Teacher recovers compensation for permanent injury caused by delayed diagnosis and treatment of fractured dominant thumb

Jonathan Herbert specialist clinical negligence lawyer acting for the claimant successfully obtained a settlement to compensate the claimant for his pain and suffering and financial losses.

Mr J presented to A&E at Worthing Hospital late in the evening on 5 April complaining of a thumb injury. An examination and X-ray were performed in the early hours the following day. The notes mentioned a fracture of the thumb distal phalanx but considered to be an ‘old’ injury. The claimant was reassured, given analgesia and discharged on the basis there would be fracture clinic follow up. The x-ray was reported on 9 April. Mr J returned to A&E on 22 April complaining of continuing and worsening pain in his left thumb. Further x-rays were performed, which revealed a displaced fracture of the thumb distal phalanx. An urgent fracture clinic appointment was arranged. Mr J was reviewed in the fracture clinic on 24 April when the plan was to review him in the trauma meeting with a view to deciding whether surgery was required. On 25 April, the trauma meeting concluded that it was too late for any active surgical intervention and that Mr J needed to be informed that interphalangeal joint fusion was likely to be the best treatment option.

It was alleged that it was negligent to fail to diagnose an acute fracture – subluxation of the distal phalanx of Mr J’s left dominant thumb on 5 and/or 6 April and that it was negligent to fail to initiate immediate active treatment between 22 and 24 April whether on-site or by referral off-site to a specialist hand surgery centre.  It was Mr J’s case that had the fracture been appreciated, he would have been referred for suitable treatment of which a variety was available.  Mr J would not have made a full recovery from the presenting injury but if his injury had been managed properly he would have retained some mobility and therefore greater function than with the fusion ultimately performed.  He would probably have recovered 30-60% of the normal range of movement of the joint i.e. a partially functioning thumb (with minor discomfort on heavy use along with the usual sequelae of a fracture; ache and cold intolerance).  Mr J ended up with a fused thumb of his dominant hand.  The loss of full function impacts upon his ability to perform a variety of dextrous tasks including writing, which was important to his occupation.

Jonathan Herbert specialises in orthopaedic cases.  If you would like to ask Jonathan a question about a potential case, or if you have a general query about any personal injury, contact him at Thomson Snell & Passmore solicitors on 01892 701226 in confidence.