A New Jersey orthopedic surgeon faces renewed malpractice charges after a young woman died from a pulmonary embolism 2 weeks after he performed surgery to repair an ACL tear.

The woman, Melissa Ringstaff, was on a hospital gurney, about to be admitted for treatment, when she lost consciousness and collapsed. She never regained consciousness and was eventually taken off life support.

Enrico A. Marcelli, DO, and Academy Orthopaedics, in Sewell, N.J., were originally exonerated by a jury, but an appeals court revived the case based on testimony that Ms. Ringstaff was never warned that calf pain, which she'd been having, was a well-known symptom of the life-threatening condition. The appeals court said the lower court had inappropriately refused to instruct the jury on informed consent, focusing instead on issues of liability and deviation.

Informed consent became an issue, the appeals court agreed, when Dr. Marcelli argued that Ms. Ringstaff had been partially responsible for her own death, because she hadn't followed discharge instructions and called him, several days after the surgery, when she became pale and stopped eating.

According to testimony, it wasn't until 11 days after the surgery that Ms. Ringstaff first mentioned to Dr. Marcelli that she'd been having calf pain. He immediately arranged for her to be admitted to a hospital for treatment of a blood clot, but it was too late.

Informed consent was an issue, said the appeals court, because "if she had been adequately warned [about the significance of calf pain], she might have been more aggressive in seeking appropriate treatment."

Through his attorney, Dominic A. DeLaurentis, Jr., Dr. Marcelli declined to comment. "Although we would like to comment on this matter, it would be inappropriate to do so at this time because the case has been remanded back for trial," says Mr. DeLaurentis.

Jim Burger