Settlement obtained for failing to follow up dislocation of finger

On 8th December 2012, Ms ZB sustained an obvious deforming injury to her left index finger and attended the Medway Maritime Hospital A&E Department. X-Rays were taken which confirmed significant deformity suggestive of an underlying dislocation or fracture at the left index proximal interphalangeal joint (PIPJ). Expert evidence confirmed the imaging showed dorsal dislocation – with some ulna translation of the PIPJ.

Ms ZB underwent manipulation under entonox at Medway Maritime Hospital A&E and subsequent re-x-ray showed the dislocation had been reduced. However, potential associated subluxation (partial dislocation) and fractures were not visible on those radiographs. Ms ZB was discharged without any follow-up at all being arranged by Medway Maritime Hospital A&E Department.

Ms ZB went on to develop a fixed flexion deformity of the left index finger which required volar release surgery at Kent & Canterbury Hospital some 8 months later which did restore some function and flexion of the digit but which remained impaired.

Peter Flory was able to obtain expert evidence from a Consultant in A&E medicine confirming that prompt follow-up of Ms ZB’s finger should have been arranged and that it was a negligent failure not to do so. Peter also obtained evidence on causation from a surgeon specialising in upper limb surgery that the delay in follow-up had been causative of the development of the fixed flexion deformity.

Following a Letter of Claim sent to the Trust and the NHS LA, liability was admitted and Peter was invited to obtain evidence proving the extent of the damage caused.

This same surgical expert was able to examine Ms ZB and confirmed that her fixed flexion deformity was permanent with pain and impaired function but that further surgery was likely to improve cosmesis and function.

Peter obtained a breakdown for the costs of private treatment with a specialist hand surgeon and was subsequently able to negotiate settlement of Ms ZB’s claim with the NHS LA for the global, full and final sum of £16,500.