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Misdiagnosis of broken bones in our A&E departments

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Is this the end of the four hour A&E target in England??

A study in the Medico-Legal Journal has recently demonstrated a worrying trend of patients being sent home from A&E departments with undiagnosed fractures, particularly of the hand and hip. A delayed diagnosis of a fracture can lead to non-union of the bone and the requirement for surgery which would not have otherwise been necessary. It can also lead to problems later in life such as arthritis or the need for a joint replacement. 

The NHS has had to pay up to £6 million over the past decade due to claims for missed or negligently treated fractures of the hand with 148 patients successfully claiming in respect of their fractured hips in this timeframe.

When a patient attends with a queried fracture, x-rays or CT scans are required which then should be assessed by a radiologist or radiographer. One of the problems which may be leading to the high number of claims is the shortage of trained specialists to meet the increased demand. In recent years, the number of trained specialists has risen by a modest 5% whereas the demand for scans has soared by 30%.

If you have suffered a delay in the diagnosis of a fracture, you would expect to be able to obtain advice from a solicitor who specialises in clinical negligence cases. That solicitor will investigate and may obtain relevant expert reports from a radiologist and an orthopaedic surgeon.

In some cases of delayed diagnosis of fractures, the value of the claim is around £10,000 to £20,000, if, for example, you have not suffered from any loss of earnings or your subsequent treatment has, fortunately, been limited to one episode of surgery.

Current Government plans for fixed fees in clinical negligence claims may mean that patients who have suffered an exacerbation of their fracture because it has been left undiagnosed will not be able to obtain the independent legal advice they require and obtain the compensation that they are entitled to. This lack of access to justice is damaging both to the patients and also to the NHS as, without claims, they will not have the statistics available to them to show where improvements need to be made.