Example of a Medical Negligence Claim
Case Report for Missed Scaphoid Fracture
IN THE MATTER OF:
S
v
T NHS TRUST
The Claimant was playing football on the 12th August 1997 when he fell and injured his right wrist. He was 29 at the time and employed as a Prison Officer.
The Claimant attended the Defendant's A&E Department that day when a series of X-rays, not including scaphoid views, were taken. The X-rays were reviewed by a Consultant Radiologist who failed to note any bony injury. The Claimant was advised that there was no fracture, he was given analgesia and told to mobilise the wrist.
The Claimant continued to experience pain in the wrist and returned to hospital on the 30th October 1997 when he was again assessed by a Triage Nurse and thereafter seen by a Senior House Officer. No further X-rays were obtained. He was re-assured that there was no bony injury and discharged.
The Claimant continued to suffer pain in the wrist and attended his General Practitioner on the 6th January 1998 for advice. The GP commissioned a scaphoid X-ray, which subsequently revealed a displaced and un-united fracture of the scaphoid. The Claimant's fracture had been undiagnosed for a period of 5 months.
Following diagnosis the Claimant underwent three operations at the Defendant's hospital in an attempt to achieve bony union. All three operations failed and the scaphoid became avascular. At this stage the Claimant's treatment was transferred to a second hospital where, in November 2000, he underwent a fourth operation for the insertion of a vascularised bone graft. Early indications were that this operation had succeeded in achieving union and revascularisation. Unfortunately however, upon examination by an expert during the course of the litigation, it became clear that the operation had been unsuccessful.
The Claimant was left with considerable distortion of the anatomy of the scaphoid and continued to suffer from pain and discomfort in the wrist, with considerable risk of deterioration. Furthermore, there was attendant scarring.
The Claimant contended that had the fracture been correctly diagnosed on or shortly after the first attendance, he would have been treated by way of plaster immobilisation for a period of 3 months. He argued that union was likely to have taken place and an essentially full recovery made with a risk of only minimal residual symptoms.
THE CLAIMANT'S ALLEGATIONS
Having obtained expert evidence from a Consultant in Accident & Emergency medicine, and a Consultant Radiologist, the Claimant alleged that there had been a negligent failure to obtain scaphoid X-rays in part as a result of the poor history that was obtained by the accident & emergency doctor.
THE DEFENDANT'S POSITION
The Defendant admitted the allegations of negligence but disputed causation, putting the Claimant to proof that different management would have resulted in a change in the outcome. The Defendant sought to argue that notwithstanding the failure to correctly diagnose the scaphoid fracture there would still have been a chance of non-union of the scaphoid fracture or vascular changes developing in the proximal polar of the scaphoid.
Each party obtained permission to obtain evidence on causation from a Consultant Orthopaedic Surgeon. The Claimant's Orthopaedic Surgeon confirmed that had prompt diagnosis been made, and the fracture immobilised in a cast, the prospects of successful union were very good. Subsequently, the Defendant chose not to disclose its expert orthopaedic evidence.
The matter proceeded upto shortly before trial when matters were settled in an agreed sum of £232,500.00. It was conceded by the Defendant that the Claimant was no longer fit for employment as a Prison Officer as his wrist injury made it impossible for him to conduct a control and restraint manoeuvre. He did nevertheless have a significant residual earning capacity although in less remunerative employment.
EXPERTS INSTRUCTED BY THE CLAIMANT
Mr. J. Wardrope - Consultant in Accident & Emergency Medicine
Dr. A. Evans – Consultant Radiologist Mr. I.C.M. Gray – Consultant Orthopaedic & Upper Limb Surgeon
Solicitor for the Claimant – Eddie Jones, JMW Solicitors, Manchester Counsel for the Claimant – Sally Hatfield of Peel Court Chambers, Manchester
Solicitors for the Defendant – Ward Hadaway, Solicitors, Newcastle Counsel for the Defendant – John Whitting
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