Hi,

Last year in May I badly hurt my ankle.

It was massively swollen and bruised

(I can upload a picture if required).

I had damaged my right ligaments in the past and had gone to the hospital and been told just to rest it for a few days.

With this in mind, I did not go to hospital for 4 days assuming it was just ligament

damage.

However, after 4 days the pain was much greater than previous + was much more swollen and bruised.

I decided I would go to hospital.

Note, I was able to limp on it, but not put much weight at all on it.

I went to Accident and Emergency and because it had been 4 days, I was subjected to 'Triage' and a Nurse gave me a lookover.

I told her I believed I had fractured it as well as ligament damage.

She claimed because I could put some weight on it, it was very unlikely to be a fracture and decided that I did not need an X-Ray.

She advised me to go home and rest it.

Over the next few months my ankle was in agony daily,

I struggled to put proper weight on it for about 4 months and could not do any sport for 7 months.

Even after this, I could not properly participate in sports and stopped after a few weeks.

I still had pain in the ankle (even when lying still and sleeping, it would be sore after walking for 5 minutes etc)

After 11 months of pain, I decided to go private to get the issue fixed.

I was given a procedure to repair the ligaments and during this procedure, there was 5mm of bone snapped off in my ankle (the fracture I had suspected).

Now, if I had been given the X-Ray when I went to A&E this fracture would have been spotted and I could have received the correct treatment at the time and would not have had to have a year of agony and being unable to enjoy sports.

Does anyone think that I have a case?

This is my ankle at the time I went to hospital

I'm not sure the photo has worked, I do not have enough posts to post a link to it either.

Hopefully this has attached now

Ankle.pdf

So where is your GP consultation?

So where is your GP consultation?

What do you mean?

I visited A&E at the time of the incident.

I followed up with a visit to my GP after 1/2 months at which point, I was referred for physio.

I also went to my GP 2 months ago when i was then referred for the surgery on my ligaments.

For (medical) negligence to be shown there must be:

1) A duty of care (not hard to show here)

2) A breach of the duty of care

3) Harm resulting, (again, not hard to show harm, but can they say the harm would have arisen anyway?)

4) no defence factors [such as

i) "an intervening act") (and / or),

ii) a reduction in damages due to e.g. Contributory negligence.]

You (or a medical expert acting on your behalf) need to consider (with access to your A&E notes).

Looking at these in reverse order:

a) were you told to return if things didn't settle within the timescale they expected? If so, expect them to blame that for some of the harm (4ii)

b) could they say that the need for an operation was there anyway, but you wouldn't have needed the operation earlier even if they had X-rayed it (3)?

c) did you suffer any repeat injury (4i)

I'm not saying any of these apply, but they may look to them as ways of deflecting / reducing blame.

Probably most importantly in terms of them being able to say "not negligence, no way" is if the notes show they did what they were supposed to, and if it was entirely correct not to X-ray it.

You mentioned that you were "weight-bearing". If the notes show that they documented this, and ALL the other factors that a competent practitioner would apply to reach a decision on X-raying : then they could say "no breach of duty of care" (2)

X-rays are a form of radiation (pretty low dose, but still enough for them to say "well, we want to limit them so that you only get an X-ray when you need one, and not if you don't......"

One asssment scheme (and probably the most widely used one both in the UK and worldwide) is the "Ottowa Rules"

https://en.m.wikipedia.org/wiki/Ottawa_ankle_rules

If the notes show they followed these (or another recognised assessment scheme) and you can't show they misapplied them or got the sssesment wrong expect them to say "well, it was bad luck for the OP but not negligent by us, as 'we did everything correctly' "

Thanks very much for your reply Bazza.

I was not told to return if things did not settle down. I was told to just go home and rest and lay off sports for a while (circa 2 months estimate). As I was under the impression (since they told me) that it was just ligament damage, I assumed that just resting for 5/6 months would solve the issue (along with my phsyio)

In terms of the operation being needed, it is hard to say, however my Surgeon said it A)a good chance surgery would not have been required B) A cast would likely have been put on at the time, increasing the chances of it healing properly (thus surgery not required).

I did not suffer a repeat injury.

Looking at the Ottawa Rules, i believe I should have been X-Rayed. I had severe pain in the Malleolar zone (in my photo you can see the huge swelling all around this area) as well as 'Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus.' When this area was touched I had sharp shooting pains in it.

Is it possible to access my notes to see what was documented?

What should my next move be?

Thanks again for your help.

You contact PALS at the hospital concerned, raise your complaint and tell them you need a copy of your medical records. It will cost you to obtain these, they will let you know the cost. After you get the records you will be able to assess if they did follow protcols. once you raise the complaint the PALS liaison officer will be in touch you and inquire what you want to happen as a possible resolution.

To claim damages will need an specialist lawyer. the NHS wont roll over easily.

I'd suggest asking for a copy of the medical record (as is your right) before you tell them you are considering a complaint.

OP: what do you want as your "best outcome" to any complaint / medical negligence case?