Traumatic experience

[moll 61]

Since having Radiotherapy in 2006/7

 

 

I have developed Osteo Necrosis of the Jaw.

 

 

I had surgery to remove a piece of my jaw bone earlier this year.

 

About 6 weeks ago my Jaw became tight and painful and over a week became intolerable.

 

 

I contacted facial/oral surgery at my local hospital where I was given an appointment,

by the time of the appointment I was basically living on Porridge.

 

 

At the appointment I told the Doctor that it felt like my jaw was broken,

he asked me if I wanted an x-ray to which I replied I would.

 

 

On examination he told me I had a serious infection and that an x-ray would be pointless

as the infection was severe and would feel as painful as a break.

I replied I would rather have an xray but was dissuaded.

 

 

I did ask him if that was his professional opinion that an xray would be pointless to which he replied yes,

and gave me a 4 week course of anti biotics and some Scandishake meal replacemnt drinks.

 

 

The pain got worse and a couple of times I nearly went to A&E and was sleeping in an armchair

as I was unable to lie in bed due to the pain in the jaw,

 

 

in the end I got another emergency appointment with Facial / oral surgery dept.

 

 

A different Doctor examined me and immediately called the consultant who came and examined me.

She immediately put me on her surgery list for the follwing week.

 

 

The whole experience of attending my appointement for surgery was farcical and is subject to a seperate complaint to the hospital.

 

 

What concerns me is that during Surgery I had a fracture that needed bolting together,

the pain and suffering that I and my family went through the preceeding weeks

I feel was avoidable if they had granted my request for an xray as my body was telling me it was broken.

But like many of us I did not want to have a " I know better attitude" and challenge the Doctors knowledge

and experience and trusted him wholly.

 

 

The question I am asking is how do I proceed.

 

 

Am considering legal action, though I loathe to do it against the NHS of which I am a great believer,

but this is not the first time I have had issues with this hospital.

 

 

I had to stop my part time job and will be seeking a sick note to go onto esa for a short while whilst I recover,

during surgery they removed one of my teeth and so now have to fork out for another partial denture.

 

 

I am so frustrated and am sure I have missed out Information that caggers may need to help me,

so I will reply as required

 

Many thanks for just letting me vent so far.

 

 

Back now to weeks of pain killers and anti biotic

[king12345]

It's difficult to challenge a doctor's opinion without further examination at the same time the wrong opinion was given.

The fact that you needed surgery few weeks after seeing the consultant could be explained with a lot of medical words.

Unless the consultant who decided to do the surgery is willing to write a report stating that in his opinion the x-ray should have been performed earlier.

It's very unlikely that he will do this because it will get his colleague in trouble.

However, I know for a fact that an x-ray is not painful in any situation and I really much doubt that he wrote this in his notes.

It may be pointless because of swelling/infection, but surely not painful.

We're talking about a beam of light in the x-ray band passing through your body, not hammer and chisel.

If I might suggest something, get better and don't think about it now.

There's no information that will go lost if you act now or later.

stress has a detrimental effect on recovery time (personal experience), especially with face injuries because you will unknowingly tense your facial muscle and slow down the recovery process when stressed.

So, relax for now, recover and get your health back, then you can think of suing.

Good luck.

[Sali]

I have learned the hard way that doctors do not always know best and to listen and act on your own instincts. It rarely fails. It's so difficult though. We don't want to be labelled as difficult, hysterical or vexatious. It may effect our future care.

 

My suggestion would be to first obtain your medical records from the GP and hospital.

 

Your jaw was finally bolted together because of a fracture. Was there ever an infection? What did the GP do to determine this - did he/she take a blood test? Is there any possibility that the fracture occurred after you saw the GP? Can an infection weaken the bone? The answers to these questions you should be able to establish from your notes and some general research.

 

Have you seen your GP since your surgery? (If you do see him/her, I would suggest covertly recording the conversation for your own records. Don't ask, it's more trouble than it's worth and it is not illegal).

 

If you believe that mistakes were made, of course you should complain (in a formal letter to the GP). A constructive complaint is not treason, it should be a way of improving a service.

 

Legal action is another step altogether. Clearly you may have suffered distress and pain for a longer length of time than was necessary. You may also have lost out financially because of the cost of the partial denture.

 

Wishing you a speedy recovery, good luck and keep us updated.

[moll 61]

Thanks for the replies, Facial oral surgery Doctor at the hospital stated that with this condition I should have had xray every visit. GP not involved during this, though will be seeing her on Monday to go through meds, will see what she says.

[BazzaS]

Thanks for the replies, Facial oral surgery Doctor at the hospital stated that with this condition I should have had xray every visit. GP not involved during this, though will be seeing her on Monday to go through meds, will see what she says.

 

You would need to establish what harm the lack of that X-Ray has caused you.

 

The Dr can note that you would have had osteonecrosis anyway : an X-ray wouldn't have changed that.

 

You'll need to show that an X-ray will have changed something, the course of the disease, what treatment would have been given or when it should have been given.

