We recently settled a claim on behalf of a client whose ruptured right biceps tendon was misdiagnosed when he attended Russells Hall Hospital A&E department in Dudley in November 2014. As a result, he suffered persistent pain, discomfort and loss of function to his right arm. A correct diagnosis was finally made six weeks following the injury, after his GP referred him for further investigations.
Our client suffered the injury to his biceps tendon whilst at work. The biceps tendons attach the biceps muscle to the shoulder and the elbow. He was seen by a locum doctor at Russells Hall Hospital and explained to him that he had felt a ‘pop’ at the time of the injury followed by immediate pain and discomfort in his arm. He showed the doctor that the muscle to the top right of his arm had retracted to just below the armpit and was told that he had suffered a sprain. He was discharged with a sling and advice to rest and to take painkillers but his symptoms failed to improve; his right arm remained weak and painful, and the shape of his biceps muscle continued to appear deformed.
Our client attended his GP who suspected a tendon injury and referred him for an ultrasound scan. The scan was performed at the end of December 2014, and showed a complete rupture of the right biceps tendon. In January 2015, our client was reviewed by an orthopaedic surgeon at the hospital who discussed the results of the ultrasound scan with him. He noted wasting of the right arm muscles compared to the left. Our client underwent surgery at the end of January 2015, to repair the right biceps tendon. Due to the passage of time since the injury, the tendon was found to have retracted and the standard of repair achievable was not as good as it could otherwise have been with timely diagnosis and management. Our client regained a good range of movement following the surgery and experienced some alleviation in pain, though there was still some residual weakness.
Once instructed, we obtained supportive expert evidence from an A&E consultant who confirmed that it was a breach of duty to fail to refer our client for an ultrasound scan and arrange a review by the orthopaedic surgeons. We proceeded to obtain evidence from an expert consultant orthopaedic surgeon who confirmed that had this occurred, a correct diagnosis would have been made and our client would have been admitted for surgery. As a result, he would have avoided the six week period of unnecessary pain and discomfort. Furthermore, a better standard of repair could have been achieved without the delay.
We wrote to the defendant trust setting out our allegations. In its response, the trust admitted the negligent failure to diagnose, and that had it not been for the delay, our client would have had a better outcome. We proceeded to consider the value of our client’s claim. In the meantime, our client unfortunately suffered a re-rupture to his right biceps tendon under similar circumstances. An ultrasound scan once again confirmed a complete rupture to the tendon, and he underwent further repair surgery in February 2018. This time a graft was taken from his hamstring to re-attach the tendon. Though the surgery was successful, our client continued to suffer from residual weakness in his right arm. Our orthopaedic expert confirmed that but for the negligent delay, our client would more likely than not have avoided suffering a re-rupture to his biceps tendon.
Court proceedings were commenced in order to protect our client’s position in relation to limitation, and in view of the fact that the defendant had not admitted the causal link between the negligent failure to diagnose, and the re-rupture. This further element of causation was admitted, and we managed to obtain a good settlement for our client to reflect the unnecessary pain and discomfort he had endured, along with the residual weakness to his right arm. This case serves to demonstrate the consequences for a patient which can follow from a failure to correctly diagnose a tendon injury in a timely manner.