Case Studies: Healthcare

Delay in Diagnosis of Ankle Injury by GP

O’Reilly Stewart Healthcare LLP were instructed to investigate medical treatment received by our client following a fall in April 2015.

Our client instructed that his GP attended his house after his fall to examine his ankle, as he was concerned that he had heard a loud crack when he fell.  The notes indicated a delay in assessment and the independent GP opinion concluded that if it is accepted that the GP was told about the loud crack on the first attendance, then the GP was negligent in not arranging for radiological or more detailed examination of our client’s ankle.

Following lengthy negotiations, breach of duty was accepted, as it was not until a further home visit, some 4 months later that a referral was made by the GP to the Orthopaedic Department.  Unfortunately, that review was undertaken some 8 months later, at which stage an x-ray and urgent CT scan on in February 2016 confirmed there was a non-union of an angulated fracture of the distal fibula shaft as well as a mal-union of a displaced fracture of the distal tibial shaft.

Whilst breach of duty was straightforward, causation was disputed.  The Defendant argued that the delay did not affect the treatment of the injury.  However, the medical experts concluded that had a proper investigation been undertaken at the time of the fall, then our client would have been treated with the relatively simple procedure of the insertion of an intramedullary nail or as an alternative, an Ilizarov frame and this would have meant that he would not have required open surgery which is what he required due to the delay in diagnosis.

Our client was already on a waiting list for knee replacement surgery, however it was accepted that it was inappropriate to proceed in the absence of dealing with the tibial mal union first.  It was further accepted that there was a clear causal link between our client’s continued lack of mobility because of his knee which could not be treated until the tibial mal union surgery is carried out.

Protective proceedings were issued, however pre-proceeding negotiations were successful.  The Defendant accepted the causation evidence and the case settled in the sum of £100,000.

 

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