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Hospital missed broken arm WWYD?

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#1 Zmuma

Posted 21 January 2013 - 08:15 PM

My DD2 had an accident prior to Xmas. She pulled a glass hall table on herself. She fell backwards with the glass landing vertically on her chest and a large glass candle hit her in the head. It was horrible, I heard the crash and new what she had done. As I came around the corner there was a split second where I thought it landed across her throat. It was the worst feeling. I could have lost her so easily.

I took her straight to the local hospital rather than the Sydney Children's hospital, big mistake. They didn't even look at her chest, just listened & were just focusing on her head. I was still quite rattled and was just glad she was ok.

She was quite happy over the next 2 days but was crying every time she fell on her butt or if she fell forward. I thought she may have bruised her chest and it was hurting when she fell. Both DH and I felt uneasy.

It wasn't until I went to play round and round the garden and I turned her hand over and she screamed and took a good 10 mins to settle. I knew then that her arm was injured. I waited until she calmed down and gently squeezed down her arm until I got  near her wrist and she screamed again. Off to the Syd Children's hospital where it is confirmed that she has fractured both bones above her wrist.

After the guilt subsided I started thinking that the first hospital should have noticed or at least given her a once over.

Is it worth writing to the hospital to complain or just leave it?  I doubt my letter would change anything. But it might get back to the treating Doctor who may be more thorough next time.

#2 Kay1

Posted 21 January 2013 - 08:18 PM

Oh my god yes!! They should definitely be notified, that is a terrible oversight! They should have done a thorough examination.

I'm sorry to say but this is why I always go straight to Sydney Kids Hospital.

I'm sorry your poor DD had to go through that. I hope she heals well soon, what an ordeal for all of you.

#3 Guest_3Keiki_*

Posted 21 January 2013 - 08:19 PM

yes take it further, many years ago my DS had a fall, not huge but he too had pulled something over onto himself. Hospital did a full body xray to rule any break.
The doctor was very wrong in this instance and missing these kinds of things could lead to a very very serious outcome in future they need to be counselled for sure

#4 Guest_3Keiki_*

Posted 21 January 2013 - 08:19 PM


Edited by 3Keiki, 21 January 2013 - 08:20 PM.

#5 Juki

Posted 21 January 2013 - 08:22 PM

This is horrific, I would be seeing a lawyer, not for money but to see what can be done about it.. You don't want this happening to someone else!

#6 Soontobegran

Posted 21 January 2013 - 08:31 PM

So did she have any obvious bruising or swelling of her arm? Was it obviously misshapen? Was she favouring it? If she did then they have missed the ball but if no then there would be no sign they should be x-raying it. It took two days for you to have her home before you noticed that it was painful for her and you said she seemed quite happy.
They would have been focused on her head because a head injury isn't necessarily immediately obvious but if she was crying, talking and her colour was ok then the presumption would have been that she didn't have any chest damage.
It's upsetting, I understand that but you do not do full body x-raying on the chance there maybe a fracture and unless there was something immediately obvious it is really not so unusual that it could be overlooked.

I am all for making caregivers accountable for making mistakes but with young children who can not verbalise where things hurt the diagnosis is harder and dependent on observation and behaviour and it appears that a broken arm was not something that you had seen signs of immediately either.

I hope she is healing well, good luck.

#7 Handsfull

Posted 21 January 2013 - 08:34 PM

What STBG said.   tthumbs.gif

#8 SMforshort

Posted 21 January 2013 - 08:39 PM

I don't think you need to contact a lawyer.

In your place I would write to the Director of Clinical Governance at the Hospital.  Tell them about the missed fracture and ask that this be brought to the attention of the attending doctor/s.  Ask for these doctors to have counselling or further education about assessing young children for injuries following an accident.  Ask to be advised of what action was taken.

I think it is great that you are using your experience to educate so that this doctor doesn't make the same mistake again.

#9 belinda1976

Posted 21 January 2013 - 08:39 PM

It's not Ryde Hospital is it?  They misdiagnosed DH's badly broken ankle.... he had to get metal plates and screws put in his ankle, that's how bad it was... and they didn't pick it up from his X-rays.

I agree with SMforshort - I don't think you need to involve lawyers etc but I'd definatley be writing a letter to the head of the hospital.

Edited by belinda1976, 21 January 2013 - 08:40 PM.