 

Otherwise there can be a breach of the duty of care but you can't show harm resulted: and proving causation is needed to prove negligence.

[zippygbr]

You would need to establish what harm the lack of that X-Ray has caused you.

 

The Dr can note that you would have had osteonecrosis anyway : an X-ray wouldn't have changed that.

 

You'll need to show that an X-ray will have changed something, the course of the disease, what treatment would have been given or when it should have been given.

 

Otherwise there can be a breach of the duty of care but you can't show harm resulted: and proving causation is needed to prove negligence.

 

exactly

 

there are also issues with IR(ME)R and repeated X-rays that don't answer a clinical question where the answer or significant information is gained from the readiation exposure.

[moll 61]

when i had the appointment i stated i thought it felt as if it was broken, he asked if i wanted an xray, i said i did, then he examined my mouth, the jaw bone was exposed through my gum, he then disuaded me from having an xray as he said it is a bad infection and the pain would be similar. Spendin over a month sleeping in an armchair waiting for anti biotics to kick in, pain was so bad i considered A&E a couple of times, perhaps I should have in hindsight. When consultant examined me next appoinntment she had me in for surgery the following week, i have seen the subsequent xray which shows a wide fracture now plated together

[BazzaS]

when i had the appointment i stated i thought it felt as if it was broken, he asked if i wanted an xray, i said i did, then he examined my mouth, the jaw bone was exposed through my gum, he then disuaded me from having an xray as he said it is a bad infection and the pain would be similar. Spendin over a month sleeping in an armchair waiting for anti biotics to kick in, pain was so bad i considered A&E a couple of times, perhaps I should have in hindsight. When consultant examined me next appoinntment she had me in for surgery the following week, i have seen the subsequent xray which shows a wide fracture now plated together

 

Sorry if the replies from zippygbr and myself weren't what you wanted to hear.

 

You have pretty much repeated yourself, and I can't see any new info you have provided. As such, I'm pretty much going to repeat myself, but I'll try to rephrase what I've said previously.

 

I'm not saying you don't have a legal case, only that you haven't yet showed that you have.

At present, if you are basing things on "they told me I could ask for an X-ray, then I didn't get one" : this will get you an apology for "poor communication by them / a misunderstanding"

 

The key issue (for any legal case) is "if you had had the Xray, would things have been done differently / better".

If you wouldn't have had different treatment or treatment sooner then the lack of Xray didn't cause you harm, and you have to be able to establish that harm to have a legal case.

 

If you had x weeks of pain and the pain was due to osteonecrosis rather than e.g. should have bolted the fracture sooner : you can't sue.

If you had had an X-ray but even with an X-ray they would have said "looks infected, bolting together infected bone is a disaster, it always falls apart, so we give antibiotics for x weeks and then plate it" again : the lack of an X-ray isnt a cause of new harm that you wouldn't have already faced.

 

I don't know if you have a case for negligence. You may or might not. I'm just trying to point you to the questions you need to get answered to distinguish

"You had weeks of pain" - and it was bad luck but not negligence from

"You had weeks of pain" - and it was avoidable and someone's fault and thus negligence.

 

I agree with zippygbr and disagree with king12345 about "We're talking about a beam of light in the x-ray band". Because it is in the X-ray band we are moving from "light" (non-ionising) to a form of ionising radiation. By all means think "light", but with greater risk of "sunburn from the inside".

 

What I knew of as POPUMET has been replaced by IR(ME)R (as noted by zippygbr), and in effect : each X-ray must be justifiable in so far as its benefits must exceed its risks.

[king12345]

In no case an x-ray can be painful.

It can have detrimental future effects and/or be pointless because it can't show the damage due to swelling and/or not affect the way the problem is addressed, but it is never painful.

I'm pretty sure that if x-ray is mentioned in the first consultant notes, it won't say that it was not performed because it would have been painful.

The consultant could have mistaken the bone sticking out from your gum to the infection swelling and advised against an x-ray.

As I said, you should try to get better first without thinking of suing.

Use your energy positively and get better, then you can sue.

There will be no difference if you sue now or in 6 months

[think about it]

King, perhaps it's just me but based on what I've read it's clear that the Dr didn't say that the x-Ray would be painful, rather that the infection would be as painful as a fracture.

 

There's been plenty said already about the merits and dangers of the exposure to radiation especially if the view is likely to be occluded by what else was going on.

 

Moll, I'm sorry you're having to go through everything that you are and you're clearly a very strong person to be able to do what you're doing. It might be worthwhile speaking to your GP or even a medico legal solicitor to see what the usual management of a case like yours would be, would they have sought to eradicate the infection before operating even if a break was identified at the time or would they have operated more aggressively to surgically deal with the infection?

 

Getting an independent take on that may help you decide how you'd like to proceed from here. Some of the best advice here too is to concentrate on your recovery for the time being, you've plenty of time to follow things up.

 

May I wish you a speedy recovery.