Delayed Radiology Services Result in Late Fracture Diagnosis
Penalty
Summary
A resident sustained an injury to the left hand and fourth finger, resulting in swelling, bruising, and pain. Initial orders for ice and splint were obtained, but an x-ray order was not received until three days after the injury. Despite the presence of pain and swelling, the x-ray was not performed until five days after the injury occurred. Documentation shows that the resident continued to experience symptoms, and nursing staff provided pain management and immobilization while awaiting further diagnostic evaluation. Attempts to obtain the x-ray were delayed due to issues with the order not being properly entered or signed by the physician, and the hospital's radiology department did not accept the initial order. The resident was transported to the hospital as an outpatient, but the x-ray could not be completed due to these administrative issues. It was only after further communication between nursing staff and the physician that a new order was obtained, and the resident was sent to the emergency department for the x-ray. Interviews with facility leadership, including the Interim Director of Nursing, Administrative Director, and Director of Nursing, confirmed that the delay in obtaining the x-ray did not meet their expectations for care. The physician acknowledged that he did not consider the injury serious enough to warrant immediate action and expected nursing staff to notify him if the order was not carried out. The delay in providing radiology services resulted in a late diagnosis of a finger fracture, as confirmed by the emergency department's final report.