The man was driving a forklift and his it arm on the side of a building. He knew he broke his arm and took the train to the closest municipal Hospital in the New York City health system. He was correctly diagnosed with having a fracture of his arm and the doctor who treated him simply put a cast on his arm and told him to follow up in the orthopedic clinic.
The patient continued to follow up every few weeks in the orthopedic clinic. They took x-rays on every visit to make sure that his arm was healing correctly. At each visit the orthopedic doctor told the patient that his arm was healing beautifully and that after seven weeks his cast would be removed.
On the seventh week, the patient returned to the orthopedic clinic of this municipal hospital. It was the same doctor who had been treating him for all these weeks. The orthopedic doctor removed the cast and was very pleased with the result.
The patient however was confused. His arm did not look normal. His arm in fact looked more like a roller coaster. It was flat from the elbow leading to middle of his arm, then went up, peaked, and then went down and then straight into the wrist.
The patient asked the doctor “What's wrong with my arm? Why is it like this?”
The doctor responded “Nothing to worry about, just go for physical therapy and massage your arm and everything will be fine.”
The patient did not agree. He asked the doctor again “Physical therapy will not fix this. Nor will massage. What are you talking about?”
The doctor again told the patient not to worry and that physical therapy and massage will make the arm straight again.
To the patient's credit, he did not agree with this doctor's assessment and went to get another opinion from a private orthopedist.
The private orthopedist took one look at the patient and asked him “Almighty God, who did this to you?”
The private orthopedist obtained the original x-rays from the municipal Hospital and it was obvious that this patient never should've had a cast placed on his arm. Instead, the patient needed surgery to open up his arm to fix the bone and surgically connect it with a steel plates, screws and pins. This is known medically as an 'open reduction, internal fixation' surgical procedure.
Instead, the doctors at the municipal Hospital did not 'reduce the fracture'. That means they failed to put the bone in correct anatomical alignment so that it is straight and not rotated. As a result, this patient's bone healed in an incorrect position that never, under any circumstance, would have gone away with physical therapy and/or massage.
As a result of the municipal hospital's violation of the basic standards of care in treating a patient with this type of fracture, he had to have corrective surgery. That meant he had to have general anesthesia and the bone had to be re-broken and then surgically connected together with a steel plate, screws and opinions. He then had to go through another eight weeks of healing and recuperation. The orthopedic hardware will remain in his arm for life unless it becomes painful at some point. If it becomes painful, then he will have to have it surgically removed.