Negligence V Complication

The case involves a rather heavy set, middle-aged gentleman, who fell from a chair in the kitchen whilst changing a lightbulb.

He landed on his outstretched right hand, sustaining a comminuted (fracture) to the distal radius of the wrist which involved the joint.

He went to an Accident & Emergency unit where under sedation there was an attempt at reducing the fracture, and the post-operative x-rays showed a reasonable alignment.

He was placed into a short-arm plaster and discharged to be followed up in the fracture unit five days later.? When he was seen at the fracture unit it was decided he would require open reduction and internal fixation (ORIF) and three days later he underwent the surgery.? His post-operative recovery was very slow.? He was out of plaster after seven weeks, however over the next few months the hand remained very painful with shiny skin.? He was diagnosed as having Complex Regional Pain Syndrome (CRPS), which is thought to be due to upset in the sympathetic nerve supply to the hand.

He sued the Accident & Emergency department, claiming that had he been operated on within 24 hours the complications would not have arisen.

The cause of his ongoing difficulties is two-fold:??

• Firstly, he sustained a very nasty fracture of his wrist?
• Secondly, he also developed CRPS, neither of which had any relationship with the delay in surgery for a total of eight days. Even without developing CRPS, the likelihood is he would have lifelong pain in the wrist because of the very serious fracture he sustained, and not in any way related to his care within the A&E department

On taking on a case, it is very important to distinguish between what is a natural outcome for a particular injury and what are known complications, before assuming any poor outcome is due to some mismanagement by medical staff.? In this case there was neither breach of the duty of care nor consequential damage related to his medical management.

MDU figures for 2018 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]