A man was sent home from King Edward VII Memorial Hospital with a cracked skull and clot between his skull and brain after an emergency department doctor failed to give him a CAT scan, The Royal Gazette has learned.

Tyrone Wilson's injuries were discovered when he returned four days later, and his angry wife Laverne has accused the hospital of "pure negligence".

The doctor, a qualified Canadian locum who works part time at the hospital, has apologised to Mrs. Wilson and admitted that he should have carried out a scan on Mr. Wilson when he was first admitted.

Director of Emergency Services Dr. Edward Schultz told The Royal Gazette yesterday that a scan should have been done immediately on Mr. Wilson, who fell 12 feet from a roof, because it is the protocol in Bermuda when someone is unconscious.

But Dr. Schultz said Mr. Wilson's injuries were caused by the fall, not from the failure to carry out the scan, and that the subsequent symptoms - personality change, headaches and seizures - would not have been prevented if he had been scanned immediately.

Dr. Schultz said he was "very concerned about the incident and had told the locum he must follow Bermuda's protocol, which is to give everyone who is unconscious or suffers amnesia a scan, and not the Canadian standard, where patients are not automatically scanned when they become unconscious.

And Dr. Schultz said the locum was not sure when he saw Mr. Wilson first on January 19 if he had been unconscious. Mrs. Wilson said her husband, who is 44 and is still in hospital, has undergone a seizure, suffers memory loss and has daily changes in personality. And she says it will be months before he recovers.

She told The Royal Gazette her husband was merely given an x-ray to his chest and back when he was taken to hospital and discharged because he was not unconscious. Four days later she returned with her husband and demanded he be given a CAT scan which revealed he had a cracked skull and clot between his brain and skull.

She said: "They are apologising, saying they are sorry the CAT scan wasn't done right away, and that's all I'm getting is apologies, but it is pure negligence. Because it was a bang to his head, they said the CAT scan should have been done.

"They are basically saying the clot formed, and the problem started immediately, but they didn't know until I brought him back. They said that when he fell, the brain was pushed forward and now his personality is not the same.

"He's got memory loss and had a seizure and every day he is a different person."

Mrs. Wilson, of Spring Benny Drive, Sandys, said she had thought about suing the hospital for negligence but friends had told her it was not worth doing because no one in Bermuda ever wins in these cases.

"I have asked around and I have been told I can't sue in Bermuda because nothing will come of it. No one ever wins these cases in Bermuda," she said.

"If I have to hire a lawyer and go through the expense and nothing comes of it, it will be a total waste. I'm just thankful that he's still alive."

Dr. Shultz said last night that Mr. Wilson's complaint when he came to hospital initially was of a chest injury and the locum's notes show he was not sure if the patient had been unconscious.

When the locum gave Mr. Wilson a CAT scan four days later, he found a fractured skull and small blood clot between the skull and the brain. "The clot did not require surgery and the patient has been followed in the hospital and repeated CAT scans have been done," said Dr. Schultz.

"We've been in consultation with a neuro-surgeon in Johns Hopkins Hospital in Baltimore and no surgery has been advised. We have explained to Mrs. Wilson that although we were very concerned that a CAT scan was not done, it has not altered our management of Mr. Wilson.

"The locum has apologised to Mrs. Wilson and said in retrospect he should have done a CAT scan (first).

"The complications he has had from his head injury were not the result of the fact that the CAT scan was not done sooner.

"Getting a CAT scan would not prevent those injuries. It should have been done when Mr. Wilson came in, but the complications were due to the primary injury and not as a result of the CAT scan not being done sooner.

"I have apologised to Mrs. Wilson in full. I don't believe it is full negligence, it is a judgment.

"We may use the locum in the future. In more than five years of employment here, I have never had any other kind of complaints about his performance."