Suffering a broken or fractured bone could be quite painful. Breaking or fracturing a bone could also leave you quite unable to carry out everyday tasks, such as being able to move about properly or even to be able to work. If you have broken or fractured a bone, you should be entitled to the best possible level of medical care. You should not be left with a missed fracture, a lack of diagnosis and no treatment.
If you are being treated by a medical professional through the NHS or a private medical service provider you will very likely receive a high level of care. This does not however mean that mistakes do not happen and that fractures may be missed on an X-ray or through other diagnostic means. Missed fractures could lead to your injury becoming much worse over time. You could even end up with a long-term injury. If you have fractured a bone, but the doctor missed the fracture, this delay in you getting the right treatment you may end up in a worse state. You could contract an infection or develop Osteoarthritis.
Even if you do not develop any additional complications or find your injury becomes worse, simply having a missed fracture or undiagnosed broken bone is likely to leave you in a lot of pain which could have been avoided. If you have had to pay for any private medical care as a result, you could also have been left out of pocket.
If you have been affected by a broken bone not being diagnosed, you could make a missed fracture compensation claim. Talk to our team today to learn more about how a medical negligence solicitor could help you to claim compensation. You can also contact our team at 0800 652 3087.
Select A Section
- What Are Missed Fractures
- Are There Different Forms Of Fracture?
- Symptoms Of Fractures And Of Missed Fractures
- Why Might A Fracture Injury Be Misdiagnosed?
- How Should Fractures Be Diagnosed?
- How Should A Fracture Be Treated?
- What Complications Could Result From An Untreated Fracture?
- Statistics Highlighting The Misdiagnosis Of Fractures
- Which Fractures Are More Likely To Be Missed?
- Your Rights As A Healthcare Patient
- No Win No Fee Misdiagnosed Or Missed Fracture Claims
- What Could You Claim Compensation For?
- How Do I Claim Compensation?
- Reference Materials For Medical Misdiagnosis
Missed fractures are breaks or fractures to bones which are not correctly diagnosed and are not treated by a medical professional. It may involve a missed fracture on an X-ray or a doctor failing to carry out the correct examination of the patient. The fracture may range significantly in severity but regardless of how serious the fracture may be, all broken bones should be properly diagnosed and treated. This failure by the treating physician could be termed medical negligence.
If your fracture was not diagnosed or treated correctly, you could make a medical negligence claim through a personal injury solicitor.
There are different forms of breaks or fractures which you could have and which could go undiagnosed or which could be missed by an attending physician. Let us look at the different forms of fracture.
Open Or Closed Fractures
An open fracture may also be called a compound fracture. This is where the fracture is serious enough to cause an open wound. The bone may be exposed and could puncture the skin, or the skin and soft tissues could have also been injured, exposing the broken bone below. This type of fracture could lead to the development of secondary infections.
Closed fractures are where there is a break, but it is contained and the skin barrier is not broken, either by the bone itself or by another cause.
Displaced And Non-Displaced
- Displaced fractures are those where bone fragments have moved and are not in-line. This may give a misshapen look to the affected area.
- Non-Displaced fractures mean that no pieces of bone have been broken off and moved out of position.
You could also describe a fracture by the fracture or break line which is formed over the bone (along or across the bone). Some of these are known as:
- Comminuted fractures – where the bone fractures into three pieces or more.
- Spiral fracture – the fracture looks like a twisting line around the affected bone. This could be caused by an injury twisting the bone.
- Greenstick fractures – there is a break on one side of the bone. Typically, these fractures only affect children.
- Stress fractures – these can be caused fatigue in the bone after repeated use over time. As these are tiny cracks in the bone, missed stress fractures could be more common.
- Oblique fracture – the fracture occurs across the bone at an angle.
Impacted fractures – the pieces or ends of a fractured bone are impacted into each other. This could end up causing a shortening of the bone.
- Complex fractures. These are fractures where the bone has been broken into several pieces and where the surrounding soft tissues have also been damaged.
- Stable fracture. Here the two ends of the bone are cleanly broken, still line up and are almost still in place. .
Depending on the mistake, error or act of NHS negligence which you suffer, you could find that any of these types of fracture could be missed by a doctor. Injuries and missed bone fractures could also be known by the bone which has been broken. For example, an injury may be referred to as a hip fracture and in the context of this guide as a ‘missed hip fracture’.
Commonly missed fractures could present with a variety of symptoms. For example, missed scaphoid fracture symptoms may be different to the symptoms of commonly missed fractures in the hand.
Breaks are generally caused by an accident which caused immediate damage to the bone and may leave the victim in pain. This pain may present at the time of the accident (break) or at a later point. Depending on the location of the break, type of break and affected bone, you could find that you are not able to move the affected part of you, or may not be able to put weight on it. If your break is not treated you could find the inability to use the affected area persists. For example, missed ankle fractures may leave you unable to walk on the ankle.
Commonly missed fractures could also include other symptoms such as bruising and swelling around the area of the break. The area around the break may also look out of place and could look deformed.
