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Physician to Physician Discussions > I got a malpractice lawsuit, what Can I do now? Help me please.

I injected radiesse in my patient cheek and he develops persistent redness and swelling unilaterally for the past 3 months. He just filed a lawsuit. Is my career over?

CB, No. Your medical career is not over. However, you may want to post some more details that may be relevant; Have you followed up and seen the patient since the treatment? Have you contacted anyone? Have you contacted your malpractice rep? What's the situation.

As far as I know, Radiesse is still temporary.

08.18 | Unregistered CommenterLanduc DO

What's cause of the redness?

08.18 | Registered Commentercharlie

I injected the radiesse in his cheek for volume replacement, he develops redness/swelling in his lower eyelid unilaterally. He didn't tell me about the complication until two months later. I offered to follow up but he refused to come back. I don't know what causes the redness.

First, do not blame yourself. With given information, if you followed the usual steps of filler injection, you have not caused, most likely, this problem.
I wouldn't blame the product either. Apparently the symptoms are unilateral and, I assume, the product was from the same lot. At this point, based only on what you have described, the etiology of the "swelling" can only be speculative. There are good chances that even a tissue examination would render a non-specific finding.
Although delayed reactions are possible with many pharmaceuticals, it is very difficult to prove it. It is always possible that the symptoms have nothing to do with product or the procedure.

The most revealing aspect of this problem, unless I misunderstood, is your patient's reaction. It seems that the outcome of Radiesse injection did not bother him enough to report any problems for 2 months. Then he refused to see you. With available to you information, as quoted, it seems to be beyond human ability to draw any rational conclusion regarding possible etiology of the "swelling".
Above all, document everything related to this problem.

Theoretically, his symptoms could be compatible with delayed reaction to Radiesse. But, the same symptoms could equally be a consequence of missed tennis ball served by his lawyer.

All the Best!
mk

I would not worry and although it is hard for us as physicians not to blame ourselves you have to learn not to put the blame on yourself. Remember lawyers are in a recession to and are more willing to take cases with no merit. The fact that this patient contacts you 2 months later destroys any case her lawyer thinks she has. They are looking for a quick pay day . I would inform my malpractice carrier, relax and move on.

Thank you so much for Mark and Charles input. I really apreciate it.

CB,

The biggest mistake practitioners make is breaking the law after "accidentally" injuring a patient. How do they break the law? They fail to file a mandatory reporting form to the FDA- form 3500A. This form is MANDATORY reporting for any medical adverse event. If you do this, 9 out of 10 times the FDA will open an investigation that will not allow for a lawsuit until the device or drug is fully reviewed, and most likely they will find blame in the product itself. On the other hand, if you DON'T report, 9 out of 10 times you will lose. It's like leaving the scene of an accident after someone else hits you- regardless if you were not at fault, you committed the crime of leaving the scene without following proper procedures. Procedures can save you, or they can hurt you.

Feel free to contact me off the forum if you need more information regarding the FDA form 3500A, or if you need help completing one.

Delayed redness / swelling has been a rare complication in very few patients treated with this type of filler. The cases I've seen usually resolve within a few months and no more than 6 months if you rule out possibility of peri orbital cellulitis. You may try some diluted kenalog injection to calm down the inflammation or try topical betamethasone for a few weeks. If cellulitis is suspected (pain, elevated WBC, fever), you must obtain a facial x ray/ CT and try an oral course of antibiotic or admit this patient for IV antibiotic treatment to protect yourself in the court of law.

This patient has never returned and offer you a chance to make things right. Law case proceedings may take years before it reaches trial. In my opinion, the redness, swelling and all of Radiesse filling effect will be obsolete by 18months. Hence no law suit since no permanent damages are present. Consult your attorney for expert advise. Don't blame yourself too hard. This will go away and you will be ok in no time. I am not here to offer you legal advise. Just chirping in my experience to make you feel better.

Thanks so much for Dr Wang's advice.

I retired from general surgery so I had faced many adversary law suits in my life: for your protection, you have to answer the law suit, within the time allowed, further:
1. Do you have malpractice insurance - notify carrier right awa
2. Notify radiesse - the co may be co-defendant ?
3. Do not Repeat DO NOT think suit will go away -- most of them are frivolous but you have to face and fight it.
Any malpractice case will be on your license record !!!!

email me on how this turns our

Just in case anyone needs to fill out a FDA form 3500a, I found a blank form in this site PDFfiller. This site also has several related forms that you might find useful.

CB its been a while so I don't know if this is still a problem. Just about everyone gave great advice.

Notify carrier
Doccument interactions with the patient
Some say don't contact the patient but I feel that open discussions can lead to reassurance and understanding on both parts
In all likelihood this is temporary which means no long term injury thus any claim will be diminished in value
probably in a year or so they will contact your lawyer and try to make a settlement, at that time discuss with your lawyer if they feel the suit had merit you can settle well within your coverage limits. In NY they have a record of these but they don't get posted unless there are several within a time span ( I forget how long, I believe 5 years)

It hurts, we don't ever expect to cause harm and often we did nothing wrong. The longer you practice the more this will occur.
Let us know whats going on. Hopefully the redness will resolve and the case dropped,

03.18 | Unregistered Commentergm

I have a patient that had this happen from another injector 5 years prior with radiesse. I used ultherapy, and it's about the only things that we felt helped.

06.27 | Registered CommenterNEMD

Looks like an immunological reaction or granulomatous reaction. Can try intralesional steriod injection coupled with RF or HIFU. May be able to break down the radiesse.

10.2 | Registered Commenterzw xie

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