Now I should point out I have no intention of doing this I just wondered what the consensus was.

Short Version.
A misdiagnosis has potentially screwed up my ankle for life. The real problem was spotted 5 months later by a private consultant.

Long Version.
I broke my leg in January ’12 but thought it was a sprained ankle. I went to the local NHS hospital and they took one look at me and said I could walk (hobble) so it clearly wasn’t broken. I was reasonably happy with this but thought it strange that they hadn’t chosen to do an xray and would have been happier if they had. I was given painkillers and told to rest for a couple of weeks.

Two months or so later I go to my GP and explain what has happened and that I am still suffering. He accepts the hospitals diagnosis, why wouldn’t he, and refers me for some physio. I have physio at the above hospital for another 2 months. And get told it might be a fragment of bone or cartilage that snapped off when I got the sprain.

I decided at this point to use my private health insurance. So back to the GP he still thing this is all reasonable and refers me to an ankle specialist. The specialist thinks it sounds like a reasonable conclusion but also thinks it odd/daft that the hospital hasn’t ever xrayed it. He books me in for an MRI the following Monday and the minor operation to remove the foreign body on the Wednesday. Anyway it turns out that I had been walking around with a broken leg for 5 months. So he did what he needed to do and I followed instructions for getting better but its still not right due to complications because of leaving it so long.

So if the NHS had xrayed me they would probably have seen the break and done something about it. As they didn’t I have suffered complications and may well do for many years to come.

So what would you do sue or just mark it down to experience?

There was a time when I would have said mark it down to experience, but if you’ve got evidence of negligence (which it seems like you might have) I would certainly at least be looking into trying to get some compensation out of it…

I’m convinced something went wrong early on in my treatment when I “damaged” my arm, but as of yet have no way to prove it. All the consultants I’ve dealt with have been lovely, and I think I’d probably feel a little bit bad about it for a while…but if I could get some money for it I think I would!

I think you may struggle to sue them. To establish negligence would be difficult I think…the decision not x-ray, based on your signs/symptoms seems not to have been unreasonable – especially given the agreement of the other medical professionals you spoke with.

I would be frustrated and a bit miffed too though, but I’m not sure if pursuing this through legal means would make you feel an better. If I were you I’d focus on feeling better.

I don’t have a problem with suing the NHS, in fact I think it’s a good idea. These public institutions are now run as businesses by accountants, so unless accidents show up as a big dent in the P&L, no one will do anything to change the system to try and prevent them.

Exactly the same happened to me, but they picked up on it in a couple of days, (they kept me in hospital) as my ankle was the size of a melon. but at first wouldn’t x-ray it. Hobbled round on it in this time. I ended up being in for 18 days. (they had to then let the swelling drop before they could operate) 🙄

I now have plenty of pins in my right ankle and suffer badly in the cold and wet with pain from my ankle.

I have looked along lines of compensation, but due to me being keep in for observation nothing I can do.

Check your not likely to get arthritis etc. I’m suffering badly at times. Which is crap considering I’m not yet 30.

In order to sue them you will have to prove negligence, which can actually be the easier part once you get that you then have to prove causation, the harder bit. You’ll have to prove that somebody else would have done it different and that would have made it better. I speak with much experience on the subject having just won one for my son. Only took just over 9 years and we still have another year or so to work out the cost of the damages 🙁

After a fracture you’re very likely to suffer arthritis, I’ve had it in my R hip since I was in my mid twenties due to an op. Aches sometimes but doesn’t stop me doing anything but it’s one concern for work when I’m older.

You need to go through the correct channels to make an official complaint, possibly through PALS first but you need to check. It needs to be followed through so will be a test of endurance.

Agree with footflaps. There’s no accountability and let’s not forget that we are paying for this. Don’t give up cos that’s what they expect you to do.

Ignoring negligence etc… and from a purely moral POV it’d be a tough one for me. I love the NHS and they’ve done A LOT for me but if I had complications that affected my life (especially income) and I thought that the NHS was at fault then I’d have to have a real think about it. I imagine that I wouldn’t try to sue but I’m not in that position so can’t say for certain…

edit: oh, in your position I think that I’d put it down as one of those things.

What kind of break was it?

