03/07/2025    Aaron Solomon, DPM

Unnecessary and Negligent Calcaneal Osteotomy - Oregon (Allen Jacobs,DPM,

The Evans calcaneal osteotomy is a procedure that
I have utilized throughout my career. I was told
early in my residency training that the Evans is
an extremely powerful osteotomy as it can provide
triplane correction to an unstable flatfoot. I am
not saying anything that those reading this do not
already know, and this is not meant to be a
treatise on the Evans calcaneal osteotomy. We all
know when done correctly this osteotomy greatly
helps those with a painful unstable flatfoot.

In my practice, the majority of the people
receiving this osteotomy are those who suffer from
posterior tibial tendon dysfunction, and it is
done in concert with other procedures. Once again,
I am not saying anything that my colleagues do not
already know. What I and perhaps many of us do not
know are the details of the osteotomy performed in
the aforementioned litigation. Were the ligaments
of the calcaneocuboid joint compromised? Was the
long plantar ligament cut? Was the osteotomy made
to close or too far from the calcaneocuboid joint,
or was it not parallel to the joint and perhaps
oblique? Or was he simply at the mercy of 12
people not smart enough to get out of jury duty?

As far as awards for plaintiffs in medical
malpractice cases are concerned, there is
certainly a geographical pattern to the amounts
awarded. Drs. Borreggine and Jacobs make a good
point that current malpractice coverage may not be
enough to cover the higher awards. Especially as
foot and ankle surgeons are doing more advanced
reconstructive procedures. Dr. Jacobs further
discussed asset protection. "Nothing is off
limits, they will take your house if they can," a
PICA attorney once told me. Plaintiff attorneys
most definitely do wealth assessment. At the end
of the day, it is all about the money. In whose
name are your assets? You? Your spouse? Once
again, as Dr. Jacobs said, talk to an attorney
about wealth and asset protection as laws differ
from state to state.

I also agree with the point made by Dr. Grife
about expert witnesses for medical malpractice
cases. I do believe we need to police our own, and
a plaintiff attorney should seek a true expert to
give testimony. It is the responsibility of
experts to offer testimony if there is a
legitimate claim of negligence. Just as a defense
expert must determine if a claim of malpractice is
defensible and an expert can offer testimony to
help exonerate the defendant of any claim of
negligence. They also have a responsibility to
advise the defendant and their counsel if it is in
their best interest to seek a settlement. We again
do not know if this was ever discussed between the
parties in the above-mentioned lawsuit. One size
fits all is not how an expert witness should be
chosen by either defense or plaintiff counsel. The
hired guns, as Dr. Grife called them, are ready to
testify for their respective lawyers who just need
to send the check. The claim may or may not be
legitimate and the physician giving testimony may
or may not be an expert in the substance of the
claim.

“The foot and ankle surgical expert witness shall
provide opinions and/or factual testimony in a
fair and impartial manner. The foot and ankle
surgical expert witness shall evaluate the medical
condition and care provided in light of generally
accepted practice at the time, place and in the
context of care delivered.” These are not my
words. They are taken from the ACFAS guidelines
for expert witnesses. Take some time to read the
affirmation statement that Fellows of the college
are to sign. Giving fair, honest and
knowledgeable testimony in malpractice cases is
sacrosanct. Experts should be afforded
renumeration from plaintiff and defense counsel
for their time and expertise, but they must be
experts.
Aaron Solomon, DPM, Fort Oglethorpe, GA

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