When test results show a positive culture for MRSA, it's a good idea to order antibiotics for your patient. But a surgeon failed to act after a MRSA test that he had ordered came back positive, court records show. The fallout from his oversight was severe: 3 additional surgeries to repair the woman's abdomen and a $3.2 million malpractice award.

The patient, Barbara A. Kremer, acquired a methicillin-resistant staphylococcus aureus (MRSA) infection after undergoing a sigmoid colon removal procedure at St. Catherine of Siena Medical Center in Smithtown, N.Y., on July 30, 2002, with post-surgical care rendered by Smithtown-based general surgeon Alfred Lieffrig, MD.

The lawsuit claims that Dr. Lieffrig failed to follow appropriate practices in a timely manner after receiving a positive culture for MRSA just days after Ms. Kremer's colon removal procedure, which led to her complications and the need for 3 subsequent abdominal surgeries in an attempt to repair the wound dehiscence and hernia that developed when the infection eviscerated her abdominal wall and abdominal muscle, says Thomas Valet, a New York, N.Y.-based attorney representing Ms. Kremer.

"There was a positive culture for MRSA in early August [2002], ordered by Dr. Lieffrig. He received the results but never ordered antibiotics," says Mr. Valet. "It was only after [Ms. Kremer] left his care in December 2002 that antibiotics were ordered. So the first antibiotics were not ordered until more than 4 months after the positive culture."

The specific cause of the MRSA infection was never determined, but an expert witness testified that the infection likely originated either during the procedure or before Ms. Kremer was discharged from St. Catherine, says Mr. Valet.

A jury found Dr. Lieffrig guilty of 3 malpractice counts, ruling that he failed to order antibiotics, failed to perform an incision and drainage and neglected to schedule a follow-up appointment for a patient that he testified had acquired a MRSA infection. The plaintiffs received a compensatory pain and suffering award for $2,500,000, and a $750,000 award for loss of services.

An attorney for Dr. Lieffrig did not respond to requests for comment.

Mark McGraw