Medics at Blackpool Victoria Hospital – including a senior nurse – ‘seemingly’ missed a dying man’s dislocated hip.
Bernard Cosgrove, 91, was treated on a ward after being found unresponsive before being discharged back to the New Victoria Care Home.
It was only then his injury was spotted – as well as a deadly infection – his inquest heard.
Coroner Alan Wilson, pictured, said in a letter to hospital boss Wendy Swift: “Had he spent a lengthier period in hospital, the dislocation and developing infection may well have continued to go unrecognised, which raises a concern about how effectively patients are being monitored, and their medical records are being considered by staff who are subsequently involved in that patient’s care.
“On this occasion, once the dislocation issue was identified this did not substantially alter his care and he was treated conservatively, but in other circumstances not recognising the problem may have directly caused a death.”
A hospital spokesman said it had replied with ‘details of improvements we have made as a result of this case’.
He added: “We have apologised for the failings in Mr Cosgrove’s care and have undertaken an internal review to identify areas for improvement.”
Mr Cosgrove, a retired draughtsman, was admitted to hospital on February 28 last year, months after having surgery for a fractured right hip he suffered in a fall.
Mr Wilson said it was during his stay his right hip joint somehow dislocated and became infected.
On Friday, March 10, despite a doctor noting a ‘rotating right leg’, Mr Cosgrove was discharged.
“Mr Cosgrove found himself being discharged back to the nursing home ... at a time when seemingly unknown to the hospital staff – including a senior member of the nursing staff – he had a dislocated hip,” Mr Wilson said.
“The fact there was a problem with a hip seems to have become quickly apparent to care home staff ... and to a GP who visited him.”
Mr Cosgrove died on Tuesday, March 21, 2017 from pneumonia, with heart disease and the hip infection contributing factors.