Failings with staff handovers and negligent nursing care led to an elderly woman falling and fracturing her spine after staff forgot she was sat on a commode following an enema. To add further insult to injury, the fracture was misdiagnosed as an old break for four days, causing unnecessary pain and suffering.

Pensioner who fractured her spine in hospital fall after being left on a commode for more than an hour awarded £60,000 compensation.

The woman, who was 81 at the time of settlement in 2015, had been left with ongoing back pain, urinary incontinence, coccyx pain and lost four inches in height. She lost her independence and was confined to the house at times, needing assistance with daily tasks due to her inability to stand for long periods.

She sought the help of Medical Solicitors’ Caroline Moore who successfully recovered £60,000 in damages three days before the case should have gone to trial. Despite the trial judge commenting the case seemed undefendable on paper, the defendant trust continued to deny liability.

In January 2011, the claimant (C) went to A&E with severe abdominal pain and was admitted to hospital with a severe urinary tract infection (UTI) and constipation. It was advised she would need multiple enemas to empty her bowel before a colonoscopy could be performed to find out what was causing her symptoms.

After the final enema was performed at around 9pm, the nurse helped C onto the commode shortly before finishing her shift. The nurse failed to make sure that C’s nurse alarm was within reach, didn’t return to help C back into bed, or properly handover C’s care to a colleague before leaving work.

It was late in the evening and the 8-bed ward was dimly lit, with most of the other patients asleep. After around an hour, having realised she’d been forgotten, C attempted to reach her alarm to call for help without disturbing the other patients. But the alarm was too far away, so C tried to get up off the commode. She lent on what she thought was a secure handhold which was in fact a wheeled trolley; as it moved, it caused her to fall heavily.

After the fall, an X-ray revealed C had a fracture to her lumbar spine, but this was wrongly presumed to be an old fracture. C was discharged from hospital where she continued to suffer with severe pain and urinary incontinence that didn’t improve. Her husband called 999 for an ambulance but C refused to return to the hospital in question, so was instead taken to hospital thirty miles away in another county.

Here, another x-ray was performed which C had a fresh fracture that had been sustained when she fell from the commode. By this time, C had developed a chest infection and her heart rhythm started to fluctuate so was unable to have a scheduled kyphoplasty to fix the fracture; the only option was conservative treatment and C was given a spinal brace to wear.

As part of investigation for the clinical negligence claim, the nurse in question had not provided a witness statement and was identified by lay evidence from witnesses on the ward. Throughout proceedings, visiting hours became a hotly contested aspect. The nurse had recorded start time for enema at 7:35 p.m., which was during the hospital’s visiting hours, but C’s husband was adamant this did not happen as he was visiting throughout. It was argued that it would have been highly inappropriate to subject a patient to an enema on a busy ward during visiting hours; the timing in the note must have been inaccurate.

Liability was never admitted for the fall, and with a trial date looming, some four years after the incident, C was very frail and suffering angina attacks. Eventually, three days before the trial began, they made an opening offer of £10,000 which was finally increased to £45,000 plus any state benefits paid as a result of the injury that had to be repaid to the DWP through the Compensation Recovery Unit (CRU). These CRU benefits were in the sum of around £15,000. C readily accepted this offer on the Friday before Trial was to commence the following Monday. She was advised she would likely recover at least double the amount at Trial but she was not feeling at all well, stressed and suffering angina attacks. Understandably, in such circumstances, she really did not wish to have to attend court.


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Case settled by

Caroline Moore

Managing Director/Head of Sheffield Office

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