Depending on where you think you have a break it may be appropriate to visit a hospital, minor injuries unit or for broken toes, a GP surgery. If attending any of these for care you find your injury is not diagnosed correctly (such as experiencing missed fractures in A&E treatment) you could have a valid missed fracture claim.
When looking at a medical negligence claim for a missed break, why the injury was missed by the doctor could be integral to the claimant being able to seek missed fracture compensation. For example, if it could be shown that any other doctor would also have missed that injury, then there may not be grounds for such a claim.
Breaks and fractures could fail to be diagnosed for several reasons, but there are some causes which may be seen more frequently.
- There may be an instance of a missed fracture on an x-ray.
- A missed fracture in an A&E department could happen because a doctor failed to carry out the correct examination or because they failed to see the break on x-rays.
- Commonly missed fractures in radiology results not being passed on to a doctor.
- Fractures being missed because x-rays are not requested.
Whether there was a missed fracture due to a radiology error because a thorough and competent assessment was not carried out, you could be able to make a missed fracture claim.
There are several simple steps which a doctor should take in order to correctly diagnose a broken bone and to make sure that you do not have a missed bone fracture.
The doctor should ask you questions about your accident and about the symptoms which you are experiencing.
They should then move on to conducting a thorough physical examination of the area suspected to be broken. They may check to see if there is any swelling or if the area feels tender and is painful to the touch. They may also look for noticeable changes in the shape of the area, such as a joint or a limb looking misshapen. They may also ask you questions about relevant parts of your medical history.
If they suspect a broken bone, or to rule it out, they may ask you to have an x-ray, CT Scan or MRI scan. This is not always necessary to confirm a broken bone. Errors could happen at this stage and lead to missed fractures in radiology not being carried out properly, or in images not be correctly interpreted.
After being examined by a doctor and having your facture diagnosed, it is important that treatment is started as quickly as possible. The location of the bone broken, the type of fracture and the severity of the fracture will be crucial in determining how the broken bone should be treated.
Scans, such as x-rays, MRI’s or CT scans, should highlight the seriousness of an injury and the type of fracture sustained. The doctor carrying out the assessment and recommending treatment should then advise on what treatment is appropriate. It is likely that in the first instance, you will be prescribed some form of painkiller. If it is necessary, a splint may immediately be applied to hold the bones in place and prevent further movement.
There are different treatment options for fractures. If a smaller toe is broken doctors may recommend a mixture of rest and painkillers. Other treatment could include placing the bone in a splint or a plaster cast to hold it in place. If the bone is seriously fractured it may require surgical intervention.
The aim of treatment will be to put the bone back into place if this can be done. Next, the area will be kept still and the bones held in place in order for them to start knitting together and healing. You may or may not require surgery. Your doctors should fully inform you of treatment options and whether or not you would need to have your break operated on.
If injuries to bones are not diagnosed (such as missed stress fractures, or missed fractures in a foot) or if they are not treated, the patient could subsequently develop several different complications. In some instances, these may be life-threatening to the patient.
Complications which could arise due to a broken bone not being treated may be:
- Fat Embolism. After a fracture, a broken bone may release fat deposits into the bloodstream. This could cause blockages in oxygen getting to vital organs.
- Deep Vein Thrombosis. In DVT, blood clots form deep veins, such as those of the legs. They could be caused by a broken bone damaging a vein. If this blood clot travels around the body it could be fatal if it reaches the lungs.
- Acute Compartment Syndrome. This describes situations where swelling and/ or bleeding happens in an enclosed muscle group, requiring urgent medical intervention. If not acted upon quickly, it may lead to serious damage to the muscle. If infection sets in, the muscle and surrounding tissues may require amputation.
- Osteomyelitis. In such cases, bacteria are able to get into the site of the fracture and to infect the bone which has been broken. If this infection is not treated gangrene may set in. in the most extreme cases, the patient may require surgical intervention and amputation.
- Avascular Necrosis. In these cases, the bone does not receive a sufficient supply of blood if blood vessels are damaged by the fracture. If the blood flow is not restored there may be bone death and related joints may be seriously affected or experience destruction.
Other possible consequences of a broken bone not being diagnosed and for which a missed fracture claim could be made, may include long-term stiffness in a joint. Bones which heal without proper treatment may be misaligned. Patients could be left with arthritis or permanent disability.
The study highlighted in this British Medical Journal article shows that a very high percentage of diagnostic errors recorded 79.9% were missed bone fractures. The most reason why broken bones were not diagnosed was the misreading of x-rays and radiographs. 77.8% of missed broken bones were caused by this. A further 13.4% of breaks were not detected or diagnosed because a doctor failed to carry out radiography.
The majority of theses mistakes were the responsibility of Senior House Officers. The study looked at a total of 953 diagnostic errors. Of these, twenty-two patients took some form of legal action, such as making a claim with a personal injury lawyer.
In the past research has been published which has looked at which bone fractures are more or less likely to be missed on radiographs (x-ray images). These may include:
- Missed foot fractures,
- Missed ankle fractures,
- Missed boxers fractures,
- Missed sacral fractures,
- Missed scaphoid fractures,
- Missed radius fractures,
- Missed buckle fractures in children,
- Missed fractures in paediatric trauma patients.
