Medicolegal Issues

Why Punching a Window Is Never a Good Idea

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In September 2007, a 23-year-old man drank a six-pack of beer, had an argument with his girlfriend, and punched a plate-glass window with both fists. He sustained lacerations to his right arm. The man removed a large piece of glass from his arm, resulting in significant bleeding. He then wrapped a belt around his arm to stop the blood flow and went to the emergency department of the local hospital, where he was treated by Dr. S.

Dr. S. removed glass fragments from the patient’s arm, sutured it, and instructed him to follow up with his family physician in one to two weeks. When the patient saw another clinician, Dr. A., for suture removal, he reported worsening neurologic symptoms in his right arm. An appointment with an orthopedist was made, which the patient subsequently canceled.

About two months later, a retained glass fragment was removed by orthopedist Dr. R. The plaintiff alleged negligence by Dr. S. for his failure to remove all the glass fragments at the initial presentation. The plaintiff claimed that as a result he suffered a median nerve injury.

The defendant claimed that the nerve injury was most likely inflicted when the plaintiff removed the piece of glass himself before going to the hospital. The defendant also claimed that the plaintiff had been negligent in his failure to seek follow-up treatment as recommended. The defendant further maintained that the physician who removed the retained glass fragment had not determined it to be in the proximity of the median nerve.

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