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"My child's broken bone being missed"

About: Perth Children's Hospital / Emergency Department

(as a parent/guardian),

I am writing to provide some feedback on our experience recently at Perth Children’s Hospital. I preface this story with a deep appreciation that staff are pressured and hospital resources are very limited, and that in our experience, the staff were friendly and very caring. However, I do hope that this feedback may prompt some thinking around how non-life threatening cases are handled, so that the right decisions are made in the first instance. Which as with our case, I believe may prevent days of undiagnosed breaks and the provision of the right treatment when it is most needed. 

After falling from a very high slide onto their shoulder and neck on the weekend in the afternoon, we brought my toddler child to PCH. Given the height of the slide and their extreme pain after the fall, we wanted to get my child fully checked and were prepared for a longer wait. Once through, the staff examined my child's movement in the affected area and vitals. We actually caught a good portion of the fall and height of the slide on video which proved strangely helpful. Whilst my child could bend their fingers and elbow, the shoulder area was clearly very painful and they could not lift that arm.

The staff advised it was very busy and they didn’t think it worthwhile waiting for x-rays, so with some Panadol and Neurofen administered we were released and told it was just likely jarred. I did ask a couple of times if they were sure about no x-rays, as my child was definitely not themself and in pain, so this decision took me by surprise. I believe it was clear they were exceptionally busy and seemingly under a lot of pressure with other patients, so I did not push the issue further.

My child was in a lot of pain that night, and agony the next day, I even had to cut their clothes off them to get them in the shower. Not wanting to be turned away from PCH with no x-ray again, I went to our GP later in the day Monday and my child was x-rayed at a radiology clinic more recently, almost two days after the ED visit. There is a, mid-clavicle fracture with full thickness superior displacement of the medial fragment with overlap, or to my untrained eyes a significant collar bone break on the x-ray which of course explained all of their pain.

So back to PCH that day almost 48 hours after the incident to get the appropriate examination, sling fitted and advice on treatment/recovery. We of course feel terribly frustrated that for 2 days we have been trying to carry on thinking it was just jarred, whilst my child was clearly in pain and had no sling for support. In particular that all of this could have been so easily avoided with the extra check of an x-ray.

As a parent sitting in a busy ED full of urgent cases, I understand that prioritisation needs to happen and that this case was not urgent, which was what made me reluctant to challenge the decision made on not x-raying. However, I do feel strongly that had a different decision been made on that night it would have saved PCH the extra resources later on, and a lot of pain for our family and my child since they left that night.

I am sure I am not the only parent who has sat there reluctant to speak up because they felt their case was not as urgent as those surrounding them, but knew deep down there was something more that needed to be done/investigated. Is there a better way that these types non-life threatening cases could be managed, so that they are still treated with the requisite rigour, albeit likely longer wait times? 

Responses

Response from Tim Jones, Child and Adolescent Health Service - WA last week
Tim Jones
Child and Adolescent Health Service - WA

Head of Department

Submitted on 06/10/2021 at 16:53
Published on Care Opinion at 16:53


Dear orangecw65,

Thank you for taking the time to share your feedback about your child’s experience during your visits to the Emergency Department at Perth Children’s Hospital (PCH).

We have received your formal complaint recently submitted to our Consumer Engagement team which we are in the process of investigating and once we have completed our investigation process we will provide you with a written response.

We apologise that that your child’s collar bone break was not identified by way of an x-ray, the mechanism and description of the injury definitely warranted an x-ray.

Rest assured that we are conducting a thorough investigation of this matter and will get back to you with a detailed response that addresses your concerns in due course.

Please feel free to contact our Consumer Engagement team if you have any further questions on (08) 64560032 or at CAHSFeedback@health.wa.gov.au

Kind Regards,

Tim Jones

Co-Director Medicine

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