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Case ref:201500474
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Date:January 2016
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Body:Grampian NHS Board
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Sector:Health
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Outcome:Upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Mr C complained about the treatment provided for a wrist injury that his client (Mr A) suffered while overseas.
Mr A attended hospital overseas where his wrist was put in a cast. He was told to attend hospital on his return home, which he did. The doctor arranged x-rays of the fracture and changed the cast. Mr A was reviewed a week later, and the cast was changed again. Mr A was reviewed four weeks later and told his wrist had healed (although the joint was tilted back slightly). He was discharged. However, Mr A continued to suffer symptoms of pain and loss of movement in his wrist, which he said were worse than his pre-existing symptoms from an old injury. He attended a private hospital, where he was told that his fracture had healed badly, and he had corrective surgery, which improved his symptoms. Mr A complained to the board about his initial care.
The board acknowledged that Mr A’s fracture had healed with the wrist tilted slightly, but said this was satisfactory. The board noted Mr A’s history of wrist pain going back to his old injury, and said that his pain was due to the new fracture exacerbating his osteoarthritis from the old injury.
After taking independent advice from a consultant orthopaedic (relating to the musculoskeletal system) surgeon, we upheld Mr C’s complaint. The adviser said the early x-rays clearly showed Mr A’s fracture was unstable and likely to heal badly, and the board should have offered Mr A the option of surgery at that stage (to prevent the fracture healing badly). The adviser also said that the badly healed fracture was the likely cause of Mr A’s additional pain and symptoms, and the board should not have discharged Mr A without offering him corrective surgery.
Recommendations
We recommended that the board:
- issue a written apology to Mr A, acknowledging that the treatment for his wrist fracture was unsatisfactory; and
- ensure this complaint is raised with the consultants involved as part of their annual appraisals, and that any training needs are addressed.