Also – why MRI something that would show up on an x-ray? I’d be thinking that the private guy is opting for more expensive imaging tests just for the hell of it.

Interesting question.

In A&E if they followed some guidelines (Ottawa ankle rules for example) AND documented their findings and they were reasonable then i don’t see how they can be sued for that. Sometimes you miss things even following accepted practice.

As your GP if you had ongoing symptoms at two months then i would be tempted to X-ray, but having said that, bad ankle sprains can easily go on for two months and i don’t know what his/her findings were.

I have learnt not to accept what another Doctor or colleague says or even what is recorded in the notes or in hospital letters. It can take you down the wrong route and cloud your own thinking. This is even more the case with A&E opinions. The Doctor seen is often less experienced than anyone they see after that, and they may be the only person you see.

re a private opinion, i sometimes surprised by what someone who is being payed by a patient is prepared to say to them.

The private opinion i note had the benefit of MRI rather than X-ray, which is nice..
Would the injury have even been visible on an initial X-ray?

I don’t think that the only way to “change the system” is by litigation.
I’m not really sure this is even an example of the system needing to be changed

You can complain.

The vast majority of Doctors i know would be upset by the complaint and try to learn from it.
They would feel they had failed.

On the other hand, if they didn’t examine you, missed an obvious fracture, kept poor notes and consequently left you with an injury causing loss of earning or quality of life, then i would say sue them and feel comfortable with the decision.

All of course IMHO.

p.s. what was your fracture?

Did a refresh after reading your long version and Andy has saved me a lot of typing.

Not sure of the name of the break but it was vertically up the tibia from the ankle joint this is why I could still weight bear. I think he did the MRI because it would show the foreign body (that he was looking for) up better in the joint fluid, I’m not 100% sure.

As I said at the moment I’m not planning on doing anything. Its just that I was challenged by somebody about it the other day and called an idiot for not wanting to sue. I wondered if I am being odd or not.

Oh and at A&E I didn’t see a doctor just a nurse. That is not to say that a nurse wouldn’t be perfectly capable of diagnosing my injury correctly just that this one didn’t.

I got the “you’d not be walking on it if it were broken” line too but they did x-rays as a precaution. Cue much excitement as I was blue-lighted off to surgery for a broken hip!

Suing is a bit of a moral conundrum tbh… The argument is that it’s the best way to discourage it from happening again. Personally I had a pretty solid case for negligence (another treatment/condition) and chose not to pursue it, it just didn’t feel right for me especially as the consultant who caused the issue is dead so the risk of recurrance doesn’t really cover it. OTOH she has a ****ing building named after her and I have a ****ed body so, maybe I should have 😉

But it’s entirely a personal decision.

AH – nurse practitioners. They have in the last 2 years missed a broken jaw, a broken tibia, a broken fibula, three broken ribs, and a broken ulna just in my family. I tend to ask for an x-ray now, or go for a second opinion if either me or the kids look like we’ve broken something or I dont believe their opinion. I have no intention of sueing anyone.

Nurse practitioners working in minor injuries units are not really all that well equipt skills and knowledge wise to be doing the job they are asked to do.

I’d at least start the procedure an fond out what your notes said. As for morally what would you do with the cash?

If it’s for ongoing care/maintenance then yes. If not I would suggest any unease could be dealt with by giving the money to a health charity.

After hearing too many cases like this I have become a little more resolute in A&E. Asking for x-rays rather than just going along with it. (It also helps to say that I can pop next door to the vets and get one done)

There is no point in MTFU in A&E. If it hurts or doesn’t feel right then it needs checking.

Footflaps couldn’t be more wrong with his comment that suing the NHS will make them notice because it will effect the P&L

It would however be worth contacting PALS.

Unfortunately problems will increase in the NHS as spending continues to be cut, which equals less, more inexperienced staff.

Funky. I was told by a NHS professional that mountain biking injuries can be classed as ‘self inflicted’.

I was very offended at this attitude. Maybe this attitude is wide spread in the nhs? Maybe the op was triaged and partly neglected?

I was made to wait over 5hours from 7am on a Sunday morning as new people came in after me with a minor cut etc etc then went through ahead of me.

Maybe if you dont like your lot in the NHS or ‘customers’ work elsewhere? Dont blame cuts for negligence. Ones cutting waste and the other is negligence. Pure and simple.

