Urgent Care Fracture & Orthopedic Injury Expert Witness
Analyzing Missed Fractures, Tendon Injuries, and Trauma Management
Urgent Care centers are the front line for "walking wounded" patients, those with falls, sprains, and lacerations. While these centers handle a high volume of minor trauma, they are also a frequent setting for missed orthopedic diagnoses that lead to permanent disability.
Dr. Max Lebow provides expert analysis for cases involving missed fractures, undiagnosed tendon injuries, and negligent wound care. He helps attorneys distinguish between a subtle injury that is difficult to detect and a clear breach of the Urgent Care Standard of Care.
The "Reading" of the X-Ray
One of the most common allegations in urgent care litigation is the failure to diagnose a fracture on X-ray.
The Urgent Care Reality
Unlike in a hospital where a radiologist might provide an immediate reading, urgent care providers often interpret their own X-rays in real-time.
The Standard
Dr. Lebow evaluates whether the provider's interpretation was reasonable for a generalist. Did they miss an obvious break, or was the fracture occult (hidden) and only visible on later imaging?
Failure to Order
A frequent breach is failing to order an X-ray entirely for a patient with point tenderness or significant mechanism of injury.
Tendon & Nerve Injuries in Lacerations
Laceration repair is a routine urgent care procedure, but it carries significant risk if the provider fails to assess what lies beneath the skin.
Missed Tendon Injuries
Dr. Lebow reviews whether the provider performed a full range-of-motion exam before suturing. Missing a cut tendon can result in permanent loss of function.
Nerve Damage
Failure to document a neurovascular exam (sensation and blood flow) distal to the wound is a common documentation failure in malpractice cases.
The "Specialist Standard" Mistake
A critical error opposing attorneys often make is hiring an Orthopedic Surgeon to testify against an Urgent Care provider.
Different Standards
"Opposing experts often apply the standard of care for a specialist such as an orthopedic surgeon... who have little or no experience practicing in an urgent care center."
- Dr. Max Lebow
The Rebuttal
An Urgent Care provider is not expected to have the surgical expertise of an orthopedist. They are expected to recognize when an injury is complex enough to require immediate referral. Dr. Lebow defends the "prudent urgent care physician" standard, not the "perfect surgeon" standard.
Common Fracture Pitfalls
Dr. Lebow has experience reviewing specific high-risk fracture types that are frequently missed in the urgent care setting:
Scaphoid (Navicular) Fractures
Wrist pain after a fall where the X-ray looks normal but the 'snuffbox' is tender. Standard of care usually requires splinting regardless of the X-ray findings.
Jones Fractures (Foot)
Often misdiagnosed as a simple ankle sprain.
Radial Head Fractures (Elbow)
Subtle fractures that require careful review of the 'fat pad sign' on X-ray.
Documentation & Follow-Up
In orthopedic cases, the discharge instructions are often the deciding factor in liability.
"Splint and Refer"
Did the provider correctly stabilize the injury and provide a specific timeline for seeing a specialist?
Worsening Symptoms
Were clear instructions given on what to do if swelling increased or sensation was lost?
Was the Injury Negligent or Inevitable?
Not every missed fracture is malpractice. Dr. Lebow reviews the films and the chart to see if the Standard of Care was met.
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