Case Study- A Needle Too Far!

A slim, 26 year old lady, was involved in a road traffic accident when she developed pain in her cervical spine, radiating down between her shoulder blades.

She was normally very active, including frequent yoga sessions, and so when she was sent by her insurance company to a physiotherapist she was offered acupuncture “as alternative therapy”.

No consent form was signed.

Immediately following acupuncture in the area between her shoulder blades she developed sharp pain on the inner aspect of her left shoulder blade, made worse by deep breathing.  She explained this to the practitioner who stated that it would be normal after acupuncture to possibly develop some spasm in the muscles between her ribs and this would wear off.  She was reassured and went home.  Over the next few hours she became increasingly breathless.  She tried to sleep but woke up early in the morning with pain and a feeling of breathlessness so she was taken to a local Accident and Emergency Department.  She was triaged as non-urgent with “query muscle spasm due to acupuncture”, and left in the waiting room between six and seven hours before she was seen by a medical practitioner.

A chest x-ray was ordered which showed a large pneumothorax (air in the space of her chest collapsing her lung).  She therefore had a chest drain inserted.

She was admitted to hospital for 48 hours, the chest drain was then removed and check x-rays showed that the lung had re-expanded satisfactorily.  No further management was required.

Initially, it was felt that an action should be taken against the hospital, with the delay in diagnosis of over seven hours.  In fact, the primary duty of care was by the physiotherapist who gave her acupuncture, did not explain potential complications and dismissed her symptoms.  The needle went in too far, puncturing her lung and she slowly developed a pneumothorax which, at the end of the day, required the insertion of a chest drain.  Hospital staff in the Accident and Emergency Department did have a duty of care, their treatment was undoubtedly sub-standard but there was no consequential damage as a result.  An action against hospital staff would be in the nature of a complaint but an action in medical negligence against them would be unlikely to succeed because of the lack of consequential damage, all of which was caused by the acupuncture.  The action proceeded against the physiotherapist.

MDU figures for 2017 show that less than one in six actions in medical negligence actually succeed with the vast majority failing on the grounds of causation. It must be remembered that subsequence is not the same as consequence. 

Initial screening is therefore essential to manage client expectations at an early stage. This avoids unnecessary effort and costs for all concerned. Too many cases are taken to Court with no chance of success. This is stressful for both the client and their legal advisor and indeed for the medical personnel involved.

For fast and effective screening of all potential medical negligence cases contact  Peyton Medico Legal Services now on 028 87724177 or email [email protected]