X-rays performed 3 days post procedure which showed displacement indicate that the implant was improperly placed?
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