How to interact with NHS staff after cover up by them

[sunscomingout]

Hi all,

Sorry for the long post...

I broke my wrist early this year (badly deformed break in my dominant wrist). My little boy pulled me over skating, he feels terrible, especially with what has followed... They operated 3 weeks later and said it was bad and needed a metal plate in. From the get go after the op it was clear something was not right, I developed severe pain in recovery once out of theatre that no drug even the strongest of opioids could touch, and was kept in for 3 days writhing in agony, it was meant to be a day case.

Flash forward clear clinical signs something not right: hand lolling to the right at an unnatural angle, unable to flex hand back or forth, side to side, or turn it over palm up. I kept expressing concerns but kept being told it was early days or just stiffness and refusing further imaging eg CT scan on the basis it was "too early" at 5 months post op and my hand was still like that. Off work as unable type fast with just one hand (writing role) and could no longer drive or cook well, impacting school run and childcare as a lone parent and daily tasks. Finally in September approached my GP and showed them my hand and wrist -- they referred me for a second opinion who referred me for a c t scan, finally it can came through nearly 9 months since op. My solicitor then also wrote to the trust asking for copies of my records and radiology. Finally they confessed (only after the letter from legal team) that my wrist soft tissues were damaged during the surgery and there has been irreversible damage and said I'll never turn my hand over again, in addition they also said the metal plate inserted was too big and has also caused damage. I'm gobsmacked, surely they knew something was wrong all along by looking at it/lack of function given their clinical experience? I feel so so upset and betrayed by the whole clinic and now I have to get another surgery by them on Tues to take the too big plate out and they are wanting me to start physio again 2-3 times a week, I feel like I can't fake having those how are you chats with the team 2-3 times a week knowing what I've just found out. Also gutting to think they were forcing my wrist & hand back in physio 2-3 times a week this year for 6 months plus given how damaged my soft tissues were as it has now transpired.

It seems it was a cover up. They literally saw me struggling every week and going from a £35k a year job to just SSP. I've been struggling to feed my kids due to all this and feel so angry. They could have admitted the mistake so early on and got the plate out at least (it's been in 9 months!). The damage done from surgery is irreversible they said though and I now have to come to terms with permanent loss of function in my main hand and wrist. Also scared about the new operation on Tuesday as lost trust in the team now :(

I honestly just thought they were going to say oh the plate was just blocking my tendons or something and they had been too disorganised/NHS pressured to remedy it, but this revelation is awful.

I feel really awkward seeing the staff now. The regular staff I've seen who broke the news were so overly fake nice too and could hear them conspiring behind the door for what to say before they came in.

I feel truly terrible. My family & friends are sick of hearing about it and my sister told me "to move forward" easy to say when you are not in that position.

I feel really low and confused about why this has all happened.

Thanks in advance for any advice or support.

Thank you, exactly! They said they used the smallest plate they had but they could have just not done it or sourced a child's one? I have held my wrist side by side with a number of friends and half have similar wrist size. Feels like a male dr (it was) blaming the female body a familiar story in history...

I think I’d go down the legal route and sue also

However I must add that any cover up will be a small number of toxic staff and not the whole team. Some maybe horrified but feel unable to speak up because the nhs is so awful with whistleblowers

The problem with healthcare in the UK is that there is no accountability asked of medical staff. They finish their shift and byeee someone else's problem. And because theres only one employers in the UK, there's zero consciousness that this would not be ok in other industries. The system has created this culture of covering up and its leaving people with really poor health. I am so angry at the NHS for the way myself and my family have been treated too so sending love op.

Exactly how I would have approached this, anyone can make a mistake. Not admitting it then a cover which caused a delay in further treatment and further damage is unforgivable, and was totally unnecessary of them to do!

I completely agree with you - anyone can make a mistake but cover ups are unforgiveable. The medical culture of covering up for other medical staff needs to stop. Its not caused by 'patients who don't understand and just want to sue us' and I resent being infantilised as a patient.

