Be alert for toddlers and medical negligence compensation claims later

Parents of toddlers who are in full swing with the Terrible Twos know only too well how alert you have to be to keep them from harm but, unless they have to go to hospital, adults probably don't think about the possibilities of a medical compensation claim arising from childish activities.

Once children start being independent, their natural inquisitiveness can easily lead them into danger and, although they have slightly gone out of fashion, play pens are an excellent idea if you have one of those offspring who really needs containing if you are to have any chance of doing household chores or even moving out of sight to fetch a book or a cardigan.

Kids are just so cunning when it comes to doing the unexpected and putting themselves, or others, in danger of personal injury.

The opened knife drawer, the iron ready to fall, the floor strewn with accident-inducing debris, including food and drink spills, electrical appliances pulled out of sockets most parents, and many other relatives, have horror stories of near-catastrophes which occur in every home with children under five.

Then we come to the things they do to themselves. Of course, when they're learning to walk toddlers constantly tumble and usually bounce back up with only a bruise or small cut as a result, despite the disproportionate wailing which emanates from the tiny lungs.

Swallowing foreign objects is another challenge no self-respecting two-year-old will fail to try, and putting toys, peas, stones or any other generally nasty small thing in mouths, noses or ears is totally normal and, mostly, results in no harm.

Cuts are fairly obvious and normally treated at home with a Mr Bump plaster and a big kiss but when an injury could be internal, diagnosis and treatment can become more difficult.

Both falls and swallowing or ingesting tiny items can result in a hospital visit for a check-up and the parent needs to keep an eye on the child for some time afterwards in case complications develop.

Following a fall, a toddler may have concussion or even broken bones but, unless there was some underlying medical reason for the original trip, the bumps should heal fairly quickly.

Swallowing or ingesting a tiny item can usually be remedied in a casualty department with delicate instruments to remove objects from noses or ears but mouths can be rather more difficult, often entailing X-rays and minor surgery, unless the advice is to let nature take its course and for the object to emerge eventually at the other end.

Doctors and nurses who work regularly with the youngest patients have specialist training and, with experience, are ready to cope with all the challenges a toddler or baby can offer but there is one difficulty neither medical staff nor their parents can get over, the fact that the patient can't communicate with conventional speech.

Crying is an obvious sign of distress but misdiagnosis is not really surprising if the doctor is restricted to saying 'where does it hurt?' or asking the parents who may not have seen the accident which led to the injury.

Modern diagnostic methods, including X-rays and MRI scans should give an indication of internal injuries, but sometimes problems don't become apparent immediately or a child can become confused and say his left leg hurts when really it's his right one which is injured.

Also, in busy A&E departments, many staff will be involved and, if a toddler makes repeat visits (as the accident-prone ones do), they could ask for different tests or treatment each time a child arrives and may not be aware of earlier medical history.

An injury through swallowing can be latent for a long time before its consequences become obvious and then it pays for the parents to have good memories of why a child could have a stomach ache for no apparent reason.

There have even been cases of pneumonia and recurrent breathing difficulties in a child who managed to get part of a plastic toy up his nose and into one of his lungs.

Although an accident where a child falls or otherwise injures himself in a domestic situation is unlikely to be the fault of anyone, his subsequent medical treatment is a situation where parents will have to be watchful to ensure every care is taken of their child so that he can be returned to full health and long-term fitness as soon as possible.

When children cannot look after themselves, it is a prime duty enshrined in law that parents do their utmost to protect their offspring from the actions or inactions of others.

Good methods and record-keeping at accident and emergency departments could well prove vital both for a young patient and for the hospital if a medical negligence compensation claim is brought because no one linked an injury going back to the Terrible Twos with pneumonia or a perforated bowel in a school-age child.

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