Negligent Delay in Diagnosis of Slipped Upper Femoral Epiphysis (Hip) Condition: £250K Awarded

Summary

Legal action following significant, negligent delay in the diagnosis of a slipped upper femoral epiphysis (hip).

Settlement

£250K compensation awarded.

What Happened

On 20 October 2014 she presented to her general practitioner with a two-week history of right upper thigh pain and difficulty in walking. The general practitioner considered slipped femoral epiphysis (SUFE) as a possible diagnosis, so referred her immediately to the local A&E Department at Rochdale Infirmary.

She was seen the same day and an x-ray performed. The medical staff thought the x-rays were normal, but they do in fact show that she did have a SUFE. The symptoms continued to deteriorate. Ultimately, she represented at the Royal Oldham Hospital on 10 November 2014; she gave a history that she had bent down to pick up a bowl and fallen, thereafter being unable to walk. The x-ray showed that the SUFE had got significantly worse. She was immediately referred to Manchester Children’s Hospital. An MRI showed that she had already lost the blood supply to the head of the femur. She underwent a reduction and fixation of the bone on 14 November 2014. At the time it was noted that the circulation was not restored.

Thereafter her femoral head collapsed because of avascular necrosis (loss of blood supply), requiring further screws on 10 January 2015 but ultimately, with complete collapse the head, removal of those screws on 10 April 2015. After that she was confined to a wheelchair when outside the house, but managed to get around the house, albeit with severe pain, with the use of aids. Her schooling was severely disrupted, with her only receiving two hours a week, and she put on a considerable amount of weight.

She was referred to Wrightington for further surgery. X-rays confirmed gross destructive arthritis of the right hip, so a right total hip replacement was performed on 5 July 2016. A cemented prosthesis was used due to the very poor bone quality that had resulted from her previous surgery.

Subsequently she had an injury to the hip, having come off a bike for in July 2018, which necessitated x-rays. The x-ray show that the prosthesis continues to be satisfactory, although far from perfect. She continues to walk with a limp. She has been told that she will probably need multiple further operations in her lifetime. She will ultimately need her hip to be fused.

In addition to her physical problems, she has had some psychological disturbances involving hearing voices and self-harming. It is unclear whether how much her physical condition has contributed to this as she also has social issues which may have had an effect.  This is being investigated.

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