Critical Limb Ischemia

Critical Limb Ischemia: When Medical Malpractice May Be Involved

At Lupetin & Unatin, LLC, we have seen firsthand the devastating impact that delayed diagnosis and treatment of critical limb ischemia (CLI) can have on patients and their families. CLI is a severe and potentially life-threatening condition that requires immediate medical intervention to prevent catastrophic outcomes such as amputation or death. Unfortunately, when healthcare providers fail to recognize or adequately treat CLI in a timely manner, patients suffer unnecessary harm. Our firm is committed to advocating for individuals who have been harmed due to medical negligence in the diagnosis and treatment of CLI.

What is Critical Limb Ischemia?

Critical limb ischemia (CLI) is an advanced stage of peripheral artery disease (PAD) in which blood flow to the extremities, usually the legs, is severely restricted due to narrowed or blocked arteries. Without adequate oxygenated blood supply, tissues in the affected limb begin to suffer from ischemia (lack of oxygen), leading to severe pain, ulcerations, infections, gangrene, and ultimately limb loss if left untreated.

Prevalence and Incidence of CLI

CLI affects a significant portion of the population, particularly older adults and individuals with pre-existing vascular conditions. Some key statistics include:

• Over 8-10 million people in the U.S. have PAD, with approximately 1-2% progressing to CLI.
• Each year, roughly 500 to 1,000 cases of CLI per million people are diagnosed.
• Patients with CLI have a high mortality rate, with 20-25% of untreated patients dying within one year and a major amputation rate exceeding 25%.

Who is at Risk for Developing CLI?

Certain individuals have a significantly higher risk of developing CLI, including those with:

• Diabetes (a major risk factor due to its impact on blood vessels)
• Smoking history (damages arterial walls and accelerates PAD)
• Hypertension (high blood pressure)
• High cholesterol (contributes to plaque buildup in arteries)
• Chronic kidney disease
• Obesity and sedentary lifestyle
• History of heart disease or stroke

Symptoms of CLI

CLI presents with severe and persistent symptoms that indicate advanced vascular disease. These include:

• Rest pain (severe burning pain in the feet and toes, especially at night)
• Non-healing ulcers or sores on the feet or legs
• Skin discoloration (pale, bluish, or darkened skin)
• Cold feet or toes
• Gangrene (tissue death)
• Loss of sensation or weakness in the limb

What Should a Patient Do If They Have Symptoms of CLI?

If you or a loved one experience any of the above symptoms, seek immediate medical attention. CLI is a medical emergency, and delays in treatment can lead to irreversible damage and amputation. Patients should visit an emergency room or a vascular specialist as soon as possible.

Diagnosing CLI: How Doctors, Nurses, and Hospitals Should Identify the Condition

Healthcare providers must use a combination of clinical assessment and diagnostic tests to confirm CLI, including:

1. Ankle-Brachial Index (ABI) – Measures blood pressure differences between the arm and ankle.
2. Doppler Ultrasound – Evaluates blood flow in the arteries.
3. Angiography (CT or MR Angiogram) – Identifies arterial blockages.
4. Skin Perfusion Testing – Assesses microcirculatory function.

How Surgeons Treat CLI

Once diagnosed, CLI treatment options include:

• Medications (such as blood thinners, cholesterol-lowering drugs, and pain management)
• Angioplasty and Stenting (to open narrowed arteries)
• Bypass Surgery (to create a detour around the blocked artery)
• Amputation (if the limb is too severely damaged)

The Urgency of CLI Treatment

CLI must be treated within hours to days to prevent permanent damage. Delayed intervention increases the risk of:

• Tissue necrosis (death of tissue)
• Severe infection (which can spread to the bloodstream)
• Limb amputation
• Death from complications such as sepsis

The Medical Standard of Care for CLI Patients

Healthcare providers must:

• Promptly recognize and evaluate CLI symptoms
• Order appropriate diagnostic tests
• Refer the patient to a vascular specialist without delay
• Initiate immediate treatment Failure to adhere to these standards may constitute medical malpractice.

When Should a Patient Suspect Medical Malpractice?

A patient or family may suspect medical negligence if:

• A doctor dismissed symptoms or misdiagnosed CLI as another condition.
• There was an unwarranted delay in performing diagnostic tests.
• Treatment was delayed, leading to amputation or death.

What to Do If You Suspect Medical Malpractice

If you believe that you or a loved one suffered catastrophic harm due to a delay in diagnosing or treating CLI, you should:

1. Seek a second medical opinion.
2. Obtain and review medical records.
3. Consult a medical malpractice attorney.

Examples of Settlements and Verdicts in CLI Malpractice Cases

• $6.5 million settlement (New York, 2022) – A patient lost a leg after doctors failed to diagnose CLI promptly.
• $3.2 million verdict (Florida, 2020) – Hospital delayed vascular intervention, leading to amputation.
• $2.8 million settlement (Pennsylvania, 2019) – Misdiagnosed CLI resulted in gangrene and limb loss. (Sources: National Law Review, VerdictSearch, Public Court Records)

Contact Lupetin & Unatin

At Lupetin & Unatin, LLC, our attorneys have extensive experience representing victims of medical malpractice in Pennsylvania, including cases involving delayed diagnosis and treatment of CLI. If you or a loved one suffered amputation, severe complications, or death due to a medical provider’s failure to properly diagnose and treat CLI, contact us today for a free consultation.