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Case ref:201305310
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Date:January 2015
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Body:Forth Valley NHS Board
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
Ms C’s daughter (Miss A) broke her leg and was admitted to Forth Valley Royal Hospital. Her leg was put in plaster and managed conservatively (without surgery). In the three months after her accident, Miss A was provided with a number of plaster casts but continued to experience pain and discomfort.
Miss A went abroad and, while she was there, had to seek medical attention as she continued to suffer pain in her leg. After seeing an orthopaedic surgeon there, she was admitted to hospital for surgery. Ms C said that doctors there told her that, without this, there would have been long term complications. She complained that her daughter did not receive appropriate treatment for her broken leg from Forth Valley Royal Hospital and had not given informed consent for the conservative treatment she received there.
We obtained independent medical advice from an experienced consultant in trauma and orthopaedic surgery. We found that there would be variations in approach about the treatment of this type of injury, and differing views between countries, between different hospitals in the same country and between individual surgeons in the same orthopaedic unit. Our adviser said that both conservative management and surgery are well supported managements for this type of injury and both are considered to be appropriate treatment. Once the decision was made to manage Miss A’s injury in plaster, the care and treatment she received was correct and plaster casts were left on for the appropriate length of time before they were removed. We also found that Miss A was able to give informed consent for her treatment.
On one occasion, there was a failure to carry out an x-ray after Miss A’s plaster was changed. The board had acknowledged this and had already apologised. Our adviser considered that they had taken appropriate action and did not identify any other failings in Miss A’s treatment. The adviser also said that Miss A’s medical records did not support the criticism of her treatment that the doctors abroad appeared to have made.