Failure to Refer to Correct Department

The TSP Clinical Negligence team is acting for Mr B who sustained a deep laceration to his left thumb. He attended the Accident & Emergency Department who diagnosed that the tendon of the thumb was partially severed. An A&E doctor repaired the tendon with stitches in an admin room within the A&E department, then he was discharged. Over the next few days Mr B’s left thumb became increasing swollen and painful, so much so that he returned to the A&E Department. When the bandage was removed it uncovered an odorous and black thumb wound. Mr B was sent to the Hand and Plastics Ward within the hospital where IV antibiotics were administered and he was immediately operated on to clean and repair the thumb injury that had become severely infected.

On investigating the matter it was found that the A&E department had failed to operate on the thumb in sterile conditions on Mr B’s first attendance. They had also failed to prescribe antibiotics and should have referred him to the specialist team during his first attendance. All of this had resulted in Mr B developing a severe wound infection. Unfortunately the only way to get rid of the infection was to wash out the wound and remove tissue and cartilage from the thumb. This left Mr B with a much worse wound that he might have had and very limited use of his thumb. The hospital involved is currently conducting an investigation into how and why this occurred.