AH – nurse practitioners. They have in the last 2 years missed a broken jaw, a broken tibia, a broken fibula, three broken ribs, and a broken ulna just in my family.

Sounds like bad diagnoses from nurses are the least of your troubles…

Interesting perspective, where’s there’s blame there’s a claim.

My mate, he and his wife had been trying for a family for ages. His wife gave birth to a beautiful boy, less than a year later he was diagnosed with stomach cancer. He was “lucky” as he had one form that was treatable.

Cut to the chase, he was given more chemo than neccasary.

The consultant informed him at a meeting and handed him a form to start the process of making a claim. My mate refused point bank.

His view was they did their best to save his life. They made a mistake “and nobody gets up in the morning to make a mistake”.

Top bloke.

That’s one perspective

Slowmart does the extra chemo affect the rest of his life. I.e the quality?

Its a case of a series of mistake(s) causing a lower quality of life and future earning issues.

I agree mike since this I have decided to be firmer when it comes to getting diagnosed with stuff.

As for what the money would theoretically be used for, a new suspension frame would make getting out on my bike again much easier. 😉

As it stands my thoughts are that me not suing them would leave more money in the NHS and therefore improve the service. I realise this is a bit idealistic and also a small drop in the ocean. I do however feel this outlook is slightly naive.

I_ache seen how much your GP is likely to earn in a year?

As it stands my thoughts are that me not suing them would leave more money in the NHS and therefore improve the service. I realise this is a bit idealistic and also a small drop in the ocean. I do however feel this outlook is slightly naive.

Perhaps look at it as initiating the complaints/investigation procedure and if compensation comes out of it then think about it.

People learn from mistakes, this only happens when they hear about them. As far as they are concerned your fine, entered then left, treatment success, good outcome achieved.

If people don’t like being told they got something wrong then healthcare is probably the wrong place for them. Do it for the next person who has no private medical to get back into the system.

I didn’t do it riding hora, and I honestly don’t think my GPs salary has anything to do with matters.

Good point Mike.

Like Mike says feel free to complain to highlight the issue, suing is not always the answer and rarely is. I’ve witnessed people afraid to do a procedure in case they get sued for getting it wrong.

Look up the figures for the nhs outgoings for patients suing. While they should of course be accountable medicine is unfortunately not an exact science for many conditions. Unfortunately too the nhs are quick to settle even without negligence as often the threat of bad press for a hospital is enough to force the pennies in to the patients grubby little paws 😉

I would take slowmarts posts view except in exceptional circumstances.

For those asking how much gps get paid, take a look at how much nurses, midwives, radiographers etc get paid and think how much of your claim might contribute to a much needed extra pair of hands 😉

Dan thats exactly my view, clinical practice can be a dark art even when all guidelines are followed correctly. I have a friend who works on an nhs litigation team and the crap they end up paying out for boggles my mind.

There is a huge difference between negligence and mistakes that occur due to clinical practice still being partly down to guess work – paediatric chemo dosing is a dark art for sure.

Can we afford to ct every possible break and does it have overall public health benefits? As a ct scan involves radiation, im guessing the answer to both is potentially no.

So unless the op can find evidence that there was a deviation in protocol I suggest he deal with it. You shouldnt get compensation just because youre one of the statistical outliers that comes with the business.

Can we afford to ct every possible break and does it have overall public health benefits?

No but an X-Ray isn’t that hard to do.

I broke my leg in January ’12 but thought it was a sprained ankle. I went to the local NHS hospital and they took one look at me and said I could walk (hobble) so it clearly wasn’t broken. I was reasonably happy with this but thought it strange that they hadn’t chosen to do an xray and would have been happier if they had. I was given painkillers and told to rest for a couple of weeks.

