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Case study: negligent treatment of ruptured knee tendon following a fall down stairs
Jim, 51 years old, Salford
JMW secured £250,000 compensation for a man who was misdiagnosed by doctors following a fall down the stairs.
Jim fell down his stairs early one morning. He landed with his left leg outstretched and his right leg bent underneath him. He felt immediate pain in his left knee and hip. He called an ambulance and was taken to Salford Royal A+E department. He was unable to walk and in so much pain he was given morphine.
When Jim was eventually examined by a junior doctor it was noted that he was in a lot of pain but no bruising, swelling or obvious deformity was seen. The doctor arranged for X-rays of the leg and hip but these were reported as showing no abnormality. Jim was diagnosed as suffering a sprain and bruising and was discharged home with crutches and painkillers at lunchtime.
Referred for physiotherapy
Jim was a self-employed builder. He took a couple of weeks off work to rest fully expecting his leg to gradually recover, but it became progressively more swollen and painful. After 6 weeks he went to the GP who prescribed anti-inflammatories and more painkillers and referred him for physiotherapy.
Referred to a surgeon and correct diagnosis
Three months later Jim was seen by the physiotherapist who was reluctant to manipulate the knee and showed surprise that he had had the injury for so long. She referred Jim to a consultant orthopaedic surgeon who saw him on a month later and diagnosed a rupture of the quadriceps tendon of the left knee.
As the injury was several months old it was unclear whether surgery would improve the leg or risk making things worse, and Jim received conflicting advice regarding the need for surgery. He was followed up regularly in the orthopaedic clinic for the next 3 years until he was eventually discharged as it was felt that nothing more could be done for him. During this time he had been seen by a number of different doctors and physiotherapists, received several different opinions and been promised operations that never materialised.
Jim now suffers pain, weakness and parasthesia (tingling, pricking, or numbness) in his left leg and requires crutches to walk. The prolonged use of crutches has resulted in him developing a shoulder injury, and his condition is unlikely to improve. He is wholly dependent on his wife for care and assistance.
Jim believed that the initial treatment he received in A+E was negligent. The negative X-ray findings in the presence of severe pain should have alerted the doctor to the possibility of a serious non-bony injury and a further clinical examination (including a straight leg raise), a senior doctor review and an urgent follow-up should have been undertaken.
None of these things occurred and by the time his condition was eventually diagnosed it was too late to successfully repair the tendon. If his true condition had been recognised Jim would have had surgery to repair the ruptured tendon and he would have been able to resume his normal activities and return to work. The case was settled by JMW Solicitors and Jim was awarded £250,000 in compensation.