I’m a senior ICU nurse and have worked in the NHS for 15 years and I am a big supporter of the NHS, yes mistakes happen, I have even made a few myself but we have a duty of candor. Often it’s the aftermath of a mistake that makes the difference and time and time again it as been shown that being honest and upfront has positive outcomes. I’m sorry this happened to you. I would sue in your position and I don’t say that lightly but you have been treated appallingly and essentially gaslit for almost a year.

in terms of going forward I would go ahead with the surgery but ask for a different surgeon. Unless it’s a very small hospital this should be easy to sort. Your relationship and trust with the original operator has irreconcilably broken down and for your own comfort and peace of mind it would be best to start fresh with someone else.

I’m an NHS doctor. I think you do have a case for medical negligence and as it appears that this is going to have significant long-term impact on you physically and financially, I think you should both complain and seek compensation.

You are entitled to ask for a second opinion- usually this is from another Dr within the same trust, if there is one. You could ask for your care to be transferred elsewhere- it could be a different hospital within the same trust, but if you want to go to a hospital in a different area that trust would have to agree to take over your care. In practice, requests for out of area transfers of care are usually accepted but you are subject to their waiting times- your place on the waiting list will be based on clinical priority only.

However, patient’s who has been proven to be victims of medical negligence do not automatically get all their care via private provider. This usually only happens where the NHS cannot provide the surgery/treatment the patient needs but the private sector can, or if the NHS cannot provide treatment in an acceptable timeframe (legally decided, not patients preference). Sometimes provision for private care costs can be part of the settlement package- e.g. the NHS ensures private care is paid for- or, more commonly, a larger award is made to cover the costs of care going forward, and a calculation of expected costs might include healthcare by a private provider. But that is on an individual basis, not a guaranteed right for all claimants. In any case, private sector won’t take on every patient anyway- either because they are too high risk (either high risk, complex patient ir high risk treatment) because they don’t have the facilities do to so; or because profit margins aren’t great.

If it’s lack of trust in NHs that is the driver for private healthcare- whilst understandable- I think it’s also useful to know that many/most Dr’s in the private sector also work for the NHS (outside London, in any case). And, those working in private healthcare are no less likely to make errors than the NHS, nor are they more accountable/more scrutinised or monitored than NHS clinicians. Private sector can be excellent and it can be awful too. Much like the NHS.

I think, though, that you may be wrong about the team deliberately trying to “cover up” though. It may be simply a case of poor clinical practice and failure to recognise an issue- involving a number of clinicians (orthopaedic surgeons and physios, for example). I think that it unlikely (though not impossible) that they have all got together to conspire to keep the truth from you. In my experience of healthcare, often the issue is often a combination of genuine error made by otherwise competent clinicians, some aspects of poor clinical practice and sometimes clinicians not trusting their gut/ not wanting to highlight something they aren’t absolutely sure about, just case they are wrong. With the latter point, please understand that I’m not excusing it- it is our professional duty to point out mistakes/errors/poor practice where we see it, and if you don’t then you have to face the consequences. I’m just trying to say it might not a deliberate, pre-planned and co-ordinated long-term deception, where every member of that team were intentionally compounding their error by continuing treatment despite being fully aware it was causing ongoing damage or was futile.

I think you may well be wise to get the plate removed as planned- especially as you say it is a different surgeon doing the procedure. You may also need immediate post-op care/physio locally until something else can be put in place given the date of your operation is so close.

Agree with much of what you say. Though, in many areas pain due to nerve damage is often managed via pain clinics run by anaesthetists who specialise in pain management (sometimes in conjunction with ongoing care from neurology, or after review by neurology to determine type of nerve damage- e.g. distinguishing between different types of peripheral neuropathy and the underlying cause of that- though in the case, it is clear what type of nerve injury this is, so I doubt neurology will have a significant role to play here).

They have damaged you, they covered it up, and you have lost out financially because of this. Sue the arse off them.

