13. Mrs K says between October 2021 and the beginning of February 2022, the Trust dismissed her mother’s reported symptoms of right-sided hip pain.
14. Mrs K told us this was because in late February 2022, a second hospital X-rayed her mother’s hips, and told her over the phone, that she had a historical fracture in her right hip from a few months prior, which must have happened during her above time at the Trust in 2021.
15. The Trust response explained that from October 2021, Mrs W had only complained of pain to the left side of her hips, which was initially treated with pain relief. It said in October, a doctor and an Occupational Therapist reviewed Mrs W on the ward, and due to continued pain requested an X-ray to exclude physical causes.
16. The Trust said that Mrs W had an X-ray of her hips of which the report explained her left hip and previous total hip replacement was deemed to be satisfactory in appearance, and that the right hip was also of normal appearance on the day the X-ray took place.
17. When deciding whether to investigate a complaint, we consider whether there are any reasons why an investigation would not be suitable. This includes considering whether an investigation would be practical and whether it would reach a satisfactory conclusion.
18. In this case we don’t think an investigation would be practical.
19. The first reason we consider an investigation would not be practical is that there is no evidence in the medical records between October 2021, and February 2022, that shows Mrs W complained of right-sided hip pain whilst at the Trust.
20. The Trust records show that throughout the period of her admission (between October, and her discharge at the beginning of February), Mrs W complained of pain in her left hip only. For example:
• ‘was provided with pain relief for pain in her left hip’ • ‘complained of pain in her hip’ and requested paracetamol for hip pain, then specified this as left hip pain’ • ‘stated she had a left-sided hip operation in November last year and feels this is where the pain is coming from’ • ‘complained of pain to her left hip and accepted regular paracetamol’ • ‘complained of pain in her left hip again which was severe enough to put her off her feet, and she has been requesting a wheelchair which is unlike her’ • ‘had discomfort in her left hip.’
21. The medical records show Mrs W first mentioned pain on her right side at the beginning of February 2022, during a follow-up call after her discharge from the Trust.
22. During the call it is noted Mrs W explained she was unable to weight bear, had pain in her right ankle which had been present for a few days, and was due to see her GP later that day. There was no report of right-sided hip pain at this time.
23. We can see from the records that Mrs W was later admitted to a different hospital via its Emergency Department (ED) at the end of February. It is noted this was because of her experiencing pain in her right ankle for the last two weeks and right-sided hip pain for two to three days. It appears this is when Mrs W mentioned pain in her right hip.
24. Because the records show Mrs W was complaining exclusively of left-sided pain throughout the period she was at the Trust, and we have not found any evidence of her having complained about right-sided hip pain during this time, we would not look to investigate this further. Any further investigation is unlikely to reach a satisfactory conclusion without clear evidence she complained of pain on her right hip.
25. The second reason we consider an investigation would not be practical is that there is no clear evidence to show Mrs W had a historic fracture of her right hip.
26. The medical notes show an X-ray was taken in October 2021, during Mrs W’s time at the Trust, to exclude any causes of her pain. The X-ray report says Mrs W’s left total hip replacement was satisfactory with no evidence of loosening, there was a reasonable joint space in the right hip, and found no bone or joint abnormality.
27. An X-ray report taken from the second hospital in February 2022, after her presenting to its ED says that Mrs W had an intracapsular neck of femur fracture of her right hip joint. An intracapsular neck of femur fracture is a type of hip fracture that happens when the ball at the top of the thigh bone breaks off where it meets the upper thigh.
28. The medical notes show Mrs W went on to have a surgical procedure to repair her right hip joint.
29. We can also see there are no records of Mrs W having had a fall during this period, and that she could not recall if she had fallen or injured herself during her time at the Trust or at home prior to presenting to the ED following her discharge.
30. As we can see no evidence that refers to the time period of the fracture Mrs W sustained, or to state that it was historic, we feel it is unlikely an investigation would lead to a satisfactory conclusion, as we would be unable to evidence how, when, or where Mrs W fractured her hip.
31. We recognise this must have been a very difficult time for Mrs W and Mrs K and are sorry to hear about Mrs W’s experience.