#10 ednaboo

Posted 21 January 2013 - 08:41 PM

I wouldn't do anything.  They treated her for a head injury because that is where you told them she hurt herself.  I don't want to make you feel more guilty, but you didn't notice that her arm was sore for two days, so it can't have been very obvious. A Dr can't order full body xrays for every child who comes into the ED - it would be incredibly expensive and time consuming. I would let it go.

Edited by ednaboo, 21 January 2013 - 08:44 PM.

#11 i-candi

Posted 21 January 2013 - 08:45 PM

My brother was an adult and the ER sent him home saying he sprained his ankle. It turned out that he broke it so badly that he needed plates and screws and spent over a week in hospital.

These things happen, my brother didn't sue. Don't listen to the PP who said to go to a lawyer  rolleyes.gif

#12 Kay1

Posted 21 January 2013 - 08:45 PM

I don't think you need to contact a lawyer.

In your place I would write to the Director of Clinical Governance at the Hospital. Tell them about the missed fracture and ask that this be brought to the attention of the attending doctor/s. Ask for these doctors to have counselling or further education about assessing young children for injuries following an accident. Ask to be advised of what action was taken.

I think it is great that you are using your experience to educate so that this doctor doesn't make the same mistake again.


#13 Mumma3

Posted 21 January 2013 - 08:48 PM

When my DD was 5, she fell off our front fence. Not high, but a nasty landing on the water meter. After a couple of hours of keeping an eye on her at home, we took her to (insert well known children's hospital in our state).

DD was not a whingy kid, but she sat quietly, pale faced, not eating, and not interested in anything for a few hours in the waiting room. When she was finally taken in, I explained to the dr that she was favouring her hand, that she wasn't "herself", and that I was concerned she may have injured her wrist. I said quite clearly, that she wasn't a whingy crying kind of kid, and would always try to be brave when she hurt herself.

My concerns were dismissed, because, as he put it "if it was broken, she would be crying" he manipulated her hand and arm, and she didn't cry out, instead screwed up her face and had a few silent tears (if he had just looked at her face, he would have seen she was trying to be brave).

Anyway, we were sent home. Next day, she wasn't using it, and was cradling it to herself. I ended up taking her to a local GP clinic, where they assessed her, X-rayed it, reviewed the X-rays, and plastered it up in just over an hour. Poor thing had a fracture in her wrist.

I called the hospital the next day, and spoke to their liaison person. I didn't want to make a fuss (and I had no desire to speak to a lawyer, as a pp suggested the OP should do). What I did want, was for that youngish doctor to be reminded that parents know their child best, that not all children scream and cry and carry on when in pain, and that he have his notes on her assessment reviewed for further training.

It is hard, OP, when professionals make a mistake, and I was very upset when it happened to us. I would let them know that it did turn out to be broken, so they can at least review her case notes, and if necessary, give the doctor who assessed her some additional training.

#14 Therese

Posted 21 January 2013 - 08:52 PM

I agree with STBG. I'm sorry they missed her broken arm but by the sounds of it it wasn't the obvious issue at the time.

#15 Dowager fancie

Posted 21 January 2013 - 08:53 PM

What would I do in this situation?

I'd be getting rid of that glass hall table before it does some irreparable damage to a child.

Edited by fancie, 21 January 2013 - 10:03 PM.

#16 outdoorgirl81

Posted 21 January 2013 - 08:56 PM

Tbh sounds more like a delayed presentation than a "missed" broken arm to me, she wasn't showing any signs, you didn't take her I with an arm injury, and both her parents, who see her all day every day and know her best didn't notice anything was wrong with her arm till 2 days later. The concept of doing a full body X-ray in such a situation is quite frankly ludicrous. The injury was detected and there was no adverse outcome, i'd be letting it go

#17 LambChop

Posted 21 January 2013 - 08:59 PM

What I did want, was for that youngish doctor to be reminded that parents know their child best, that not all children scream and cry and carry on when in pain, and that he have his notes on her assessment reviewed for further training.
  Love your work !  Reality that can potentially make a real difference to future treatment for yourself and others.

Edited by LambChop, 21 January 2013 - 09:00 PM.

#18 Oriental lily

Posted 21 January 2013 - 08:59 PM

I agree with soontobegran and fancie.

