Mr H of West Bromwich received £25,000 in compensation from Sandwell and West Birmingham Hospitals NHS Trust following their failure to correctly manage his broken wrist.

 

Mr H, aged 34, was messing about a work during a lunch break. He went to punch a foam block when his friend took a step backwards, altering the point of contact. Mr H’s right hand was forced downwards when contact was made. His hand became cold and numb and he was in considerable pain.

 

Mr H attended Accident and Emergency at Sandwell General Hospital that day. He received x-rays which did not reveal any break. He was put into a plaster cast as a precaution and an appointment was made for him to attend the fracture clinic two days later. At the clinic the Consultant was suspicious that Mr H had suffered a fracture to his scaphoid bone (http://www.patient.co.uk/health/Scaphoid-Fracture.htm) which is common with this mechanism of injury and, notoriously, is rarely revealed by x-rays.

 

The treatment plan was for Mr H to remain in cast for 6-8 weeks. Five days later Mr H reattended the fracture clinic at the hospital. He was seen by a Trust Doctor (i.e. less well qualified than the Consultant he had seen previously). No additional x-rays were taken and the Trust Doctor decided there was no break. He decided to keep Mr H out of cast and provided a splint for him to use at night. Mr H was encouraged to mobilise the hand and returned to work at a factory, which involved manual work.

 

One month later Mr H returned to Accident and Emergency as he was in increasing pain in his wrist. Further x-rays and a CT scan were carried out which, by that time, revealed a minimally displaced scaphoid fracture. He was put back into a cast for five weeks.

 

One month later Mr H was seen again by the initial consultant who noted “I have seen him about two months ago with a suspected scaphoid fracture. He was put into plaster. Unfortunately following this he was taken out of plaster and mobilised. His fracture has now gone on to non-union.”

 

Mr H was referred to an expert wrist surgeon at Birmingham City Hospital. He underwent surgery three months later to fix the bone in the correct position. There was a threat he would need further surgery to include a bone graft which looks to have subsided.

 

Mr H recovered reasonable use in his hand although it will never be as good as the left hand. He instructed Brindley Twist Tafft and James to investigate the treatment that he received.

 

Expert evidence obtained suggested that had Mr H remained continuously in a plaster cast for an appropriate duration (6-8 weeks) on the balance of probabilities the fracture would have healed without further treatment and the surgery would have been unnecessary. His recovery period would have been shorter and he would not be left with a pin in his wrist which may later require surgery to remove.

 

The Defendant trust admitted the allegations made in that the original consultant’s treatment plan should not have been overturned by a more junior doctor. Settlement of £25,000 was negotiated which included the above factors under general damages. In addition Mr H had missed considerable time off work, been restricted on a family holiday and had been unable to assist his wife in caring for their baby.

Richard Stanford

Medical Negligence