They don’t X-ray routinely and certainly not because someone has a sore leg.

http://www.gpnotebook.co.uk/simplepage.cfm?ID=x20060717214620511440

Haven’t read the rest of the thread but it’s quite normal for them not to x-ray particularly at the early stage where it’s too swollen. Mr MC had something not disimilar where they dind’t x-ray it said it was broken and not to walk on it! Actually turns out it’s theo ther way, ligament and cartilage damage and he should’ve been stretching it and putting weight on it which potentially screwed it up longer than it should. IMO you just have to suck it up and move on.

mr MC then also had the tricep rupture in betwys, went to Bangor A&E who thought that’s what it was but needed to discuss it with the other Consultants. Consultant rang us a 8pm when we were in the campsite and said “yup it needs surgery ASAP go to your local A&E tomorro”. Drive home go to local A&E who refere us to fracture clinic …despite havin X-rays, paperwork etc from Welsh consultant. A week later fracture clinic appointment they say “we can’t do antyhing you need an ultra sound”, go to book ultra sound “oh it’s the summer holidays we can’t get you in for 2 weeks” .. I have a cob on they say “sorry too many people on annual leave”. 2 weeks later have the ultra sound …”oh yeah you need urgent surgery”. Meet up with consultant who states tricep reconnection needs to occur within a month we are now 3 weeks a 4 days past the accident…..hurried up into surgery with talks of possibly never being able to straighten his arm again. Not a happy bunny but hey you have to accept it as they aren’t negligent just shite!

We tried suing our local hospital after one of the doctors there could not recognise a massive infection in one of the screw holes of my wife’s new tibial nail following a break. “Soft tissue damage” was what he called it, despite massive swelling and lots of heat. It looked like a bloody zit and, the next day when she was admitted through A&E, they were amazed it had not burst.

What’s worse is that, as she had to have the nail out, they left her out of any sort of cast (despite me asking whether the break had healed due to seeing a line at the fracture site) and she re-broke her leg two days later. Cue several months in a cast and effectively off work.

We did not win. Apparently negligence could not be proved.

As mike asks for mistakes to be pointed out: ‘you’re’ not ‘your’.

😀

A few questions enter my mind

How common is the injury, as a % of ankle injuries

What would have been done had it been seen earlier

My version of the story is that I fell over walking the dog

A&E said sprained ankle

After 2 months of activity and pain went back to GP

X-ray shows calcification of the Achilles inserion. So that was the end of running. It seem to be causing a few bike problems now as well, 20 years later…

Any way physio takes history and gives thorough examination

At the end I look at him and say its a sprained ankle. He laughs “you eliminated that in the first 20 seconds of talking, you fell the wrong way”

Any way as I couldn’t point the foot down he conluded he had pulled by leg out of my foot. He pushed it back in and pointing was restored. A real little miracle

I think the MTFU thing is part of the issue here to, I’m sure most of us would play down the pain etc. and so they wouldn’t x-ray but in reality if it really is bad then you should request one is done. Yeah it might be a drain on the resources but at the end of the day it’s your health and it could potentially impact the rest of your life.

I had a mate who cracked two vertebrae in an MTB race, he was able to get up unaided though and figured he just had a bit of whiplash, I drove him to A&E but he got sent away just telling him to take it easy and see his GP on Monday if the pain didn’t ease up. I called in to see him the next day and he said the pain was worse so after I insisted I took him to A&E again where he got it x-rayed and they found the fractures, I hate to think what could have happened if the fracture opened up etc.

There’s no accountability and let’s not forget that we are paying for this

And of course, private health care/medical companies are so much more accountable.

http://en.wikipedia.org/wiki/Poly_Implant_Proth%C3%A8se

Remind me who’s paying for that **** up? Oh look, it’s us.

I called in to see him the next day and he said the pain was worse so after I insisted I took him to A&E again where he got it x-rayed and they found the fractures, I hate to think what could have happened if the fracture opened up etc.

The craked ribs things are a well you have cracked ribs, they are more bothered about collapsed lungs in that one. They didn’t bother with mine as it doesn’t change outcomes. They didn’t worry about a collapsed lung as I’d been on 4 flights in the 4 days before accident and diagnosis.

I’m suing the nhs of negligence resulting in death…

If you break something riding your mountain bike and no one else is involved then surely the first mistake or error of judgement in the chain of events is yours. In that case it might be morally dubious to keep any money you made by suing the nhs. You then left with the decision as to whether or not taking such action is the best way of improving care in the future. I would of thought an official complaint might do that just as we’ll without the risk of putting money into the hands of lawyers. I think you are right not to sue but there’s no reason not to make sure it’s a matter of record