OP I just wanted to say how sorry I am this has happened to you. Take all the good advice on this thread and also sue them

Thanks for your advice. Just had a prehab appointment ahead of the surgery tmrw. They have booked me in for physio already just this Friday and you are right I should engage with this until another option is available as I'll suffer further issues otherwise. I struggle to see how they did not realise there was an issue my hand sits in a radial deviation at about a 2/3 o clock position and looks very odd and also has no function/ability to flex or supinate. I did a SAR myself and got all the scans prior to my op the hand is broken but clearly straight on x-ray and in a neutral position prior to surgery then after surgery it is bent to the right clearly on every scan after and even in the X-rays taking during surgery it all of a sudden leans to the right which signals something has happened during surgery to cause this. Surely if I can see this looking back as a lay person they could have? Well they didn't even need scans my hand is bent to look at and would surely have a concerned dr ordering a ct/further imaging if the reason was not apparent on x-ray. In their defence the first surgeon did write "surgery completed without complications'. But still visually and functionally it was hard to deny there was in an issue in the 4 consultant follow ups I had (it was a different person each time) and the last one dismissed it as just CRPS which is when I knew I'd have to get my own records to figure it out and get a second opinion (not something a patient should be having to do looking at their own case to find the issue 🤣). You are right my gp actually referred me to Spire to see this second opinion consultant (who also works at the trust involved). He can't do surgery at Spire for me due to severe asthma/resuss options so kept me at the trust but took over my care essentially. I'm not the sort of person to be rude to anyon, just feel very awkward around them after me saying for 9 months why is my hand sticking to the right why doesn't it move and being told it was just stiffness or early days and refused ct/further imaging til I complained. Very bizarre! Honestly my hand looks so odd a GP who sat next to me on a train and got to chatting to was even appalled and noticed a problem, I don't know why they as experts didn't the only plausible reason seems cover up but it could just be mass disorganisation, that would make me feel better. It's been so draining over a year and I have a deformed non functioning dominant hand and wrist 😭

Hopefully the plate coming out should help with the deviation and deformed look even if as they say the soft tissues damage cannot be undone!

don't know why it erased part of text think because I used --

These comments are interesting I hadn't considered nerves damage. I must say days after my op my hand started shaking then leaned over further like the leaning tower of Pisa !

I think the consultant is saying ligaments and tendons damage caused by one during surgery (there was a lot of drilling and hammering!) I was awake, maybe something got hit? Anyway he said damage done during surgery, and two further soft tissues damage caused by the plate being too large. I wish the clinic letter post this discussion had been sent out prior to my op tomorrow, I would like to see the specifics 🤦🏻‍♀️

I’m an NHS limb surgeon. Sorry to hear what happened.
I’m glad that a different senior consultant is doing your procedure. They will definitely be aware of what has happened to you and will want to make sure you have a better experience.
You don’t need to see a neurologist . Your surgical team will get nerve conduction studies if required and If you still have pain going forward then a pain control specialist ( usually an anaesthetist) is the better person to see, as well as a hand therapist who will give you physio exercises.

Good luck !

Definitely sue. Even if the problems caused during surgery couldn’t have been avoided, the lack of follow up still sounds like medical negligence. You could get a decent sum as obviously your hand has so much of an impact in your life. I’m really sorry this happened to you. Get a decent solicitor and not a no win-no fee type.

CRPS is rarely just.

I have severe nerve and soft tissue damage to my ankle following an accident.

I've accumulated a collection of diagnoses that basically describe the damage.

It is likely given what you state that there is nerve damage.

I personally have a peripheral neuropathy diagnosis as well as a CRPS diagnosis.

There are people who specialise in CRPS - I saw Dr Shenker at addembrookes in Cambridge. He is rheumatologist but CRPS crosses specialty lines.

You might find these people helpful:

www.burningnightscrps.org

Victoria who runs it organises zoom sessions and they have a telephone helpline largely staffed by people with CRPS so they have experience of the medical system and can help talk you through it.

