A pensioner died from her injuries after 17 rib fractures were not spotted on a hospital X-ray and she was sent home.

Procedures at the Erne Hospital in Enniskillen have come under scrutiny after medical staff failed to spot any of the broken bones that caused the death of the 73-year-old woman.

Mrs Elizabeth McTeggart, from Cappog, was the front seat passenger in a car involved in a head-on collision on the Sligo Road in Enniskillen on April 20, 2009.

She and her daughter Martina had been shopping and were heading home when a car coming in the opposite direction crossed onto their side of the road and crashed into them.

Mrs McTeggart suffered a chest injury and was taken by ambulance to the accident and emergency department at the Erne Hospital where she was examined by a doctor.

An X-ray was taken but no fractures were detected so she was given pain killers and sent home. She died four days later.

Yesterday an inquest in Enniskillen heard that her family was assured the X-ray was "clear" but that her son, John McTeggart, was "horrified" at the state she was in, given the bruising and pain she was suffering.

The state pathologist for Northern Ireland, Professor Jack Crane, told the inquest that he carried out an autopsy on the body of Mrs McTeggart and found that 17 of her ribs had been fractured, five of them in two places. There were also fractures of her sternum.

"It was these chest injuries that were ultimately responsible for her death," he concluded.

He said a rib fracture by itself does not necessarily cause death but there are a number of complications associated with it and the pain can interfere with breathing.

Coroner Brian Sherrard heard that following Mrs McTeggart's death an Incident Review Report by hospital management at the Western Health and Social Care Trust found that Mrs McTeggart arrived at the hospital at 4.45pm.

She was examined by Dr Christopher Potter, a locum who was there for that day only, and finished his shift at 5pm, handing the patient on to a colleague.

The report stated: "It was the view of staff present that if the fractures had been detected it is unlikely the patient would have been admitted. Her observations were stable."

It also found that Mrs McTeggart was treated and discharged by junior medical staff without being referred to any of the three consultants on duty.

Dr Potter told the inquest he examined the pensioner, who complained of pain to the chest and abdomen, consistent with her having been wearing a seat-belt.

However he revealed that X-rays taken after 5pm would not be seen by a consultant radiologist until the following day.

The inquest continues.