FRACTURES: MISDIAGNOSED AND MISTREATED

Misdiagnosis or mistreatment of a bone fracture can have significant implications for an injured party though, fortunately, not all misdiagnoses or mistreatments result in further injury entitling the injured person to seek compensation.

There are cases where misdiagnoses does not just delay the securing of a correct diagnosis but leads to significant additional damage and potential lifelong sequelae.

The erroneous diagnosis, to entitle a person to compensation, must be one that a competent Medical Professional would not have made  Misdiagnoses claims may be pursued against doctors, radiologists or medical facilities. In some cases there may be more than one responsible party

An example of what can happen in the event of a misdiagnosis is the onset of bone infection. Where a fracture is not correctly diagnosed, a patient may not be made aware of the risks associated with a fracture and may, in ignorance of the extent of his or her injury, act in a way that is detrimental to the existing but undiagnosed fracture. An injured party might, for instance return to work or sporting activity before the fracture has healed.

It is not unusual for the HSE and Health Professionals to defend such claims or to allege that the Injured Party must accept some personal responsibility for the deterioration in the injury where medical advice given (though not comprehensive) was ignored. If medical advice is ignored it is possible that compensation for a misdiagnosed fracture may be reduced to take contributory negligence into account.

An interesting case came before the UK Courts recently arising out of an ankle injury suffered by an Ms J when she fell at home.

An X-ray was taken at the hospital and a sprain diagnosed. The ankle was not immobilised and Ms J was sent home on crutches.

The pain in Ms J’s ankle intensified in the following weeks and on the recommendation of her GP she underwent physiotherapy which only exacerbated the condition. Some 9 weeks after the initial injury an MRI scan disclosed a  fracture which had not united and which ultimately required further surgery. The pain subsequently continued in Ms J’s ankle and her pre-accident activities were curtailed.

The case ultimately settled for stg125,000 on the basis that the Attending Physician who misdiagnosed Ms J’s injury was negligent  in failing to recognise the classic clinical signs of fracture and in failing to ensure that he had a complete set of X-Rays and to re-order when the Radiologist alerted him that the ones he had did not demonstrate the distal end of the fibula.

The interesting case of BK comes to us from another Jurisdiction, namely Ontario where our Partner Nicholas Russell B.C.L., A.I.T.I., B.A practised Law in the mid 1980’s

This 2014 case related to a high impact wrist fracture which was first treated by Doctor G who performed a closed reduction(the effect is to return a fractured or broken bone to a correct anatomical position). A closed circumferential cast was applied which it should not have been and this turned out to be a compensatable  error.

When BK complained of significant pain after the application of the cast, he was told by Dr G that it was normal to experience such pain and swelling in the initial period. Dr. G failed to discuss the potential for  or the signs of compartment syndrome with  BK. This syndrome  has the potential to lead to muscle necrosis or the loss of a limb. The syndrome is a serious condition resulting from expanded tissue within a confined space.

Subsequent emergency intervention by another physician found that the  cast had been applied too tightly and that a compartment syndrome injury had been suffered as a result . Notwithstanding that  Emergency surgery was undertaken BK was left with permanent damage to his wrist which included extensive scarring anda  limited range of motion and received Court compensation as a result.

Dr G’s conduct had fallen below the acceptable standard of care. The application of a closed circumferential cast could not accommodate the inevitable swelling in BK’s wrist. A splint or a bivalve cast that was split to the skin should have been applied instead. In this way, the anticipated swelling could have been accommodated.

Further, Dr G had failed to warn BK about the increased risk of complications from his high impact injury. Significant compensation was paid as a result.

 

 

 

* a Solicitor may not calculate his fee or levy any other charges as a percentage of any award or settlement

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