You will need a physio who has experience of nerve problems not just a standard physio. If you are having significant problems moving it then mirror box therapy is very highly rated.

You can also get apps for your phone - the idea is that you start with motor imagery - so imagining moving it.

It sounds bonkers but it does actually work.

Thanks for this info. Sorry I know CRPS is not just that, it can be an awful debilitating condition from what I've read. So sorry to hear you are suffering with it! In my case I felt the consultant (one of them) was trying to use it as the reason for the misalignment of my hand and wrist when it was obvious something else was wrong as it transpired. I'm sure I'll be at huge risk of CRPS now even if there isn't already an element, I don't get hypersensitivity etc though or usual presentations of it currently. I'm about to have a box of matchmakers before my pre surgery food curfew kicks in ... wishing you a merry Christmas

@sunscomingout you have had some great advice, and I’d just like to add one more suggestion. I do hope the remedial surgery is successful, but given that damage isn’t completely reversible, I suggest that you consider voice recognition software for your writing. It does take some getting used to, but the software is very good these days, and it would be considered a reasonable adjustment at work so your employer should pay for it. I’ve used it myself and provided it to others in the course of my work (I’m a health & safety professional).

If your employer isn’t very savvy about this stuff, PM me when you’re ready and I’ll advise.

Thanks everyone for your advice and kind words. I'm in my gown ready for the surgery and feeling very nauseous, I think fear!!

Thanks for this, I am definitely thinking of using voice typing, especially as I'm taking a small job in the new year which involves marking and I also want to write a new book! Would love to know about any programmes better than word!

Hi everyone, little update, had the surgery, arm block failed... could still feel most things 🤦🏻‍♀️ so had to switch to GA quickly which they had been wary of due to uncontrolled asthma history! Anyhow woke up ok, bit wheezy nothing major since. I can now turn my hand over a bit more already with the silly plate out that was taking up so much space, though I've been warned not to expect to be fully able to turn it over again. Very shocked at how good I feel physically as the last operation I was writhing in agony, severe swelling and bleeding, can barely tell I've had an op this time with the new surgeon swelling wise!! Makes me think more the first surgery was very rough and did damage.
My hand is still turned out to the right though (like a kink in the wrist), I did feel tearful when they took the bandage off and I saw it today. Obviously wasn't expecting miracles but .. Has anyone got any stories of reversing soft tissues damage or getting further assessments to see what has been damaged (the most I've had is a CT scan). I can't flex it back or forth or side to side still more than 15 degrees. It is painful around the incision. The surgeon was telling me how far he could get my range of movement under GA and was like "it's down to you now" like I've brought all this on myself haha. Wish me luck wrapping the kids presents 🤣

Not my experience, my experience is a rushed halted halfway way through rushed at the end angioplasty leading to a second angioplasty being required less then 2 months later.
Cardiologist claiming the symptoms were caused by meds that I was on for 12 years and then sudden onset asthma. Asking me if 'I didn't think he had done his job properly' then discharging me without telling me or any follow up.
My being forced to use the same Cardiologist for the second angioplasty, them refusing to see me before the angioplasty and sending one of the team.
Being incredibly rough so I had to have a lot of morphine during
My being greeted by the Cardiologist as I went in to the second one by them asking how I had seen the senior member of staff who had ordered the second one.
All of the staff seen following the complaint telling me the arm pain was not under any circumstances nerve damage. Including the orthopaedic surgeon they sent me too who fucked up because he showed me the scan they did on my shoulder not.my arm that showed the top of the swelling that was compressing the nerves following the completely unnecessary 2nd angioplasty.

So yes they do collude in irdwr to protect the almighty nhs

Me too. And I don't usually recommend that either.

You have been treated disgracefully.

I'd ask to be treated elsewhere from now on. You have no confidence in the team who 'treated' you in the past.

I'm so sorry this has happened to you.