CHARLESTON – A Kanawha County man says a podiatrist’s negligence led to him having his pinky toe amputated.
Steven Toler and his wife Jessica Payne filed their complaint October 2 in Kanawha Circuit Court against Dr. Seth Craft and Foot and Ankle Clinic of the Virginias Inc. Craft is employed by the defendant company.
According to the complaint, Toler was first seen by Craft on March 26, 2024. He had a four-week history of ulcers on his left fifth metatarsal phalangeal area and his left heel. Toler, who now is 54 years old, also was diabetic.
The fifth metatarsal is the long bone on the outer side of the foot, connecting the ankle to the little toe.
Toler was found to have global edema and erythema of the foot without proximal streaking. X-rays taken showed no evidence of osteomyelitis, but they did show hardware in the lateral wall of the calcaneus.
Craft debrided both wounds but did no cultures, according to the complaint. He was placed on Bactroban topically and Augmentin orally, and he was placed in a surgical shoe with peg assist.
At a return visit the following week, Craft did not note infection and again debrided the wounds without taking cultures. The next week, Toler returned again. The record shows he had no protective sensation in his foot. That meant the foot ulcers had to be protected so healing could occur, according to the complaint.
Toler continued to wear a surgical shoe rather than being placed in a more effective offloading device such as a total contact cast or a cam walker, the complaint states. Craft again debrided the wounds without taking cultures.
On April 16, 2024, Craft again debrided the wounds without cultures being taken. He did the same the next week. On April 30, 2024, he debrided without taking cultures and placed Toler into a total contact cast for offloading. Craft again debrided without taking cultures on May 8 and May 15, 2024. He did prescribe Augmentin against on May 15.
At the June 6, 2024, appointment, Craft against debrided the wounds without taking cultures. He placed Toler on Doxycycline instead of Augmentin and told Toler to return in two weeks. At the June 25 appointment, Craft again debrided without taking cultures.
On his final visit to Craft on July 9, 2024, Toler had the wounds debrided again without having cultures taken. No antibiotics were given “despite this lack of progress.”
On July 16, 2024, a nurse saw Toler’s wounds and said she thought it would be “in his best interest” to see Dr. Brad Hoffman, another podiatrist there. Hoffman is a wound care specialist.
Hoffman determined the ulcer under the fifth metatarsal had penetrated to the bone and caused erosive changes consistent with chronic osteomyelitis. Toler’s history also revealed he had smoked since he was 16. Smoking would compromise his ability to heal his diabetic foot ulcers, according to the complaint.
Toler was admitted to Charleston Area Medical Center for an MRI and surgical debridement. Hoffman performed the debridement with the removal of his left fifth toe on July 17, 2024. The left calcaneus did not have osteomyelitis, but the fifth metatarsal did not acute and chronic osteomyelitis.
Both wounds were infected with MRSA and pseudomonas. The MRSA was resistant to both Augmentin and Doxycycline, and pseudomonas can’t be treated with either. Toler was treated with Vancomycin and Zosyn. He had an acute kidney injury from Vancomycin, so he was switched to Zosyn.
Toler had a staged further resection of the fifth metatarsal and secondary closure of his forefoot wound on July 23, 2024, and he was discharged the next day.
He accuses Craft of medical negligence for violating the standard of care, and he accuses the defendant company of vicarious liability.
Toler and Payne seek compensatory damages, general damages, court costs, attorney fees, pre- and post-judgment interests and other relief.
They are being represented by R. Dean Hartley and Mark R. Staun with Hartley Law Group in Charleston. The case has been assigned to Circuit Judge Carrie Webster.
Kanawha Circuit Court case number 25-C-1164
