...to think this is malpractice?

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My husband fell on ice on Wednesday and dislocated his knee and fractured it in two places. He was admitted to a&e by ambulance, assessed, the knee clicked back into place in the process. They gave him an x ray and said he would have surgery to pin it the next day. They gave him crutches to use but he was too weak and collapsed, banging his head. A CT scan was done to check his head. They then released us with meds and told him not to eat after midnight and wait for a call. Since then (it's Friday now) we've chased and chased, we've tried the fracture clinic, our GP and PAL. We just get sent round in circles. The trauma nurse called us last night and said they would call us when they wanted him in but she didn't know when it would be. He wasn't released with any paperwork, we don't know who his consultant is and when we tried to find out they just didn't pick up and we rang off after 30 mins. His pain meds run out on Sunday. AIBU to be shocked at the way we're being treated? He was given crutches and a brace but he can't use the crutches as he's too weak, and I'm practically dragging him to the bathroom. I don't know what to do, is this normal??

Why is he so weak, what age are we talking? When they spoke to you on the phone did they not give a rough timeframe, sometimes it isnt the next day and can take a few days to schedule but they should have advised you on that.
If you cant care for him and he cant get to the toilet dump him back at A&E

Oh, one more thing, they told us that he should never have been released and were surprised when they couldn't find him on their rounds of the ward on Thursday morning.

So why didnt they re-admit him then?

Hi, he's 48 and doesn't have the upper body strength and coordination to put all his weight on his arms and swing his good leg. The coordination issues started years ago but he refuses to go to the doctor about it. Usually just walking about is fine, he's just not very "steady" on uneven surfaces and can't correct himself easily if he trips.

Not sure, they were only willing to say he had on his notes surgery would be "after Friday". Thank you though I wondered about taking him back to A&E.

It will be a case of that they have more emergency cases to deal with thats why hes getting pushed back, its not malpractice. Its just the state of the nhs.

Winter pressures are high and many hospitals are declaring critical incidents at the moment (no beds). It's not right but it's the way it is after years and years of underfunding, rising costs, ageing population and staffing issues. So it's likely there was nowhere to admit him to and that's why he was sent home. It's not that unusual for trauma patients to not be allocated a consultant, you get whoever is on rotation for that day. It's about clinical priority, not allocated specialist. If you are concerned about your H's mobility, his safety and your ability to cope you need to push it with your GP or return to A&E. I'd also use this as an opportunity to illustrate the need for your DH to address his weakness issues, moving forward.

Malpractice - no
Very busy period - yes

If you can't get hold of a medical professional before his prescription runs out, you can get ibuprofen and 12.5mg codeine or co-codamol (paracetamol 500mg / codeine 8mg) over the counter from the pharmacy. That should manage his pain until you can get some help. Just make sure you read the labels re dosages, intervals, and duration (no more than 3 days).

There will be a list as long as your arm of cases waiting for theatre and they just have to prioritise who to bring in. That’s not malpractice, it’s just busy and the snow and ice will have made things busier. You can get more pain medication from the pharmacy.

I’m very surprised they sent home with fractures. Did he dislocate his knee joint or his knee cap?

⬆️ This.

There’s also a case to be said that he’s been okay for months- years (!) being unsteady on his feet and now suddenly requires urgent treatment. He needs to see the GP about his proprioception.

So a trauma nurse called, which means they are aware of him and gave him a ballpark on surgery. 111 might be able to get a doctor to call you back and provide a prescription for more painkillers.

If you can’t cope at home then I’d call back the trauma nurse and ask how to proceed.

If you are in England the nhs app might have some details in terms of letters / documents / results that might help, but he may not have a named doctor.

Not malpractise, just the reality of the NHS in winter.

I'm sorry that you and your husband are going through is OP. I don't think there is anything abnormal or "malpractice" about the wait for surgery. That is just how what happens to non-life-threatening cases when the NHS is overstretched.

However I think you could definately go to your GP to get them to chase the referral as it seems like your husband's mobility with the crutches is significantly worse than they probably expected of a man who had hurt one leg and had crutches! Separately, he needs to be asking his GP for a referral, probably to neurology about the unsteadiness and inability to correct himself if he trips. That could be the start of something nasty - MS, Parkinson's, MD all spring to mind. Probably HOPEFULLY not that serious, but he needs a referral sooner rather than later.

why has the been to the doctor about this, I could get myself around on crutches as a 51year old with a torn meniscus, serious joint and tendon issues, fibromyalgia. There’s two sides to health, doing stuff for yourself is the first line, he needs to get himself sorted out if he can’t even get himself around

Agree with PP, I don't think this is a case of malpractice as much as it is the NHS trying to manage around being incredibly stretched. Frustrating for you certainly but did DH mention his weakness/mobility issues when they gave the crutches initially? I think that is actually the more pressing issue here as I can imagine most services would expect a grown man with no known neurological/physical difficulties would be able to manage on crutches with a leg injury.

I speak as someone who dislocated and fractured my knee and subsequently had corrective surgery. This was over 20 years ago so not representative of current care but I didn't spend a night in hospital at all and waited around a month for corrective surgery at the time on over the counter pain meds (your husband has my sympathy- its painful stuff!) Obviously if you have severe health concerns and cannot manage his needs, go back and present at A & E with full disclosure of the neuro/stability issues DH has. If you feel you can wait/chase up, speak to the pharmacy re. suitable pain meds to take him through.

Two fractures of the knee always require urgent treatment.

I thought you were going to say he was 80.

You have clearly got a far, far more serious problem than his knee. That will be fixed in the next week or so, I should think.

He has got to go to the GP about his upper body/muscular issues. There is something very wrong there.

ETA: I just reread your post and realised that he tripped because he has whole body muscle weakness and lack of co-ordination. Seriously OP, he's not right. You can use this incident to get him to get some medical attention. He can't ignore it any more.

I think the issue is that he has nothing in his medical records about weakness/poor mobility and coordination difficulties.
A&E presumably are there for emergency situations and they have 'treated' what he presented with as far as possible when he visited - the fracture - by giving the brace and putting his name down for theatre.
Sadly as others have said it is a busy time of year and he is not a priority. The only issue I could see raising is that there was no contact on any discharge note to follow up if necessary.

I would use this as a good example of why he should seek medical help for other conditions. Especially as you said this started to happen years ago. This surely needs investigating and could be a contributing factor to his fall and if treated sooner, maybe he would be less unstable.

Yeah, I really think (ex physio) that two fractures and a dislocated knee (even if it was only a patella) at his age, following a fall on ice, should have triggered a flag in the attending clinicians.

And his not being able to cope on crutches should be a massive signal for more investigation. OP, if you have heard nothing by Monday, get an appointment with your GP and he should be pushing things ahead for you.

I'm far more worried about his uninvestigated mysterious weakness than by his knee.

Not Malpractice, sadly the reality of a busy time of the year and an unfunded system. As your husband has not attended gp/hospital regarding his mobility issue this is not on his records and is probably not being taken into account.

Hi op , his neurological issues sound like MS . I would tell the consultant when he finally gets in for his knee op . MS can present just like this and go on unchanged for years . .