Doctors prevail after man loses toes post-surgery

Jurors found no negligence on the part of medical providers after a man lost his toes following an ankle surgery, allegedly from burns he suffered from an automotive heater while being driven home.

Reiner Kaschner sued Midwest Podiatry and Associates and its physicians in the wake of the 2016 ankle replacement in which a nerve block was used. Kaschner alleged he experienced thermal injuries from having his still-numb toes under a heater vent while being transported in a relative’s Jeep after discharge from the hospital.

The resulting medical complications eventually led to the need for amputation of the man’s forefoot. In 2020, he would also undergo a below-the-knee amputation due to phantom pain issues.

While medical personnel warned Kaschner to keep his foot safe from injury or damage, plaintiff’s attorney William Wunderlich said the warning should have specifically covered possible injury from temperature.

“Most people don’t necessarily think of the fact that you could get burns or frostbite a lot easier than you ever would anticipate,” he said.

The defense contended that Kaschner’s complaints of discomfort after surgery showed that the nerve block was already wearing off when the plaintiff was released and that general warnings to “protect the limb” were sufficient.

“Our theory was that if he truly was insensate during this car ride, it was less likely an effect of the nerve block and more likely a multifactor result of his prediabetic neuropathy,” said defense attorney David Perron of Brown & James, who represented the podiatrists.

He further noted that the plaintiff began overusing the ankle despite warnings to stay off it, and that he resumed smoking tobacco, which can cause vasoconstriction and make healing more difficult.

William Magrath of Lashly & Baer, who defended the anesthesiologists in the case, said the defense argued the patient failed to elevate his leg on the 60–90-minute car ride, which may have caused the limb to swell against the cast.

“The pressure of the swelling caused decreased blood flow to his toes which, together with compression of the nerves in his foot, caused his toes to become numb,” he wrote in an email.

Jurors returned a full defense verdict. Wunderlich, who said no appeal is planned, believed his case was hurt by Kaschner’s absence from trial due to health issues. Instead, he had to rely on deposition testimony to make his points.

“It is not ideal when my client was unable to testify,” he said.

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Defense verdict

Medical malpractice

Venue: St. Louis County Circuit Court

Case Number/Date: 18SL-CC04620/Aug. 9, 2023

Judge: Joseph Walsh III

Plaintiffs’ Experts: Mitch Rackers, St. Louis (mechanical engineering); Arthur Hertling, New York (medical); Howard Shapiro, New York (medical)

Defendants’ Experts: Allen Jacobs, St. Louis (medical); Allen Hamdan, Boston (medical); Thomas Saak, St. Louis (medical)

Last Pretrial Demand: $395,000

Last Pretrial Offer: $0

Caption: Reiner Kaschner v. Robert K. Duddy, Mid-West Podiatry and Associates, Luke Sehy and Srinvas Reddy

Plaintiffs’ Attorney: William Wunderlich, High Ridge

Defendants’ Attorneys: David Perron and Philip Willman, Brown & James, St. Louis, (for Duddy and Mid-West); William Magrath and Riley Brown, Lashly & Baer, St. Louis, (for Reddy and Sehy)