On March 28, 2023, the Boston Globe reported on a jury verdict awarding $20M to a 43 year old man who was repeatedly misdiagnosed as having sciatica pain in his leg, rather than a blood clot. The delay in diagnosis of the blood clot led to an avoidable amputation. Mr. Luppold first presented to the emergency room at Lowell General Hospital on March 7, 2015 complaining of discomfort in his left foot that was unusual. The nursing staff documented that the foot was turning purple and was cool to the touch. Based on a longstanding history of radiating sciatica, a physician's assistant diagnosed worsening sciatica and sent the patient home. Six days later Mr. Luppold returned to the ER complaining of severe pain in his left foot. A nurse practitioner also diagnosed sciatica as the cause without any diagnostic work-up. Four days later Mr. Luppold visited his primary care physician who performed an ultrasound which revealed that the cause of his pain was a blood clot.
The correct diagnosis, discovered 10 days late, was a deep vein thrombosis (DVT) and arterial thrombosis. The DVT led to tissue necrosis leaving no treatment option other than an immediate above the knee leg amputation to save the patient's life. The jury was persuaded that had the ER department ordered an ultrasound 6 or 10 days earlier, the DVT would have been diagnosed and treated thus avoiding an amputation. Luppold v Lowell General Hospital