Toddler Broken Tibia and Hospital Negligence - Help!

lawlorlane

Hi, apologies if this is the wrong place, cant quite find where to place it! Please move if it needs to be moved!

Ok, I have a few queries, questions, rants etc......... so I shall start from the beginning and list my 'help' topics after -

On the 16th January 2009 I was visiting a Toys R Us store with my parents and 18 month old DD. DD was trying out a smallish plastic rocking/seesaw type toy and fell off. From what I saw she seemed to have fallen and landed on her arms, im guessing instinct to protect her face but came totally off it. She was crying quite uncontrollably so I checked her over but couldnt see anything wrong physically. I just assumed she was crying through shock and maybe could have bumped herself. After she had clamed down I placed her into her buggy and she fell asleep. We left the store and went straight to the car and started ur journey home, all through which DD was very tearful and seemed stressed. Once home I took her upstairs where OH was and he sat with her. When I came up she went to stand up to come over to me but fell straight to the floor an screamed and cried in pain. I immediatly realised something was wrong with her right leg as she couldnt stand on it and was refusing to walk. I phoned up our out of hours surgery who advised me to take her straight to A+E as they would want to xray it. In A+E we sat waiting (as expected) for over 3 hours before being seen by what should have been a triage nurse but was a Dr called in as emergency (I assume no staff to carry out triage?!?!?!) By this time it was almost 11pm and DD was asleep in buggy. Dr told us it was just a sprain and def not broken as there was no swelling, no bruising and she was asleep. She did wake as soon as he touched her foot and cried and pulled it awa but he said that was due to the pain fom the sprain. According to him, if she had broken bones she would be in severe agony and would not have slept. He told us to take her home, patted my head and said 'dont worry mum, she is fine, take her home to bed where she can relax, in a few days time she will be up and running around again!' I felt slightly patronised by the patting and felt like I was being treating like an overprotecting mum. Anyhow, we went home but for two days DD did not move from my bed, where we tigger and pooh on the go constantly. I was giving her calpol for the pain and she slowly picked up. She was moving around for the next week by crawling and was still refusing to use her right leg. She gradually pulled herself up onto the chair but kept her leg raised, I was so sure it was more than a sprain so went to see GP who referred us straight for an URGENT xray. We went for xray and guess what? - DD had broken her tibia. I felt huge guilt that she had been left for over 10 days with it. In casualty they explained that she would need a cast for at least 6 weeks. When I was explaining how it happened and the events after the consultant was shocked to hear that she was given no xray when we first came to A+E as she is so young she could not possibly explain the pain or where it was so an xray would have been vital even if to just rule out a break. So she had her cast fitted and back home she walked around on it and seemed back to her happy self, and adjusted to life with the cast. We went for fracture clinic appt 6 days later, he explained that they would keep the cast on for about 4 weeks total and take some more xrays and see how she walks on it. So Monday 23rd February we went back and had cast removed and some more xrays. Xray showed that majority of fracture had healed nicely and just a small part remained which would heal itself without the need for the cast anymore. But when she tried to walk on it she fell and gave upset howl. Consultant explained that this was due to her muscles being weak from not being used, the leg being stiff and the wierdness of having the leg cast off. He said within a few days she will start to feel better and will try moving around on her foot and once she realises she can she will be ok. He discharged us with no need for follow up. However, call it mothers intuition or just simple observation, Over the last few days I can see she is still in pain when trying to use her foot. She has now given up on using it has gone back to how she was when all this first happened, adjusting to not using it, she cannot walk on it still, stands with her right leg in the air, or uses her toes bent over if she is determined to reach for something high up. I have tried putting pressure on her foot to see her reaction and she yelps with pain and says 'no mummy no'. I have just made an appt to see GP for monday (soonest availaible one). So my questions, queries are -

* Are the hospital negligent for the fact of not xraying DDs leg when we first visited. If so, how do I go about making a complaint? Dont get me wrong, im not after compo I just feel the hospital should be aware of mistakes they have made. And I guess an apology would be nice .

* Should the cast have been removed after only 4 weeks if the break was still there, even if just a small part?

* Should I be waiting a little bit longer before seeing GP - Intuition tells me NO but maybe I was expecting too much too soon?

* And if possible, if anyone has suffered a broken bone, could you tell me what DD could be experiencing now the cast is off? she is too young to tell me herself. Could she still be in pain after now and will there be tingling, like pins and needles or does it take a while for the affected area to feel back to normal?

I am grateful for any advice anyone can give me.

Many TIA.

lynnexxxo

Personally, I would get back on the phone to the gp and tell the receptionist that you need an appointment TODAY. Don't take no for an answer. It is obviously very sore for her so there is a problem.

With all respect I think you have to become a 'pain in the !!!' parent. You should listen to your instincts, forget that the doc might think you are overreacting, you daughter is in pain! I think that probably your dd should have been xrayed at the initial hospital visit but i suppose the doctor seen a sleeping baby and probably just assumed she was fine.

I don't think its normal to have as much pain, i can remember feeling a bit funny getting my cast off but it certainly wasn't extremely painful.

