Settlement of claim for negligently missed femur fracture

Posted: 26/10/2015

Camilla Wonnacott of Penningtons Manches’ clinical negligence team has settled a claim against Barking, Havering and Redbridge University Hospitals NHS Trust for an elderly client whose fractured femur was left undiagnosed for three weeks and was then poorly managed. 

Our client, a fit and active 70 year old, fell at home and visited A&E with severe pain in her left hip. An X-ray of her pelvis was performed but when she was examined by the doctor in A&E, he failed to take heed of her significant pain, a visible inequality in her leg length, and to seek the results of the X-ray before deciding that she could be discharged. The following day, the X-ray was reviewed and clearly showed a fracture of the femur. This was reported internally but no action was taken to arrange any follow up. Our client spent the next three weeks in extreme pain and very limited mobility. After an appointment with her GP, she was sent straight back to A&E where the X-ray was finally reviewed and arrangements were made for surgery. The situation was complicated further by a blood clot and then very poor post-operative follow up, causing a prolonged recovery period for our client.  

We investigated the case and obtained supportive expert evidence before formally presenting the claim to the trust. Following the submission of the claim, the trust indicated a willingness to enter negotiations and a settlement was reached. Philippa Luscombe, partner in the clinical negligence team at Penningtons Manches, comments: “Claims involving missed fractures in A&E departments are surprisingly common despite many hospital trusts introducing radiology protocols so that X-rays reviewed by junior A&E doctors are checked by someone more senior.  

“We have been involved in a number of claims against A&E departments for missed fractures – usually either from a failure to perform X-rays when clearly indicated, misinterpretation of them, and/ or a failure to have a proper system in place for reporting and following up. One hopes that this trust will have taken the steps they identified to improve this aspect of their care.”

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