MacIna

I. Background

Ms. Macina first complained of hip pain in November 2019. She was

encouraged to exercise and manage her diet. In March 2020, Dr. Chantelle Chand

referred Ms. Macina for x-rays which found moderately severe degeneration of her

right hip. She received a hip injection in June 2020, and reported “fantastic relief”

that lasted for a month. In July 2020, she reported that conservative treatment

options were not working, and she would like to move forward with hip

replacement surgery. In Fall 2020, she was diagnosed with severe degenerative

disc disease. She presented with severe degeneration in her L4-5 vertebrae.

In December 2020, Dr. Steven Nishiyama diagnosed her with both

degenerative joint disease in her right hip and degenerative disc disease in her

24-204 back. She was told that hip replacement was the only “ultimate resolution to her

problem.” Despite this advice, she decided to continue “conservative”

nonoperative treatment.

Her treatment regimen included everything short of surgery. She received

opioid pain medication, another shot in her hip, physical therapy, a lumbar branch

block, a dorsal ramus block, and…