Hospital failed to diagnose fractured hip, and operation was not to recognised standards

What happened

Miss B lived independently despite having dementia. She was taken to hospital after a fall at home. Four days later, staff carried out an X–ray because Miss B had complained of pain in her hip. The X–ray did not show a fracture and after two weeks Miss B was transferred to a rehabilitation unit. One week later, Miss B had more scans of her hip, and staff diagnosed a fracture. The hospital carried out a hip replacement operation, but the wound did not heal well and Miss B began to deteriorate mentally and physically. Miss B was discharged to a nursing home where she stayed for the rest of her life.

Miss B's niece, Mrs L, complained to us that the hospital should have diagnosed the fracture sooner. Mrs L felt that Miss B would not have gone into a nursing home if she had been diagnosed and treated earlier.

What we found

We partly upheld this complaint.

The hospital wrongly dismissed the possibility of a fracture after one X–ray. In order to fully consider the possibility of a fracture, the hospital should have examined Miss B's hip and carried out a side view X–ray and further scans. This did not happen. Miss B's pain early in the admission suggested that the hospital missed opportunities to diagnose the fracture sooner. This meant that Miss B was in pain for much longer than was necessary.

With regard to the hip replacement operation, the hospital used an implant that is not recognised in current best practice guidance. However, we did not find that this affected Miss B's subsequent recovery and her admission to a nursing home.

Putting it right

The hospital apologised to Mrs L, paid £1,500 to Miss B's estate, and completed an action plan that showed learning from the mistakes so that they will not happen again.