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"Failure to detect a fractured femur"

About: Causeway Hospital / Accident & Emergency Causeway Hospital / Medical 2 Dalriada Hospital / Physiotherapy Recovery Service Northern Ireland Ambulance Service / Emergency ambulance response

(as a carer),

Last year on a Bank holiday Monday my husband had a swollen leg and knee the size of a football. He was given morphine by the ambulance crew in order to transport him to A & E where he was left in the corridor outside A &E on his own. I arrived one hour later. Some time later he was seen by a doctor. Following an x ray the doctor said there was no break, put a full leg brace on the leg, gave him a walking frame, told my husband to put ice on the leg and sent him home.

Once the morphine had worn off my husband was in agony. At home later that week and following a GP a visit he was taken by ambulance to the Dalriada hospital for intensive physio!

By the following Monday he had a UTI and was disorientated, an ambulance crew transported him to the Causeway A &E. The Causeway A&E felt like a war zone and my 6 foot 2 husband was left on a stretcher bed in a corridor for four days. Staff were so busy I had to toilet my husband using a commode and a flimsy screen and wipes from my handbag. On entry to A &E my husband was seen by a registrar who asked me about the leg and I watched as they wrote the details down.

On the Friday, five days after his  admission, my husband was delirious and suffering from sepsis. A doctor appeared and said they had read my husband’s notes but could not find the cause of the infection. The doctor spoke of a possible problem with a kidney but said this was not related to the infection. I asked the doctor, ‘but what about his knee and his leg ! ‘ the doctor replied ‘his leg?’ and then pulled back the bed sheet, looked at the knee and rushed off, appearing minutes later with the same registrar, that I had spoken to about my husband’s leg five days previously, and told the registrar they wanted a C T scan of the leg done immediately. The CT scan showed a fracture to his femur close to the knee joint. For all of this time my husband had been mobilised for toileting in A& E.

He was immediately transferred to Medical 1, suffering from sepsis and Delirium caused by the undetected fractured femur. He remained in Medical 1 and was given a cocktail of antibiotics for a sustained period until his bed, which had a heart monitor, was required by another patient , he was then transferred to a separate side wing, still suffering from delirium and sepsis. His delirium was so bad at one point that he needed to be sedated. One Sunday morning I was notified by a nurse that a nurse wrongly administered a further dose of sedative on the night shift, I lodged a formal complaint against the nurse. It was only after this very upsetting incident that the ward doctor and psychiatric doctor were prepared to come and listen to my son and myself. 

My husband was in hospital for over ten weeks and the delirium gradually subsided once the psychotic drugs were stopped, at our request! 

Some of the nursing staff and some of the auxiliary staff were very good with my husband . I cannot say the same about the doctors. 

My daughter in law is a G P and at one point a ward doctor asked me if she was here in N I or England!! Why? 

Throughout my husband’s time in hospital I kept meticulous records of all medical staff names and what was done to and for him and what was said. 

Ironically, when the ambulance staff first took my husband to A & E one of them said the knee needed a CT scan done to find the problem. Sadly that didn’t happen, if the doctor had initially requested a CT scan the fracture would have been detected.


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Responses

Response from Neil Gillan, Co-Production & Partnership Lead, Quality, Safety & Improvement, Northern Ireland Ambulance Service 2 weeks ago
Neil Gillan
Co-Production & Partnership Lead, Quality, Safety & Improvement,
Northern Ireland Ambulance Service
Submitted on 10/04/2025 at 17:24
Published on Care Opinion on 11/04/2025 at 09:01


picture of Neil Gillan

Good afternoon MTA,

I would like to begin by thanking you for taking the time to share your experience of the Northern Ireland Ambulance Service. It was heartening to learn of the support provided by the paramedics. As an organisation we are committed to consistently showing compassion, professionalism, and respect for the patients we care for.

I hope your husband is recovering well.

Best wishes

Neil

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Response from Nicky Butcher, Assistant Clinical Services Manager, Medicine, Dermatology and Medical Photography, NHSCT last week
Nicky Butcher
Assistant Clinical Services Manager, Medicine, Dermatology and Medical Photography,
NHSCT
Submitted on 11/04/2025 at 14:30
Published on Care Opinion at 14:31


Hi MTA,

I am Nicky Butcher, assistant clinical services manager at Causeway Hospital, and medical 1 is one of my areas.

I am extremely sorry to hear your experience, and can only apologise for the obvious distress this has caused.

Medical 1 has no cardiac monitor beds, so can I check that this was the correct ward please.

