Medical Mistake Claims - Simpson Millar LLP

Delayed Diagnosis of Fractures

Author: Neil Fearn  Bullet  Dated: 15/08/2014

Failure to diagnose a fracture can have long-lasting effects that go beyond just pain. It is possible for some fractures to heal without treatment but usually early diagnosis and treatment is needed to optimise recovery and a return to full function.

Where can it go Wrong?

In A&E, many people turn up after having had a slip, trip or fall. Many of them will have a soft tissue injury only. However, medical professionals tend to rely on using an x-ray to confirm that there isn't any damage to the bones. An x-ray can show with a high likelihood, whether or not the bone has fractured.

Fractures are not always easy to recognise on x-ray even by the most trained eye. Sometimes a series of x-rays are needed or scans to make a diagnosis and it is usual practice that x-rays and scans as well as been seen by the treating doctor are also considered by a radiologist to ensure nothing has been missed.

Situations where negligence can occur include:

  • Not carrying out an x-ray, and just assuming the injury is only soft tissue
  • Failure to carry out the standard tests for examining potential fractures
  • Not examining the x-ray properly
  • Failure to give follow up advice – for example "Come back if the swelling doesn't go down"

What to look out for

There are several things which may suggest a fracture. We all know that if you hear a gruesome crunching noise as you land on the floor, there's a chance you've broken something, but what are the other indicators:

  • The elderly have a substantially higher risk of fracturing a bone, both because they're more likely to fall than other adults, and because their bones are weaker
  • Swelling around the area that's been injured

The complications of a fracture, if left untreated, can include:

  • Compartment syndrome – a dangerous condition which can result in amputation if not dealt with as soon as possible
  • Fat Embolism – can also result in death if not diagnosed and treated promptly
  • Deep Vein Thrombosis (DVT)
  • Avascular necrosis – The fracture disrupts the flow of blood, causing the bone to die
  • Non-union (when the bone doesn’t heal together) or mal-union (when the bone has healed in an abnormal position) but is a delayed complication of a fracture
  • Tenderness and joint stiffness is a long term complication of a fracture
  • Osteomyelitis (infection of the bone)

Failure to diagnose and treat fractures can have lasting effects that aren't limited to just pain. Financial compensation can be used in situations like this to help with medical costs and other expenses, such as care needs, where a friend or relative has to take time out to assist you when you're left injured after a medical blunder.

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