Penningtons Manches has recently settled a claim against the Whittington Hospital NHS Trust for an alleged negligent failure to diagnose an undisplaced fracture of the radius. The client injured his right arm after falling onto his outstretched hand and attended A&E at Whittington Hospital. The A&E clinician treating him requested an X-ray of the right arm and the claimant was subsequently diagnosed with a right forearm sprain. He was discharged without any follow up. His arm did not improve and he subsequently re-attended A&E several weeks later with ongoing pain and restricted movement. Upon further examination and another X-ray, the presence of a displaced radial fracture was noted and he required major surgery to re-position and stabilise the fracture.

The client’s case was that the fracture should have been picked up during the first visit to hospital and the hospital’s failure to do so was negligent. Having obtained the claimant's medical records, it was clear that the formal X-ray report noted an undisplaced radial fracture. However, no attempts were made by the A&E department to contact the claimant once the radiology report was available. It was his case that, had the fracture been identified initially, the arm would have been immobilised immediately. This would have avoided the period of significant pain and discomfort and the later need for surgery because of displacement of the fracture. Liability was admitted shortly after the letter of claim was submitted.

Commenting on the case, Amy Milner, an associate in the Penningtons Manches clinical negligence team, said: “This is one of a number of cases we have against A&E departments for failing to assess and investigate injuries properly – particularly hand and wrist injuries. In many cases, the delay in receiving appropriate treatment results in patients needing significant surgery and making an incomplete recovery. While this may well be a resourcing issue, we are seeing a number of clients with classic signs of fractures who are advised that they have only soft tissue injuries. Some are not being X-rayed at all and some, like our client, are having X-rays which are not properly interpreted or acted upon. It is frustrating to see the same errors re-occurring for patients who attend A&E promptly and would make a full recovery with appropriate care. In turn, the need for surgery and follow up that could have been avoided costs the NHS significant sums. In this case, the trust was quick to admit negligent care and we hope that lessons have been learned.”