Surrey ER failed to detect man's broken hip, dislocated shoulders

A man from Surrey, B.C., is demanding that a hospital be held accountable after he was taken to emergency unconscious but uninjured and came out with broken, dislocated shoulders and a broken hip.

Man left permanently disabled; wants answers after trip to Surrey Memorial Hospital

A man from Surrey, B.C., is demanding that a hospital be held accountable after he was taken to emergency unconscious but uninjured and came out with broken, dislocated shoulders and a broken hip.

Garry Melien's injuries were so serious he now has chronic pain and difficulty lifting his arms, he says. ((CBC))

Garry Melien, 65, is now permanently disabled and wants to know why emergency-room doctors at Surrey Memorial Hospital failed to detect and treat his injuries right away.

"Even when I walk now, for heaven's sakes, I have a limp in my right leg. It's never going to be right again. My shoulders are never going to be right again," Melien told CBC News. "I can't lift my arms. I haven't been able to drive. I can't even play ball with my little dog."

His health nightmare began in May 2007, when he fell and hit his head. Two days later, he had a seizure and was taken by ambulance to Surrey Memorial. Ambulance records show he was unconscious but had no injuries.

In the emergency room, Melien had a second seizure. According to hospital records, staff gave him medication to calm him down. They moved him onto his side and then onto a stretcher to send him for tests. Then, because there was no neurosurgeon available at SMH, Melien was moved again, into an ambulance, for transfer to Royal Columbian Hospital (RCH) in New Westminster.

Melien has no memory of his first few days in either hospital. He was quickly diagnosed with bleeding in his brain, which was quickly stopped with medication. At RCH, Melien's wife, Marion, was shocked when a doctor came out to tell her Melien had suffered a serious injury — fractured and dislocated shoulders.

"A neurologist came out to ask me 'Where did he get his broken shoulders?' " said Marion Melien. "I was stunned."

Melien's injuries were so serious he needed complicated surgery. The orthopedic surgeon had to remove one shoulder, then insert a prosthetic shoulder on one side and a pin in the other.

"The doctor who performed surgery on me said he said he's never seen shoulders mangled like that," said Melien. "He said it was like I was in a motorcycle accident."

Then, two weeks later, after medical staff tried to move him out of bed, they discovered he also had a broken hip.

A known complication from seizures

It turns out that fractured shoulders and hips can be caused by violent seizures. Several sources of medical literature warn doctors not to miss this complication because delayed diagnosis can result in long-term disability.

"It's not uncommon that patients discover they have an orthopedic injury after they have a convulsion," said Dr. Urbain Ip, medical director of emergency at Surrey Memorial. "They wing their arms back: that's how they get the dislocation and fracture in some patients."

Fractures caused by seizures are not uncommon, according to Surrey Memorial's medical director of emergency, Dr. Urbain Ip. ((CBC))

Ip also acknowledged it is important to diagnose and treat the injuries as soon as possible.

In Melien's case, though, records show Surrey Memorial failed to detect his fractures at any time during his stay in emergency. They also moved him around — putting him on his side and lifting him on and off stretchers — with broken bones.

Ip said staff are careful when moving patients and, in seizure patients, primarily focus on the head injuries. He also said there is no way of knowing now whether the delay in treatment made Melien's injuries worse.

"It's always good to recognize it in the first instance," said Ip. "Does it change the outcome? It's something we never know. But I can assure you that appropriate assessment and treatment is always our goal."

That answer is not good enough for the Meliens. They're still upset at Surrey Memorial, not just for missing his injuries in the first place but also for not explaining to them later what had caused them.

Injuries never explained by medical staff, Meliens say

Melien was transferred back to Surrey for several weeks of recuperation and said even then, no one could answer his questions about how he was injured.

"They were asking him [Garry] how it happened," said Marion Melien. "And he would tell them every time, 'I think it happened here. I'm pretty sure it happened here in [Surrey Memorial] emergency.' And that was the end of it."

Records from Surrey Memorial's ER make no reference to Melien's injuries, according to his wife, Marion. ((CBC))

"I don't know how many doctors I talked to, but I just kept telling my story over and over," said Garry Melien.

His wife added: "I'm mad because nobody bothered to come forward and say, 'Well, gee, I'm sorry, let's get to the bottom of this; let's find out how this could have happened and maybe it won't happen to somebody else.'"

Melien believes that, like thousands of other Canadians, he was a victim of a medical error — in his case, a failure to detect and treat his broken bones right away. The Meliens said they contacted three lawyers and none would or could take his case.

"Somebody should pay me something for this. I don't know how much or whatever and that's why I think — try to get a lawyer involved," he said.

Many lawyers won't take such cases

Linda Wong, a Vancouver lawyer who specializes exclusively in medical malpractice, said lawyers are wary of taking on a case like Melien's, because it would be impossible to prove whether his injuries were any worse because of the delays in treatment.

"In addition to the financial risk, there's also a lot of time involved for them," said Wong. "There are very few [lawyers] in the entire province doing this. It's very high-risk, very expensive kind of litigation. A lot of specialized knowledge is required."

Wong said she would like to see a reduction in the number of medical errors, so fewer people would want to sue in the first place.

"It would be great if there could be some way of reducing hospital errors and improving the checks and balances," said Wong.

Up to 30% of Canadians affected by medical errors

Recent surveys by the Commonwealth Fund, an international health-care foundation, estimate 25 to 30 per cent of Canadians will be victims of medical error at least once in their lifetime.

Before his seizure and injuries, Melien was an active realtor, the family's breadwinner.

"I was about 3½ months in the bloody hospital and I was on my back," Melien said. "I couldn't walk. I had to lay on my back for, it was over two months I was on my back, and I couldn't do anything for myself. I was totally helpless."

He said he has lost thousands of dollars and almost a year of his life. He expects to have chronic pain and very limited movement in his arms for the rest of his days.

"I just want to know how this could happen," said Marion Melien.