Be strong. Insist she gets seen today!

lawlorlane

Lynnexxx0 - Thank you, I will phone the GP and explain to receptionist and hopefully they will get me in today! Its hard to know exactly what shes feeling and I have tried to look up on sites what she should be like but have found nothing!!! I totally accepted the A+E docs explanation as of course he is the Dr. But as she had spent most of afternoon and evening crying and in pain and with it being 11pm at night, she is normally in bed around 7pm, I think back now and think, well of course she was asleep, she would have been totally wiped out after all that!!!

Paparika

ditto the above, where would you be now if you contiue to go by the original Dr's advice.

Pain in the asre mum you maybe labeled but at least you had the sense to know you knew there was something wrong.

I thinks pals http://www.pals.nhs.uk/ should be a start, they can help liase with the hospital re any complaints you have, you want everything in writing from now on, don't accept verbal, as you may need evidence if this goes to court. I am not sure if you can but ask for a copy of your daughters medical notes, especially from that day the doctor said it was just a sprain, suggest grabbing those asap, pals again should help with that, although be prepared to pay for the copy.

lawlorlane

Paparika - Thank you. I would rather be a pain in the bottom mum than have her in anymore pain. I am going to do DDs lunch then have a look at site while she is occupied! She is currently very dependent on me due to being in pain but also because she is again unable to do most things for herself, poor lamb! Thanks again :-)

Baileys_Babe

Can you get in touch with the fracture clinic and demand a reassesment, asap. We had to do this with my 7 year old nephew as he needed follow up treatment & physio.

Wishing you and your DD hugs in resolving this. BB

lawlorlane

Hi BB - The actual Fracture clinic consultant said if I am concerned about anything then to go to my GP. I am not sure if that means I need to get him to refer me or whether tht was just for concerns!?!?! Did you actually go straight through to fracture clinic then without going via your GP? I olny wish DD could talk more so she could explain the pain. I have never heard her say mummy so much in one day, lol. Can I also ask what sort of follow up treatment he needed? Thanks for the hugs, we both need them I think!!

shelly

I know this is a different part of the body but my Dad recently fractured a wrist and on having the cast removed the wrist, hand and arm got very swollen and painful.
He was having shooting pains in his arm but he put up with them for a few days. One evening though the pains were becoming regular and agony for him so I took him to A&E only to be told this is normal whilst the muscles and tendons etc sort themselves out and get used to being used again.

Had he been warned to expect this he would have just carried on but as he wasn't warned he was worried that maybe it hadn't healed properly.

Crazy_Jamie

* Are the hospital negligent for the fact of not xraying DDs leg when we first visited. If so, how do I go about making a complaint? Dont get me wrong, im not after compo I just feel the hospital should be aware of mistakes they have made. And I guess an apology would be nice

On the negligent point, they probably aren't legally. The test for general medical negligence is called the Bolam Test, and it is less strenuous than you may expect. It essentially states that providing a reasonable body of medical opinion agrees with the course of action taken (this is regularly narrowed down to say that it is reasonable if 10% of doctors/nurses would have done the same thing), that action is not negligent. So the fact that you were told she should have been x rayed the first time doesn't necessarily mean anything, nor does the simple fact that the doctor was wrong. I am by no means a medical expert, and don't know anything more about this case than what you've written here, but the course of action taken and the conclusion reached sounds like it would be considered reasonable legally.

Of course, the threshold for medical negligence is not necessarily your concern here, and certainly the doctor made a mistake originally, which is valid cause for complaint in the real world. As such, I see no reason why a letter of complaint would not be appropriate. On the balance of probabilities I don't think he's legally negligent, nor do I know how easy it would be to make a mistake like that, but if you're not interested in claiming legally (and it's probably right that you're not- damages would likely be minimal) then you don't need to worry about that. The fact that he made a mistake that caused your child more pain is more than enough for a letter of complaint. You might even get an apology out of it, which is ultimately what you want.

lawlorlane

Thanks Shelly - I was not told what to expect with DD either, just that it would take a few days for her to feel comfortable using it again! The info on your dads wrist is great as I can then try and relate what she could be experiencing. I am not sure she is in constant pain though as she is happy in herself (saying that she is a tough cookie, bit of a tomboy really!) its just when she tries to use the leg for walking or standing. As its the Tibia, this is the bone that takes the pressure when walking and standing, I get the feeling that its still not right as she is only upset with it when trying to use it. Does that make sense? Thanks :-)

GrammarGirl

Hello, I shattered my pelvis and broke my tibia aged 5 (was hit by a car) and was kept in hospital in traction for 6 weeks before my parents were told I was well enough to have my cast off and go home. On the day my cast was removed I was in so much pain I couldn't put weight on my leg - I stumbled while trying to walk, crashed to the floor and broke my tibia again. I had to stay in hospital for another 6 weeks and was in a wheelchair after that.

Now, I don't want to frighten you AT ALL with that story - your daughter's injury sounds a lot less complicated and like it will heal far easier than mine did, but one thing you can take from that is the bone takes a long time to heal and, especially with children, the cast should be left on longer because they are much more likely to knock a healing bone and reverse the process.

I'd echo what others have said - get back to the doctors sharpish and see about getting another cast back on, or at least some kind of support. Incidently, don't let the hospital try give your daugher crutches (they probably wouldn't, as she's a bit younger than I was)! I was given them before the wheelchair and it very nearly happened all over again!!