Some of the most common fractures which may be missed in a diagnosis may be broken toes. In the smaller toes minor fractures may be much harder for a doctor to diagnose due to the slighter nature of the break and the small size of the bone affected as a whole. In addition fractures which are non-complex, such as missed calcaneus fractures, may initially appear less serious than they are could go undiagnosed.
Depending on the fracture you sustained and the actions taken by the doctor who failed to spot the break, you could be able to make a personal injury claim.
If you are being treated by the NHS, the NHS constitution sets out your rights as a patient. It also sets out what rights people have as members of the public and as a staff member working for the NHS. The constitution states what commitments the NHS has to patients and staff as well the services responsibility to patients. As a patient you have the right to be treated fairly and effectively. This right is applicable whether dealing directly with the NHS or with those supplying services to the NHS, such as health centres run by third-party healthcare providers for the NHS.
You can find the constitution for NHS England here.
In most cases where you have been affected by a missed break, such as a missed fracture in your foot, you are likely to be able to make a no win no fee medical malpractice claim. If you are able to make a no win no fee claim, the solicitor would take on your claim (such as a claim for missed spine fractures) without you having to worry about making payments upfront for any legal fees. The simplest way to put this is that if your solicitor takes on your claim but does not secure you compensation, there will not be anything to pay them. There are no catches. If you do not win, you do not pay.
If the solicitor you work with is able to win your claim, they will probably take something called a success fee. This may be taken from the settlement you are awarded. It could amount to up to 25% of this total but is not likely to be more as there are legal limits in place.
How much you will be charged and how you will be charged will be discussed with you before a solicitor would agree to take on your claim.
If your doctor missed a fracture or misdiagnosed a break in one of your bones, you could have had to undergo subsequent medical treatment to put things right. Whether you underwent treatment by the NHS or sought private medical care, having this happen to you could be costly.
Aside from the costs of private medical care (if used), you may have incurred other costs and expenses. You may have needed to travel back and forth to medical appointments, or have had to pay additional accommodation costs, such as adapting your home if you were left disabled. All of this could increase the financial pressures which you may face if you have had to take time off from work.
Missed fracture compensation amounts which may be paid out for the injury itself may differ significantly. That which is paid out for smaller bones with a less serious break may be much lower that missed fracture compensation amounts for complex fractures over large and important bones, such as your thigh bone.
By finding a specialist solicitor to take on your claim, they will be able to assess the impact that the injury has had on you, as well as what costs that you have faced as a result of this. They should take all of this into consideration when they look at putting together the claim that you make. Your solicitor should then work on your behalf to make sure that you do then receive the best possible compensation settlement.
Types Of Damages
|Type of damages - General damages / special damages||Reason for compensation|
|General damages.||Compensation for your injury.|
|Special damages.||Lost income, earnings and benefits.|
|Special damages||Costs of medication and medical treatment.|
|Special damages||Costs of adapting your home or of adapting your vehicle.|
|Special damages.||Accommodation and travel related costs.|
You may also be able to claim compensation for things such as the wider effect which the accident has had on your family and family life. You may also be compensated if your injury has had a significant impact on your social life. This may be if you have had to give up activities which you previously participated in, but which you are no longer able to do so.
If you have suffered a missed fracture or discover that a doctor did not detect a broken bone which was subsequently not treated, and if you were within the personal injury claims time limit, you could make a claim.
You may also be able to claim compensation through a medical negligence solicitor or medical negligence lawyer if a close relative died due to complications resulting from a fracture. This claim would be made on behalf of the estate of the person.
If you are able to make a medical negligence claim, such as for a ‘missed fractures emergency department’ claim, the compensation could;
Ensure that you have the money which you need in order to be properly supported during your recovery as well as through your ongoing medical care. It may also ensure that you have sufficient funds if you have been left with a disability.
The claim itself could help to increase awareness of this type of medical error, or such errors being made at this medical facility. Highlighting what has happened to you may help to prevent further such occurrences in the future.
To find out if you could make a no win no fee medical negligence claim, it is a good idea to speak to a personal injury solicitor who specialises in claims for medical negligence. Getting independent legal advice could help you to know what your options are and whether or not you could make a claim. You can call us today on 0800 652 3087 to discuss what has happened to you.
Medical Negligence Assist have used information from a variety of different medical resources as well as personal injury claim information in order to create this detailed guide on missed fracture medical negligence. We should note that the circumstances in this guide could present through NHS negligence or as private medical negligence.
British Medical Journal
This resource looks at Diagnostic Errors In Accident And Emergency Departments which could be made. We can see that of 953 diagnostic errors, 79.7% were missed fractures. The leading cause of these at 77.8% were misreading radiography, such as a missed ankle fracture on an x-ray.
These are guidelines from NICE relating to the assessment and management of non-complex fractures as they can be treated in specific facilities.
Information on missed hip fractures including national level incident data presented in a resource from NHS Improvements.
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