Decision Report 201507812

Summary

Mrs C complained about the care her son (Mr A) received at Hairmyres Hospital after he attended the A&E department on three separate occasions. Specifically, that he had a fracture of the scaphoid bone in his wrist which caused him significant pain for over 18 months before it was identified.

In responding to the complaint, the board said that there was a missed opportunity to recall Mr A for a specialist scan which may have diagnosed the fracture.

We took independent medical advice and found failings by staff in A&E and radiology when Mr A attended on the second occasion with ongoing pain over the scaphoid bone. Whilst such fractures can be difficult to diagnose, we considered that the second x-ray showed a mildly displaced fracture which should have been reported by radiology. In addition, we found there was a lack of assessment by a senior member of staff in A&E given the ongoing wrist pain and tenderness over the scaphoid bone.

Recommendations

We recommended that the board:

• apologise to Mr A for the failings identified;
• ensure that the A&E staff involved reflect on the failings identified in this case at their annual appraisal as part of their professional development;
• review their procedures with a view to ensuring there is provision for a senior doctor to review patients who make an unplanned return to the emergency department; and
• share these findings with the radiologists involved in this case and identify any training needs in relation to the reporting of scaphoid fractures.