Doctors Not Negligent in Partial Amputation of Woman's Leg, Court Rules

A woman who alleged doctors unnecessarily amputated her lower left leg has lost her medical negligence claim against the Hunter New England Local Health District (HNELHD).

During a two-week Supreme Court civil hearing, Vesna Zvicer alleged medical negligence, claiming psychological and physical injury.

She was admitted to John Hunter Hospital in Newcastle on November 11, 2020, and amputation was recommended when her condition — sepsis — worsened.

The procedure was carried out in January 2021 at Macquarie University Hospital, but Ms Zvicer argued her leg was "salvageable" and sought damages on behalf of herself and her children.

On Wednesday, New South Wales Supreme Court Justice Edward Muston dismissed her claim.

"I have concluded that HNELHD did not breach the duty of care it owed to Ms Zvicer," he said.

"For the same reasons as I have given in reaching that conclusion, I am not satisfied that HNELHD breached any duty of care it owed to Ms Zvicer’s children."

Sepsis and necrosis in left leg

The court heard Ms Zvicer had extreme generalised sepsis and acute compartment syndrome in her lower left leg.

The court heard surgeons "prodded and poked" the leg muscle and determined the leg was dead and unviable.

They feared Ms Zvicer's heel could become gangrenous.

Vesna Zvicer's lawyers argued doctors could not have been certain her leg was necrotic without fasciotomy surgery.

"Just looking at the skin and poking it doesn't answer the question [of] is this necrotic and how severe it is," her barrister Adam Casselden SC said.

"The chance, if any, of salvaging Ms Zvicer’s left leg had to be weighed against the risks associated with performing a fasciotomy on that limb," Justice Muston said.

"The first of those risks lay in the fact that Ms Zvicer was critically unwell when the surgery was performed."

Fear of death without amputation

The court heard when the amputation was scheduled in January 2021, she discharged herself from John Hunter Hospital only to return after becoming unwell.

Ms Zvicer was ultimately transferred to Macquarie University Hospital, where the amputation was carried out on January 16, 2021.

HNELHD argued the operating surgeon "acted in a manner which, at the time, would have been widely accepted in Australia by peer professional opinion as competent professional practice".

Justice Muston ultimately accepted the surgeon's fears she could die without an amputation.

"The tissue breakdown associated with muscle death causes the release of chemicals from within the cells that make up that tissue," he said.

"If pressure in a dead compartment was released — these chemicals wash out into the patient’s bloodstream and can cause major cardiovascular collapse and, potentially, death."