The Penningtons Manches clinical negligence team has just settled a claim on behalf of the estate of a pensioner who received substandard medical care from King George’s Hospital in Ilford. Our client was a fit and active 76 year-old when she fell outside her home onto her outstretched arms, injuring her wrists and left shoulder. A few days later, she went to A&E at the King George Hospital. She explained what had happened and was examined but the A&E doctor focussed on her shoulder and right wrist. X-Rays confirmed that she had not caused any bony injury to her shoulder but had fractured her right wrist. No examination or X-Ray of her left wrist took place.
Unfortunately, the fracture to her right wrist was wrongly classified in A&E and, as a result, was incorrectly treated. She had fallen onto her wrist while her hand was bent forwards rather than backwards but the plaster cast that was fitted did not immobilise the type of fracture she had sustained. Thus, she was sent home from A&E with her left wrist fracture undiagnosed and untreated and her right wrist fracture wrongly classified and incorrectly treated.
Our client attended in hospital for review three weeks later, explained the treatment she had received in A&E and complained that she was still suffering considerable pain in both wrists, which she could not use. Further X-rays confirmed she had fractured her left wrist and that the fracture on the right was in a poor position. She was told she would need surgery which took place a couple of days later. During the operation, only her right fracture was fixed in place. The left fracture was just manipulated back into place and placed in a cast but was at high risk of displacing.
She was reviewed two weeks later but nothing further was advised despite her on-going pain and inability to use her wrists. She was reviewed again two weeks after that, when she was still in pain and unable to use her wrists properly. She was told that surgery was inadvisable and would leave her hands deformed with no improvement in function. This was despite X-rays that clearly showed unacceptable position of the fracture.
Our client approached us 10 months after her fall with significant on-going pain and loss of function. We reviewed her notes and records and identified a number of points during the timeframe where we were concerned that the care she had received was sub-standard. We sought expert evidence and this confirmed a catalogue of failings in both the A&E and orthopaedic care our client received.
The expert evidence enabled us to write to the hospital to allege that neither of our client's wrist fractures shad been properly diagnosed and managed. While it was likely our client would have needed surgery to both wrists, if had this been advised and performed within the first four weeks of her injury - as our expert advised it should have been - our client would probably have recovered normal or near-normal function and, essentially, been pain-free. The hospital accepted it had breached its duty to our client but denied the pain and loss of function she was experiencing were due to their failures, arguing that her fractures were complex and were always going to cause her the pain and impaired function she was experiencing.
We therefore had to issue court proceedings to pursue this claim. The hospital continued to maintain that it had not caused any of the damage our client was suffering. Sadly, in the course of pursuing the claim, our client passed away. We continued to advise her estate and, ultimately, the Trust entered negotiations to settle the claim.
Andrew Clayton, associate in the clinical negligence team said: “Sadly, this was a case where there were multiple failings in our client’s care from her initial assessment in A&E through to her orthopaedic care and review. Despite admitting its failings, the Trust took a long time to accept that its failures had left our client worse off than she would have been. Although we eventually achieved a good settlement, it was disappointing that its stance meant that by the time the claim resolved our client had passed away. This is one of a number of cases that we have been dealing with involving mismanagement of wrist fractures although was unusual in that it involved injuries to both wrists and different failures in the care of each.”