I am not aware of any formal complaint regarding any of my staff nurses regarding medication incidents.

I am contactable at 02870327032 x 375233, or by email

nicky.butcher@northerntrust.hscni.net, and am more than happy to discuss issues regarding any of my areas, or teams, in order to learn from and provide a better experience for our service user and family.

Thanks,

Nicky.

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Response from Victoria McCrory, Assistant Clinical Services Manager, Medicine and Emergency Medicine, NHSCT last week
Victoria McCrory
Assistant Clinical Services Manager, Medicine and Emergency Medicine,
NHSCT
Submitted on 14/04/2025 at 09:54
Published on Care Opinion at 10:01


Hello MTA

My name is Victoria McCrory and I am the Assistant Clinical Services Manager for Causeway Emergency Department (ED). I am very sorry to hear about the experience which you and your husband encountered whilst attending Causeway ED. The care which you have described does not align with trust core values, nor the standards of care which I expect to be upheld within the department.

I am sorry to read that on his attendances to ED your husband was placed in a corridor, and on the second attendance the ED felt like a war zone. I also note from your feedback on the second attendance your husband spent up to, perhaps more, than 5 days in ED. I apologise that your husband was placed in corridor spaces within the ED. Causeway ED has been operating under sustained pressures for a long period of time. Sometimes as a result of these continuing pressures the department can become overcrowded, and corridor spaces, which we use as escalation spaces, need to be used. At times when the department is overcrowded and escalation spaces are in use, the department can become very busy, with a high volume of people. I wish to assure you that nursing management within the department continue to work closely with our patient flow and site co-ordination teams to promote flow through the hospital, to help reduce the number of people waiting in ED and help reduce the need for escalation spaces to be used.

I sincerely apologise that your husband had to use a commode in the corridor with a screen. I understand how difficult this would have been for you both, and is not the standard of care we aim to achieve in ED. I will share the learning from this concern with the staff in the department via safety brief, and staff meetings to facilitate patients who require to use a commode a private space to do so.

As Care Opinion is an anonymous feedback forum I am unable to review or investigate individual concerns which you have noted in relation to your husbands assessment and care. If you wish for these concerns to be further investigated please contact me on the detail below. Please be assured that if you choose not to contact me with further information, that your feedback will be tabled at the next ED Governance meeting for review and shared learning. The key points from your feedback will also be shared with staff through daily safety brief, board rounds and tabled at the next set of staff meetings.

I would like to Thank you for providing a positive note re some of the nursing and auxiliary staff which you and your husband encountered, despite the difficult experience which you both had.

Thank you for taking the time to leave your feedback on the Care Opinion Forum; All feedback is important to us as a department. Issues and concerns raised help to direct learning and drive service improvement. I hope your husband is making a strong recovery, and I hope should either of you have to attend the ED again for care and assessment, that your experience will be more positive.

Yours Sincerely

Victoria McCrory

ACSM CAU ED

Tel; 028 7032 7032

Victoria.mccrory@northerntrust.hscni.net

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Update posted by MTA (a carer)

I wish to correct my typing error!

My husband was a patient on Medical 2 and not Medical 1.

My sincere apologies to any staff I may have offended by this typing error.

Response from Nicky Butcher, Assistant Clinical Services Manager, Medicine, Dermatology and Medical Photography, NHSCT last week
Nicky Butcher
Assistant Clinical Services Manager, Medicine, Dermatology and Medical Photography,
NHSCT
Submitted on 15/04/2025 at 13:01
Published on Care Opinion at 15:33


Good morning MTA,

again, many thanks for correcting.

Much appreciated

Nicky

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Response from Karen Sheridan, Assistant Clinical Services Manager, Medicine and Emergency Medicine Causeway Discharge Lounge, DAU, Phlebotomy, Medical 2, MAU, NHSCT last week
Karen Sheridan
Assistant Clinical Services Manager, Medicine and Emergency Medicine Causeway Discharge Lounge, DAU, Phlebotomy, Medical 2, MAU,
NHSCT
Submitted on 16/04/2025 at 13:38
Published on Care Opinion at 14:17


Dear MTA,

My name is Karen Sheridan & I am Assistant Clinical Services Manager for Medical 2. I am sorry to hear of you and your husbands experience. I am sure this was a very worrying time for you both. With regards the medication error which occurred whilst your husband was in Medical 2, I am happy to look into this & discuss this further with you if you wish. You can contact me on 02870327032 ext 375371 or by email: karen.sheridan@northerntrust.hscni.net.

Best wishes,

Karen.

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