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Elderly woman lived final months with near-severed hip

Left in needless pain

Discipline of a doctor who failed to diagnose an elderly woman’s severe hip fracture, leaving her in needless pain for the final three months of her life, has been upheld by B.C.’s Health Professions Review Board.

That College of Physicians and Surgeons of B.C. discipline consisted of a remedial interview and the results being placed on the doctor’s record. The review board ruled that was reasonable.

However, the woman’s daughter believes that’s inadequate, lacks transparency and does nothing to protect elderly patients.

The unnamed doctor became the woman’s physician during the time she was a resident of a long-term care facility from April 2017, until her May 2019 death.

She had an unwitnessed fall in her room in February 2019.

While staff decided she was uninjured, she listed to one side. Soon she was complaining of pain in her right hip and knee, her right knee was swollen, and she was limping.

The physician prescribed Tylenol for pain. And after an examination, a knee X-ray was ordered. That showed no evidence of a fracture and she was given another prescription.

As pain increased, the doctor instructed a physiotherapist to cease weight-bearing and range-of-motion exercises. The physician said the patient had a bone contusion and increased a prescription.

Soon after, the doctor asked that the patient’s care be transferred to another physician.

The new physician ordered an X-ray of the right hip April 24, 2019. It revealed the right hip ball was almost completely severed from the femur and “had been for a long time.”

The new physician weaned the patient from the earlier prescription and began hydromorphone, which was steadily increased until the patient died.

The woman’s daughter laid a complaint with the college against the first doctor.

The college agreed the final weeks of the patient’s life were unnecessarily painful, that the doctor’s patient assessment was inadequate and an X-ray should have been ordered rather than pain medication.

The daughter took no issue with the finding. Rather, she disputed the college’s response to the conclusion being an educational and remedial interview with the college as well as recording the findings on the doctor’s file.

“She believes this is unreasonable, as it fails to warn the public, particularly the vulnerable geriatric population, of the registrant’s substandard care,” the July 15 review decisions said. “She thinks the registrant should be barred from working with elderly patients.”

She believed the response lacked transparency and was unreasonable.



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