Opinion ID: 900097
Heading Depth: 1
Heading Rank: 3

Heading: Toenail removal costs Pine Ridge man his leg

Text: By Pamela Stillman Times Staff RAPID CITY____When Hobart Lee, 71, of Pine Ridge had two ingrown toenails removed in December at the Pine Ridge Hospital, he never thought it would lead to the amputation of his left leg. The leg was amputated Jan. 22 at Rapid City Regional Hospital, because of the toenail removal procedure, Mr. Lee said. He has retained an attorney to bring suit against the podiatrist who removed the toenails, Dr. Judd A. Sparagon. Dr. Sparagon knew he was a diabetic, Mr. Lee said, but removed the toenails on each of his big toes by cutting them out which produced bleeding. Both toes became infected, but the infection in the left foot spread, causing poor circulation in the leg and it had to be amputated below the knee, Mr. Lee said. His right foot also is infected, and he fears he may loose [sic] that leg too. Dr. Sparagon regularly travels from the Veteran's Affairs Medical Center in Hot Springs to the podiatric clinic at the Pine Ridge Reservation Hospital, which he developed in 1989. Because of patient confidentiality he is unable to talk about Mr. Lee's case without a release from the patient. He said that Mr. Lee was examined and treated appropriately in outpatient clinics conducted in Pine Ridge through sharing agreements with Public Health Service. (Mr. Lee's attorney advised against signing a release for Dr. Sparagon at this time.) Dr. Sparagon is from New York and has worked for the Hot Springs VA hospital since 1982. In 1989, the doctor became one of fewer than 50 podiatrists board certified in public health. Mr. Lee believes that there might have been a better way to remove the toenails. It just doesn't seem like the right way they should do it (remove toenails). Maybe that's the way podiatrists do it, but diabetics cannot take it. It shouldn't have bled that bad, he said. In a recent article written for a national VA publication, Dr. Sparagon talked about the seriousness of diabetes on the reservation. Asked what motivates him to keep going back, week after week, he grows very serious and tells you about the high incidence of diabetes on the reservation with the accompanying foot problems. Thirty percent of the Indian people down there have diabetes and no access to podiatric care. We're all they have right now, the article said. Mr. Lee is concerned that he is not the only one to have had an amputation because of the toenail removal process used, and he wants others to be aware of complications which could arise from this type of procedure. There are a lot of diabetics that I heard about this happening to, but they may not say anything. Mr. Lee does not know what would have happened if he had not had the toenails removed. One doctor said it would have given me problems____but who knows? Who knows where I might have been in the next 10 years. Mr. Lee's physician at the Pine Ridge Hospital, Dr. Allen Dobbs, said he knows about Mr. Lee's case, but cannot talk about it because of patient confidentiality. He did say that diabetic patients can be at extreme risk with extremities, no matter what is done. There can be a problem even if it is a minor procedure. There could be a problem even if the procedure is not done.... I know that podiatrists have reversed dozens of amputations, Dr. Dobbs said. Mr. Lee is in a local nursing home while his therapy continues. [¶ 10] After publication on April 10, 1992, Sparagon demanded, by letter to Stillman, that N.A.P. retract the article. On April 14, 1992, N.A.P., through its owner Tim Giago (Giago), stated it would correct the false statements, but requested Sparagon to specify which parts were incorrect and why they were incorrect. [¶ 11] Sparagon replied to Giago on April 27, 1995. Sparagon stated that the following statements were untrue: (1) the title; (2) the statement that Lee retained a lawyer to sue Sparagon who had removed Lee's toenails; (3) the statement that Sparagon knew Lee had diabetes and removed Lee's toenail causing bleeding; (4) the procedure caused infection of Lee's left foot, and the infection spread causing poor circulation; and (5) the statement that Sparagon believed that he treated and examined Lee approximately at the Clinic. Sparagon did not state why the statements were untrue, and never told N.A.P. he was not the treating physician. [¶ 12] N.A.P.s publication published another article about Sparagon's request for retraction; however, it did not retract. Sparagon filed suit against N.A.P. claiming defamation. Sparagon claimed that the article was defamatory because it suggested he did something wrong by removing Lee's toenail that caused the leg to be amputated. [¶ 13] N.A.P. investigated the Lee case after Sparagon sued. The investigation showed that Stillman, when preparing the article, interviewed Lee who told her that Sparagon removed his toenail and it became infected causing the amputation. Lee also stated that other persons had a similar problem. [¶ 14] During discovery, Patrick Lee testified Stillman did not request consent to talk with Lee's physicians, and if he was asked, he would not have recommended consent. Patrick Lee stated neither he nor Lee, his uncle, was told the nail removal caused the amputation, but he told Stillman that Lee was holding Sparagon liable for his condition. Patrick Lee did not want Stillman to publish the article since Patrick Lee did not want to try his case in the newspapers. Patrick Lee later amended Lee's claim against the federal government to remove the allegation that Sparagon was the attending physician.