Decision report 201101238

Summary
Mrs C hurt her leg after a fall at home and went to a hospital's accident and emergency unit. Mrs C said she was told her leg was in shock and was given pain killers. She was also told to keep an eye on the swelling and to go to her doctor's surgery if it got worse.

The pain continued to get worse so she went to the surgery. She said that her doctor telephoned the hospital and was told to complete a letter of referral. Nine days passed and as Mrs C did not receive an appointment and was in considerable pain, she went directly to another hospital, where she was x-rayed.

The x-ray revealed that Mrs C had a fractured foot, which was set in plaster for four weeks. As a result Mrs C said she was left in significant pain for months and was unable to work. She complained to us about the care and treatment she received in the first hospital, and was unhappy that her foot was not x-rayed on the day of the accident.

Our medical adviser looked at this complaint. The adviser said that many such injuries result in sprains or soft tissue injuries. A few patients have fractures. However, many fractures are minor and do not require much treatment other than pain relief, support and gentle mobilisation as a patient's injury heals. Others may need a plaster cast for pain relief.

The adviser said that overall, according to NHS guidance and what was in Mrs C's medical records, x-rays were not indicated when Mrs C attended the first hospital. We took the view that clinical staff carried out adequate, appropriate investigations and treatment of Mrs C's injury, according to NHS guidelines, and that she was given appropriate follow-up advice.