Glass Foreign Body in Laceration
Case #121
A 35-year-old man presented to the ED with a laceration.
He had fallen while carrying a glass.
The glass broke and caused a 4cm right forearm laceration.
A resident saw the patient.
He had a normal neurovascular exam.
The laceration was irrigated and repaired.
Several months later the patient noticed weakness and paresthesias of his right hand.
He was seen by a hand surgeon.
The surgeon recommended a surgical exploration of the area of the laceration.
A glass fragment was discovered.
The patient was left with permanent dysfunction of his right hand.
The patient hired an attorney and sued the hospital.
They offered to settle for $95,000.
The 2 sides reached a confidential settlement in 2020.
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MedMalReviewer Analysis:
Lacerations caused by broken glass are notorious for containing foreign bodies. There was no x-ray obtained at the initial visit, which may have avoided this outcome. Here’s an excellent (and brief) review of glass foreign bodies: https://jetem.org/glass_foreignbody/
The plaintiffs sued the hospital rather than the resident, which is the appropriate legal maneuver. Residents should not be named as defendants in medical malpractice lawsuits except in rare circumstances.
Better to make sure that you do an extensive exploration of the wound, irrigate generously and for sure warn the patient of a potential occult FB and to return if any symptoms occur when an ultrasound could confirm.
Remember not all foreign bodies are visible on X-ray, including some types of glass. And of course wood splinters, etc. Not a slam dunk.