Orthopaedic Negligence Claims

Examples of orthopaedic claims

Delayed diagnosis of cauda equina injury

Sometimes, orthopaedic negligence could occur in a delayed diagnosis of developing cauda equina syndrome.

A delay in diagnosis can lead to suffering severe symptoms of bladder and bowel dysfunction, and also foot drop. If this is not treated early enough, the injury can be permanent.

Clients who come to us may have experienced substandard care by a number of different care providers that they have come into contact with. It may be that they have developed cauda equina syndrome as a result of a failure by an orthopaedic team of an NHS Trust to arrange an MRI scan, which would have confirmed the condition.

Below is a list of other ways orthopaedic negligence can occur in terms of cauda equina diagnosis:

• Failure to carry out an MRI scan in a reasonable time when presenting with neurological signs
• Failure by the doctors to carry out a perineal examination
• Failure to carry out any neurological examination
• Failure to arrange urgent neurosurgical consultation or review

If the surgery is carried out too late, then it is more than likely the outcome is not ideal, and the consequence of the delay could leave a patient with symptoms including sexual dysfunction or numbness in the lower limbs.

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Delayed diagnosis of shoulder injury

In instances of orthopaedic negligence, there would be a failure to carry out investigations to diagnose or rule out rotator cuff injuries, dislocation or fractures.

These kinds of injuries are usually diagnosed when someone reports persistent shoulder discomfort, or the development of stiffness. Without diagnosis, the individual may find they are limited with the use of their shoulder because of the ongoing pain.

Some shoulder injuries may cause a long period of rehabilitation, or could require additional surgery as a result of the delay. Our clinical negligence solicitors have worked on a vast range of orthopaedic injury claims where a soft tissue injury, dislocation or fracture has been missed in a shoulder injury diagnosis.

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Orthopaedic Operator Error

This is when surgery takes place without sufficient care.

Any person who has a sports injury, has fallen from a height or been involved in a road traffic accident (that has resulted in high impact against their body), accepts that they may have an orthopaedic injury. They accept that they may never be quite the same but they do not expect to be worse or lose the opportunity of reasonable healing due to a professional person making an error who is providing them care.

If an orthopaedic injury is diagnosed in the emergency department, the individual knows that they are likely to need some treatment and a period of rehabilitation. It can be a great disappointment to learn that they have been left with a deformity due to negligent treatment.

Our medical negligence lawyers represent clients who have come to realise that their deformity or disability was avoidable, and some are only recognised many years later. Individuals have varied injuries depending on what the initial injury was.

If you have had treatment for an orthopaedic injury that has resulted in an unexpected deformity, our lawyers will investigate if this was avoidable. We will work to determine whether any of the following occurred during your treatment:

• Failure to identify a dislocation
• Failure to review X-rays
• Failure to carry out further investigations
• Failure to use appropriate instruments, components, plates and screws
• Failure to conduct the operation with sufficient care (protect anatomy surrounding fracture site)

For example, a small fracture of the upper limb that is inadequately treated at surgery can be life changing, and possibly require long-term assistance with personal care or carrying out a job that requires the use of both arms.

Orthopaedic negligence claims can also relate to hip replacement operations. As a result of negligence, a patient could be faced with nerve entrapment or a discrepancy in leg length. Find out more about hip replacement claims.

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Orthopaedic delayed treatment and delayed recovery

If you have suffered a fracture and orthopaedic treatment begins (whether that involves surgery or not), but your recovery has been slower than expected and you have regularly complained of ongoing or new symptoms, you do expect to have this investigated so you can be reassured. Sadly, this isn’t always the case.

Our clinical negligence solicitors often see cases where pain has been experienced to a level that normal day-to-day life has been impacted, to the point of clients requiring time off school or work.

In cases like this, our clients usually inform us that the investigation carried out to diagnose the problem was not discussed as an option when they first complained of their symptoms.

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Lack of Pre-Op Evaluation

The main goal of the pre-op evaluation is for the clinician to evaluate a patient’s surgical and anaesthetic perioperative morbidity or mortality, so the operation is carried out safely. From the patient’s perspective, the ultimate goal is to get them back to their original (or as near as) mobility as soon as possible.

Our clients who have had unexpected outcomes often report that they had not understood the procedure that was taking place, or their medical records do not evidence any pre-op evaluation. Having the pre-op evaluation may have otherwise altered the pathway of care, and avoided a complication or unsatisfactory outcome.

More commonly, our findings are that:

• An uncovered hidden condition should have been investigated further;
• A test or referral to high risk assessment team was noted but not carried out;
• Failure to optimize a known medical condition in order to reduce surgical or anaesthetic perioperative risks;
• Failure to obtain informed consent;
• Failure to explain the likely outcome and ensure this is understood.

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Orthopaedic failure to X-ray and/or failure to interpret X-ray

X-rays, CT scans, ultrasound scans, or MRI scans are a routine part of orthopaedic healthcare. They can be performed to diagnose suspected injuries, check the progress of healing, and/or guide the doctor’s decision on continued treatment for the patient. These routine checks and scans can also dismiss and exclude possible clinical diagnosis of concern, following observed signs and symptoms.

Our medical negligence solicitors deal with all sorts of cases where there has been a failure or several missed opportunities to diagnose an orthopaedic injury. We even have examples where the original X-rays show the injury, but it has been missed on plain imaging.

We have experience of cases where there has been a failure to undertake further radiological investigations, by way of CT or MRI, of the hip which has led to delayed diagnosis of a hip injury.

Case example: failure to diagnose a left femur fracture

Our clinical negligence solicitor, Catherine Leong, gives details of a claim she handled:

“Failure to diagnose the fracture of the Claimant’s left femur led to discharging them home, where they then naturally put weight on the fracture. As there was no admission and full imaging was not taken, we could not be sure if the fracture was displaced at time of injury or displaced over time before it was diagnosed.

“Sometimes cases have a series of errors and continued delays in arranging treatment. Our case included failing to counsel the Claimant in relation to the need and importance of them undergoing relatively urgent surgical reduction and fixation of their fracture. These kinds of failures impact on options of course of treatment and rehabilitation. With a delay in diagnosing a fracture, the window of opportunity can be lost for early reduction and fixation.”