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Case Study: Human Bite Infection
JMW has helped secure £25,000 compensation for a young man after his human bite injury was wrongly diagnosed.
22-year-old Simon got in a fight after drinking in his local pub. On striking his adversary in the mouth and coming into contact with his teeth, the knuckle (metacarpal) joint of Simon’s right middle finger was damaged.
On attending A&E, the joint was noted to be painful and swollen, but an X-ray revealed no bony injury. A zigzag laceration over the joint was cleaned and closed with 4 sutures.
2 days later, Simon attended his GP as his knuckles looked very inflamed, with the redness beginning to track up his arm. A diagnosis of cellulites was made and antibiotics (Flucloxicillin) prescribed.
Septic arthritis diagnosis
The following day, as the redness was moving even further up his arm and the glands in his armpit were swollen, Simon attended the local Minor Injuries Unit, where the antibiotic dosage was increased. Although he was initially sent home, he was quickly recalled to hospital and IV antibiotics commenced. That evening he underwent an exploration and washout of the wound and a diagnosis of septic arthritis of the joint was made. The washout procedure was repeated 3 days later and he remained in hospital for a further week.
The joint remained very stiff and stuck in a flexed position, and after 3 months Simon underwent a further operation to loosen adhesions (arthrolysis) and reconstruct the extensor mechanism in an attempt to restore a degree of function in the joint.
This was only partially successful and Simon (who is right handed) continues to suffer pain, stiffness and reduced mobility in the joint. As he has already developed arthritis, there is a 40% chance he will require a joint replacement in the next 10 years.
Simon’s claim is that his injury should have been diagnosed and treated as a human bite and had hospital guidelines been followed, on the balance of probabilities, his wound would not have become infected and he would not have gone on to develop arthritis with the resultant disability.
Human bite guidelines
Human bite injuries very readily become infected because of the multiple bacteria in the mouth and the guidelines state that they should be irrigated with iodine then left unsutured and the patient referred immediately to the trauma/orthopaedic team if the injury involves a joint. Also Augmentin or Erythromycin are the recommended antibiotics.
The case was settled for £25,000 by Steven Brown, one of the experienced solicitors at JMW.