Delay in diagnosing hip dysplasia in young child

We have represented a young girl in her clinical negligence claim, which arose from a delay in the diagnosis and treatment of her dislocated hips at birth. We investigated her early paediatric care and evidenced the failure to make a timely diagnosis of hip dysplasia.

The defendant NHS trust accepted our evidence and admitted breach of duty of the care it owed. It was then common ground that, but for the admitted failures in our client’s hospital paediatric care, her hip dysplasia would have been diagnosed within eight to ten weeks of life, she would have been treated on a conservative basis, and she would not have needed any surgery. As it was, our client was not diagnosed with bilateral dislocation of the hips until she was four years old, by which time conservative treatment would not have been effective.

Our client had ‘developmental dysplasia’ of her hips. With diagnosis within eight to ten weeks of life, as should have happened, she would have undergone treatment with the application of a harness and repeat ultrasound examinations to ensure reduction of her hips and a return to normal morphology. She would then have had stable hips for the rest of her life, full mobility and not required any subsequent surgery.

As it is, our client is now likely to suffer increasing pain and further deterioration in her mobility as she grows older, with hip replacement surgery required by the time she reaches her thirties. Two further hip operations will be needed on each side for revision of total hip replacement.

Our client is presently independently mobile and does not use walking aids, but only over shorter distances. For anything longer than about 15 minutes of walking, she needs to use a wheelchair. Our client is likely to require use of a wheelchair indoors by the age of 75, when she will also require assistance with transferring and lifting, using a hoist. 

This claim was complex for many reasons, one of which is that our client has severe learning difficulties. She has significant behavioural difficulties, which have been considerably exacerbated by her mobility impairment and reduced independence, and by the dependence on her parents for activities, which, even with her cognitive impairment, she would not have required but for her hip injuries. She would otherwise have had some degree of separation from her parents, whereas now she needs constant supervision and support, which in itself is frustrating for her. 

Given the added burden arising from her physical difficulties, which resulted from the delay in the diagnosis and treatment of her hip pathology, our client has increased care needs. She will also require single level accommodation, as she cannot safely manage stairs with her restricted mobility.

A significant amount of complex expert evidence was required in this claim and the legal ‘causation’ arguments were difficult. The causative impact of the delay in diagnosis was disputed by the defendant NHS trust, as was the specific nature of the dislocations and how they would have been treated in any event. The claim was discussed at length between the parties at a settlement meeting (a form of alternative dispute resolution) to avoid the time and costs associated with litigation. Our client’s current and future needs were looked at carefully and a substantial settlement (in seven figures) to provide for those needs was negotiated and agreed upon. Our client’s parents were also compensated for the additional care they had provided for their daughter and the expenditure they had incurred in relation to her additional needs.

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