Delayed diagnosis of a broken wrist

Medical history

The scene of this accident was painfully ironic. Outside the GP's surgery, on his way to the doctor for a routine appointment, an elderly man slipped and fell heavily. In the consulting room, he described the fall and complained of pain and swelling in his wrist. The GP examined the joint and noted full movement. He diagnosed a sprain, applied a crepe bandage and prescribed an anti-inflammatory medicine. Some days later, the man returned with his pain no better. The GP re-examined his wrist, again confirmed full mobility and found no increased tenderness on movement. His notes recorded 'very little bruising'. He advised his patient to discontinue bandaging and to begin using the wrist.

Four weeks after the accident, the patient re-attended. The wrist was swollen and tender, although movement was full. The GP referred him to hospital where a 'dinner fork' deformity was noted. An X-ray confirmed a displaced Colles fracture. Manipulation of the joint was not possible so long after the fracture. After six weeks in plaster, the man was left with a deformed joint which was beyond repair. His wrist was weakened and ached after any exertion. He found himself unable to continue certain tasks including decorating and home repairs.

Court papers

Three years after the accident, the GP was served with a county court summons. The patient alleged the failure to refer immediately showed negligence and he claimed compensation for pain and suffering. The MDU instructed solicitors on the member's behalf and asked a GP expert to review the case. He considered the GP's failure to diagnose a fracture immediately was understandable as there was little swelling and no deformity. He noted, however, the GP's suspicions might have been aroused at the follow-up visit when pain and swelling remained and bruising was seen. Bruising is not normally associated with a sprain and could have alerted the doctor to the possibility of fracture. He also pointed out that, while the hospital had noted the 'dinner fork' deformity, this physical sign had been missed by the GP. The expert believed the delayed diagnosis had contributed to the patient's permanent disability and advised that the claim should be settled.

The settlement

After some negotiation, and the member's consent, the patient accepted £7,000 plus legal costs.

This page was correct at publication on 01/01/2002. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.