Pasti

FACTS

Background On April 1, 2011, then 83-year-old Pasti fell and injured her wrist. The same day, Pasti received emergency medical treatment for her wrist injury at Providence Tarzana Hospital. Upon being discharged, she was referred to Darakjian, an orthopedic surgeon. On April 5, 2011, Pasti went to Darakjian’s office. In a typed “Orthopedic Evaluation” report prepared contemporaneously with the visit, Darakjian recorded the following information and impressions: “Surgery can restore better alignment, although normal function is not anticipated, even with surgery. Restriction in the range of motion can be present with or without surgery. Surgery has the additional risk of vascular injury, nerve injury to the median nerve and tendon injury that can affect movement of the fingers. Additional surgery may become necessary if there is a tendon injury or for hardware removal. Due to her age, the bones are soft and the risks of complications and failure of the surgery are much higher. A lengthy discussion was held with the patient about the risks and complications. The patient is adamant about not having any surgery. She understands that the fracture will heal, however, a deformity…