FY2 in orthopaedic department
A 91 year old, was admitted from nursing home 5 days ago following a fall.
Other information you have about the patient;
Since she fell down she has not been able to walk.
She had an x-ray of the hip done which was reported as normal by the radiology dept.
When the physiotherapist came to mobilise Patricia but she complained of hip pain.CT scan was done which showed fracture of neck of femur.
The radiologist have reviewed the initial hip x-rays and found a neck of femur fracture.
A Cast will be placed.
Her son Peter is here and would like to talk to a doctor. He had been told earlier that his mother’s x-rays were normal.
Mother has dementia son has LPAWhat you must do:
Talk to the son, give him an up date about his mother conditions and address the concerns
LPA (Lasting Power of attorney)
Patient: Dr why didnt you tell me you guys missed fracture?
Doctor: I am sorry you had been given different information on different occasions
I will explain everything to you
Can you please tell me what you have been told so far
Don’t waste time asking about nursing home, asking about the fall, asking about dementia
You mentioned Xray, what did they tell you about the Xray?
Who talked to you? nurses?
Do you know what happened with the physiotherapy?
Did anyone tell you about the fracture?
Ct scan?
Social history: You are LPA, are you the next of kin as well?
Go through Structure: Medical Error (No invite, No warning shot)
Are you going to punish them?
(Generalise the answer) This will be investigated then they will take necessary actions according to hospital protocols.