Currently in the UK all new born babies have their hips checked for dysplasia which occurs when the ball and socket joint of the hip has not developed properly and there is risk of dislocation. If, during the physical examination, the doctor suspects a problem, the baby’s hips are scanned. However, the signs of hip dysplasia can be subtle and may be missed. Untreated hip dysplasia can lead to significant problems later on, including a shortened leg, hip pain, mobility issues, the need for corrective surgery and potentially a hip replacement later in life.
An orthopaedic study undertaken by surgeons at Southampton Children’s Hospital has recently concluded that only undertaking a physical examination of the hips of new born babies is inadequate, resulting in too many late diagnoses of dysplasia and significant problems for those children. While early diagnosis of the condition allows for it to be treated usually very successfully by the baby wearing a removable splint for two to three months, missing the condition during the new born check can have dire consequences for the child and his or her family. It also means that the NHS may be liable for a substantial negligence claim.
The president of the British Society for Children's Orthopaedic Surgery, Professor Tim Theologis, commented: "This study has provided evidence that the current selective screening for neonatal hip dysplasia is ineffective and the percentage of infants diagnosed late is unacceptably high."
Penningtons Manches’ clinical negligence team is currently working with a family whose daughter was born with hip dysplasia. Her condition was not recognised until she was four years old, by which time it was too late to operate in order to help her. The child has significant mobility problems arising from the delay in her diagnosis, is likely to require hip replacement surgery more than once in later life and may ultimately need to use a wheelchair. She requires professional care, adapted accommodation, physiotherapy and occupational therapy as a result of her hip problems and her restricted mobility.
The NHS trust which was responsible for the child’s paediatric care has admitted that her hip problem should have been diagnosed within the first eight to ten weeks of her life and to have missed it was negligent.
Alison Johnson, a partner in Penningtons Manches’ clinical negligence team, has put forward a claim for this child on the basis that she had developmental hip dysplasia. She explained: “Had our client’s condition been recognised and treated promptly, as it should have been, she would have worn a splint or harness and is likely to have made a good recovery, retaining normal mobility without the need for surgery. She has a claim for considerable damages to provide for her needs throughout her lifetime.
“We welcome any move towards better use of radiological scanning to avoid missing hip dysplasia in new born babies as the impact of a late diagnosis can be life-changing.”