The Taylor&Emmet Blog

Scaphoid Fractures – Failure to provide the correct medical care

I handle new enquiries for the Clinical Negligence Department and one injury I hear about fairly often is a scaphoid fracture.

The scaphoid is one of the carpal bones in the wrist. A scaphoid fracture is usually caused by a fall onto an outstretched hand, often during sports. Correct diagnosis and prompt treatment of a scaphoid fracture can be essential to reduce long term complications.

I have spoken to clients who would like to see if they can take action against their GP for failing to refer them to the hospital for tests after they have fallen on their wrists. I have also spoken to clients who have visited the hospital with their injury and may even have had an X-ray, but the hospital have failed to diagnose a fracture.

In both of these cases there could be a medical negligence case to answer, but it depends on the facts. It might be that the fracture was clearly shown on the X-ray from the start but was missed by the radiographer. The radiologist may have had reason to perform another X-ray to double-check the diagnosis but failed to do so. Perhaps a cast had been given but it was put on too tightly causing further damage.

It is well known that scaphoid fractures may not be visible on the initial X-ray and may only become obvious later on. If there is any doubt about whether the X-ray shows a fracture, as a general rule, the medical professional should put the wrist in a splint and arrange a re-examination with the radiographer in 10 to 14 days. If this is the case but the patient has been refused a re-examination, it may be that the medical experts have breached the duty of care they owe to that patient.

To bring a successful medical negligence claim it is not enough to show that the medical professional’s care has fallen below a reasonable standard. It must also be shown that the delay in diagnosing or treating the scaphoid fracture has caused the patient’s injury to become worse than it would have been had the appropriate level of care been provided. For example, it might be that the delay in treating the fracture has caused it to become more displaced so that it may never heal completely, causing that person ongoing complications.

I have recently been approached by a specialist Consultant Hand Surgeon who says that the orthopaedic literature indicates that treatment of a scaphoid fracture over 4 weeks after the injury is generally associated with a high risk of failure. Of course each case is different so timings may vary slightly between individual cases.

If the scaphoid fracture is missed and the patient is not put in a cast until 4 weeks or more after the injury, it is possible that they may need to have surgery to re-graft the bone and maintain the blood supply. It might be that had the diagnosis been made sooner and the wrist put in a cast sooner, the operation would not have been needed. There are cases where the patient is left permanently injured, even after surgery, because of the delay in immobilising the wrist.

Any of these outcomes could have devastating implications for that person’s ability to work and to carry out the day to day activities we take for granted.

If you would like to discuss a new enquiry I would be happy to talk to you free of charge on 0114 218 4000 to determine whether you may have a case worth pursuing.

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