Negligence in Emergency Medicine – A Liddy’s White Paper

Mistakes and negligence occur relatively frequently in emergency medicine. The main reason for this is that emergency departments are largely staffed by inexperienced doctors (mainly foundation year 2) who move post every 6 months. Though they are supervised by more senior staff.

One common area in which negligence occurs is with breaks and fractures.

When a patient arrives a fracture or dislocation they must be asked how the injury was caused as this will tell the doctor about the force and direction of the injury and hence what type of injury is most likely. A full examination should also be carried out. If a fracture is suspected an x-ray should be taken (though of course the patient should be stable before moving on to x-rays).

Sometimes if there is a fracture and dislocation then the dislocation must be dealt with first to avoid risk of tissue damage due to lack of blood supply. Some types of fracture do not show up immediately and therefore are diagnosed by examination rather than x-ray. If the fracture is displaced, or there is any doubt at all, a more senior orthopaedic opinion must be sought immediately.

Typical complications follow certain types of fractures/dislocations. For example serious nerve damage can occur following dislocation and relocation of the shoulder.

Certain fractures can be difficult to diagnose or see on an x-ray. For example a fracture of the neck of the femur happens a lot with elderly people. Sometimes they can continue to walk but generally it is painful if they are asked to rotate their leg, but the break itself can be difficult to see on x-ray.

But regardless, it is usually mandatory to arrange an x-ray where there has been a dislocation, both before and after it is reduced.

Children tend to suffer fractures just above the elbow. This brings with it a risk of muscle degeneration or injury to the medial, radial or anterior nerve. It is essential for all of these conditions to be checked at the A&E department and treated quickly.

The above are typical procedures and what should be standard practices in A&E departments. If they have not been adhered to and you have suffered as a consequence then you may be entitled to some form of compensation. To find out if this applies to you then contact us on 01226 731 314.