Ligon v. Allen

• Citation: 162 S.W. 536,157 Ky. 101
• Parties: LIGON v. ALLEN.
• Decision Date: 23 January 1914
• Court: Kentucky Court of Appeals

162 S.W. 536

157 Ky. 101

LIGON v. ALLEN.

Court of Appeals of Kentucky.

January 23, 1914

Appeal from Circuit Court, Henderson County.

Action by Amos Allen, by his guardian, against Peyton Ligon. From a judgment for plaintiff, defendant appeals. Reversed and remanded.

Hines &amp Norman, of Louisville, and Clay & Clay, and N. Powell Taylor all of Henderson, for appellant.

John C Worsham and H. M. Stanley, both of Henderson, and Newton Belcher, of Greenville, for appellee.

MILLER J.

This is an appeal from a judgment obtained by Amos Allen, who sues by his guardian, against the appellant, Dr. Peyton Ligon, for damages for alleged malpractice in the treatment of appellee's broken arm.

On December 4, 1911, the appellee, a boy about nine years of age, fell from a box to the floor of his father's store and fractured the bone in his arm called the humerus, about two inches above the elbow. The appellant a practicing physician, was promptly called and set the arm, binding it in splints and leaving the finger tips exposed. Appellant says he examined the fracture and placed the ends of the bones in apposition, retaining them in position by placing an angular splint from axilla to the ends of the fingers inside of the arm, and from shoulder to elbow joint on the outside, and that over these he applied a wider bandage down to and including the hand, leaving a part of the fingers exposed. He left the boy about 10 o'clock at night, with instructions for the father to call him promptly if the boy suffered any pain or showed any symptoms that indicated the need of attention. The father did not call appellant during the night. On the morning of the second day thereafter, about 36 hours after he had applied the dressing appellant made his second visit, and from an examination of the exposed fingers he saw the circulation of the arm was not good. He thereupon removed the dressing and found the arm to be considerably swollen, with blisters on it, and other evidence of defective circulation. Appellant then called Dr. Letcher to see the case with him on the same day; and, owing to the defective circulation of the arm, the doctors discarded the splints and used only bandages to hold the cotton on the arm, and splints only for the purpose of protecting the arm.

Appellee testified that he had suffered greatly during the night, but that the pain was removed intermittently by taking several small tablets which appellant had left with his father to be given to the boy in case his arm pained him.

Appellant says, however, that the defective circulation was not due to the tightness of the bandage which had always been sufficiently loose not to interfere with the circulation, but that the defective circulation was due to some injury to an artery or pressure from the fragments of the broken bone which caused the formation of a clot, and that this, with a natural swelling of the parts, produced such pressure upon the musculospiral nerve as to interfere with the function of that nerve; and that this condition frequently results from such fractures where no bandages or splints have been used. For about ten days appellee continued to suffer greatly with his arm. At the end of that time appellant and Dr. Letcher extended the arm for the purpose of increasing the circulation and relieving the pressure of the blood supply Dr. Floyd administering the chloroform, and Dr. Forward being present. The doctors agree in the opinion that no surgical interference at that time was proper, and that such interference would have been dangerous. In the meantime the blisters upon the arm had developed into running sores.

About three weeks after the fracture the arm was examined by Drs Watson and Smith. Upon a careful examination and measurement, the arm was found not to have shortened. Thereafter appellant and Dr. Letcher made daily visits to appellee for some time, and later visiting him at intervals of every three or four days, until February 14th, when they ceased to call at his father's residence, but instructed the father to bring the boy to appellant's office in order that he might observe the condition of the boy's arm and direct such treatment as might be needed. In the meantime the father was instructed to massage and flex the fingers and elbow joint.

Appellant testifies that, when he and Dr. Letcher saw the boy's arm for the last time on February 14th, its condition was much improved; that the bone had united and showed no deformity or shortening of the arm; that it was healing in a satisfactory manner; and that appellant and Dr. Letcher then believed that with continued massaging, which they repeatedly urged upon the boy's father as of supreme importance, the arm would be restored to all its motions. Appellee, however, did not go to appellant's office after February 14th. And a few weeks thereafter appellant learned from appellee's father that he had sent the boy away for treatment; the father declining, however, to tell where he had sent him.

Appellee testifies, however, that his arm became stiff and the hand drawn, and that, by the time he had been discharged by appellant on February 14th, the muscles had hardened, rendering the arm and hand practically useless. This condition of the arm, however, was not reported to appellant.

In April appellee's father sent appellee to Dr. Ford, at Livermore, Ky. for examination and treatment. Dr. Ford took an X-ray photograph of the arm and concluded that an operation would be necessary in order to relieve the pain caused by what he thought was the lapped bone of the broken arm. This operation was performed by Dr. Ford and his assistant, in which they took off about an inch of the protruding bone, and then wired the two ends together with a silver cord. Appellee testifies that the operation relieved the pain and enabled him to raise his hand as high as his shoulder, but the muscles and ligaments in the arm remained atrophied; the arm becoming withered to some extent and having little life.

Appellant testified that the X-ray photograph taken by Dr. Ford before the operation performed by him in April did not correctly show the condition of the boy's arm as it was at the last time appellant saw it in February, since the arm at that time was not shortened or deformed, and the boy then had full use of it at the elbow joint; the fingers were not deformed, but could be flexed and extended considerably; that the arm as a whole was in a very good condition and showed marked signs of improvement, with every reason to believe at the time that, if appellant's directions to flex and massage the fingers and elbow joint had been carried out, the use of the arm would have been restored. Dr. Letcher corroborates appellant in all respects as to the treatment of the boy's arm and its condition on February 14th, and states that the treatment of the arm by appellant was that which is usually given and required by good surgery in such cases.

Dr. Letcher further testified that, when he last examined the boy's arm on February 14th, there was very good motion in the elbow joint; no deformity of the arm at the point of the fracture nor in the hand; very good movement of the fingers and hand, with every indication that, if the improvement should continue, good use of the hand and arm would result; and that he joined appellant in urging upon appellee's father the importance of taking the boy to see the appellant at short intervals thereafter in order that he might see the injured arm and continue to advise as to future treatment. Dr. Letcher further says that he is satisfied the symptoms which developed in the arm could not have been produced from any bandage that had been applied but was largely due to the general physical condition of the boy, which was poor; the mother of the boy having been tubercular and the boy addicted to the use of cigarettes. He says that, of all the fractures of the body, a fracture at the point where this one occurred is most frequently attended by stiffness of the elbow joint.

Drs Floyd, Watson, Poole, and Forward all corroborated the appellant...