#19 Soontobegran

Posted 21 January 2013 - 09:02 PM

QUOTE (PinkNBlue85 @ 21/01/2013, 09:42 PM) <{POST_SNAPBACK}>
I understand they are too young to verbalise what is wrong with them but its not that hard to give the child a full check over.

There is really nothing to say that examining the child's arms and legs would have revealed a simple fracture.

If they missed a badly aligned, bruised and swollen arm then there is definitely cause for concern but since the child was happy when she went home it seems there was nothing immediately obvious.
X-rays are not something that will be done when the child is asymptomatic, they need to be kept to a minimum in children.

As I said missing the fact that it was obviously malformed and the child was unable to use it would mean they have screwed up but the fact that she went home happy without her parents noticing her having a problem with it for more than a day it really does not have to equal negligence.

#20 matt1972

Posted 21 January 2013 - 09:05 PM

I would be extremely upset if a piece of furniture of mine injured my young daughter and that feeling would be immensely compounded if I didn't notice that she had a broken arm for over 2 days but I wouldn't try and make some body else responsible for it.

For the PP who said contact a lawyer "but not for money" what other reason could there be for contacting a lawyer in this instance?

#21 Academic

Posted 21 January 2013 - 09:07 PM

I had a similar thing when I was hit by a car about seven years ago. It was obvious that I had broken my shoulder, and that is what they x-rayed in the hospital (after first making sure I didn't have any life-threatening injuries). They didn't x-ray anything else, even though my whole body felt like it was on fire and I couldn't really pinpoint one pain over another.

Two weeks later, I noticed that my wrist was still aching a lot, particularly since I was restricted to using that arm to do everything as the other was held in a cuff and collar. I mentioned it at my follow-up appointment with the orthopedist and he sent me to x-ray. Sure enough, I had a fracture in that wrist.

About two weeks after that, I realised my left big toe hurt a lot (it had hurt a lot in the hospital initially and I pointed it out, but no-one seemed particularly interested, I guess it seemed minor compared to the other potential injuries they were testing me for) and again had it x-rayed, again it was broken. Of course there is little that can be done for a broken toe anyway.

I was surprised that I didn't have my whole body x-rayed given the impact my body had suffered. It really annoyed me, more so with my wrist because I'd been using it and I shouldn't have been. I never followed it up, I'm not sure what it would have accomplished, but you are well within your rights to complain to the hospital about your poor DD, especially as children are less able to articulate their pain or realise they might have a fracture.

Edited by Academic, 21 January 2013 - 09:09 PM.

#22 bakesgirls

Posted 21 January 2013 - 09:08 PM

TBH, I wouldn't make a big deal over it. She was examined for a head and chest injury, as that was the injury that you knew of. It took you, her parent who knows her best, 2 days to notice that something was amiss. A doctor, or any person for that matter wouldn't have known to check her arm if she was showing no signs of distress, and there was no obvious deformity.

I also agree with PP's that have said that hospitals can't be ordering full body xrays for every kid that shows up with an injury 'just in case'. It would cost a fortune that our health system just can't afford, not to mention exposing people unnecessarily to xrays they don't need.

Hope your daughter is feeling better soon OP.

#23 flopsy

Posted 21 January 2013 - 09:12 PM

Twice I have presented at the hospital and been sent home with a "sprain" and have had broken bones. Recently DP got sent home with "cramp" and he had a fractured leg. Unfortunately it happens and some of the time fractures don't show up on xrays until days later anyway.

If you didn't realise her arm was even sore for two days after the event I don't think its too outrageous that the doctors didn't pick it up when you told them she hurt her head and chest. She must be a very tough little girl!

#24 TeaTimeTreat

Posted 21 January 2013 - 09:12 PM

You can check for fractures without doing a full xray, when we have taken DS in for a fall they have manipulated limbs and watch him and how well he is able to walk/stand, took 5 mins tops for them to diagnose a foot fracture and clear his arms, wrists, collarbone etc, they then sent him of for a foot xray.

I would complain in writing and request they be more thorough.

#25 ~Jodama_Feral~

Posted 21 January 2013 - 09:17 PM

QUOTE (Oriental lily @ 21/01/2013, 09:59 PM) <{POST_SNAPBACK}>
I agree with soontobegran and fancie.

Me too. Especially about the table, sounds as though you knew it was a danger and should have got rid of it ages ago or secured it to the wall.

These things happen all the time. Sometimes they dont show up for a few days. I wouldnt be doing anything more about it.

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