Podiatry & Podiatric Surgery Expert Witness

Overview

About Podiatry & Podiatric Surgery Expert Witnesses

A podiatry expert decides whether a foot or ankle problem was treated the way a reasonably careful podiatrist would have treated it: whether surgery was the right choice, whether it was done well, and whether a diabetic wound or infection was recognized and escalated in time. This page covers podiatric medicine and surgery. Orthopedic foot surgery has its own field, circulation problems belong to a vascular surgeon, diabetes care to an endocrinologist, and a fall in a nursing home to a geriatric or nursing expert.

The expert reads office notes, operative reports, foot and ankle radiographs with the original images, wound measurements, photographs, vascular studies, lab work, consent forms and later records from the surgeon who revised the work. Serial wound notes are often decisive. They show whether a wound was improving and how long it was left alone.

Elective Foot Surgery

Published data show elective surgery driving claims. A study of 72 foot surgery malpractice cases from 2004 to 2017 found that 76.4 percent alleged malpractice by a podiatrist and 15.3 percent involved orthopedic surgeons ¹. Most cases involved elective surgery, at 81.9 percent, and the plaintiffs were mostly women ¹. Failure to treat was the most frequent allegation at 38.9 percent, followed by inappropriate surgical procedure at 25 percent ¹. Defense verdicts came in 68.1 percent of trials ¹. Podiatrists were litigated mainly over elective procedures, most often for persistent pain and deformation ¹. These are verdict reports, so they are a selected sample.

A claims review from Europe adds a useful comparison. Among 460 orthopedic foot and ankle claims, most related to delay in or wrong diagnosis, or to elective surgery, and its authors called missed fracture diagnosis and disappointing results of elective procedures the most common causes ². They point to clear communication and expectation management before elective surgery ².

So a bunion, hammertoe or neuroma case usually comes down to indications, technique and consent. Was conservative care tried? Did the chosen procedure fit the deformity? Was the patient told recurrence, nerve injury, stiffness and persistent pain were possible? Post-operative films should be compared with the pre-operative ones. A complication alone does not prove fault, so the expert explains how the operation should have gone and where it departed.

Diabetic Feet and Amputation

Diabetic foot cases carry the highest stakes. The question is usually delay: a wound that was debrided in the office for weeks while infection reached the bone, or a cold foot that was not sent to a vascular surgeon. The expert reads wound depth, probe-to-bone findings, pulses, imaging and lab trends. Good podiatric care matters here. A large study of adults with kidney failure and a new diabetic foot ulcer found that foot and ankle care by podiatrists before the ulcer was associated with lower rates of amputation or death ³. That is an association, and it cannot say what would have happened to one patient.

Causation can be hard. Diabetes, kidney disease, smoking and circulation can each lead to limb loss despite good care. A study of amputation malpractice litigation reported malpractice in 6 of 43 diabetic patients in its series ⁴, and legal systems differ, so that figure is only a signal. An expert should separate what a timely referral would have changed from what the disease would have done anyway.

Scope and Coverage

State law defines how far a podiatrist may go above the foot, and how far surgery may extend into the ankle. Hospital privileges add a second limit. Medicare Part B pays for a podiatrist's services within the scope of the license if they would be covered when performed by a physician ⁵. A billing or scope claim therefore starts with the state practice act and the facility's bylaws.

Who Is Qualified

Look for a licensed doctor of podiatric medicine in active practice at the time of the events, with surgical experience in the same procedure. The American Board of Foot and Ankle Surgery certifies podiatric surgeons ⁶, and a separate board addresses podiatric medicine. Ask about hospital privileges and how often the expert does the operation. If the claim concerns circulation or infection, add a vascular surgeon or infectious disease physician on those points.

Qualifications

Qualifications to Look For

• ✓Licensed doctor of podiatric medicine in active practice at the time of the events
• ✓American Board of Foot and Ankle Surgery certification for surgical opinions, where held
• ✓Regular performance of the procedure at issue
• ✓Hospital privileges in a comparable setting
• ✓Direct wound care experience for diabetic foot opinions
• ✓Skill reading foot and ankle radiographs
• ✓Prior deposition or trial testimony on podiatric standards of care

FAQ

Frequently Asked Questions