Manchester United have been accused of harming the career of a former player by failing to treat an injury “promptly” and “appropriately”, leaving him with more serious long-term problems, according to a £1m lawsuit obtained by Sky News.
While defender Axel Tuanzebe is still in the Premier League at Burnley, he blames United for no longer being able to play “without restriction or impediment” – impacting his career and earnings.
The landmark case has been brought by the footballer claiming clinical negligence – shining an unprecedented spotlight on the inner workings of a leading club’s medical care and alleged handling of an injury.
The lawsuit lodged at the High Court in London shows the 27-year-old Congolese player “expects to recover damages in excess of £1,000,000”.
An academy graduate at United, he left the club in 2023 after 17 years. United declined to comment.
The case centres on stress fractures at the back of the spine, which the British Association of Spine Surgeons says footballers are vulnerable to.
It’s alleged Tuanzebe sustained a left-sided pars fracture in January 2020, which became chronic by July 2022 when he also developed a right-sided pars fracture.
The lawsuit says: “Appropriate treatment plans would, on the balance of probabilities, have resulted in the claimant avoiding the pain and discomfort set out below and would have resulted in him being able to play professional football at elite level without restriction or impediment.
“As it is, although he continues to play at an elite level, this has impacted his career and earnings.”
The details of the injury have never previously been reported.
Injury origins
The case centres on how MRI scans in early 2020 were interpreted following a hamstring injury suffered in a League Cup match in December 2019 against Colchester.
A suspected pars fracture was detected – referencing spinal stress fractures in the lower back, which athletes can suffer from repeated movements.
The lawsuit says: “It is the claimant’s case that the defendant [United] negligently failed to properly investigate the claimant’s pars fractures, failed to rest the claimant and failed to refer him to a specialist sports spinal surgeon.
“As a result, the claimant’s symptoms significantly progressed to bilateral grade 4 fractures, and he developed a left-sided chronic spinal fracture.
“Had the claimant been appropriately rested, his left-sided pars fracture would not have developed into a chronic condition and the right-sided fracture would have been avoided altogether.”
The fractures, which developed by July 2022, caused Tuanzebe “significant pain and discomfort since their development and deterioration.”
Return to playing
The lawsuit claims that in January 2020, United “failed to refer him to a specialist sports spinal surgeon” who would have apparently advised at least 12 weeks of rest to allow the fracture to heal.
But Tuanzebe was back playing by March 2020 for United in the Premier League 2 development competition and returned to first-team action in October in the Champions League against French side Paris Saint-Germain.
Then United-manager Ole Gunnar Solskjaer hailed “a tremendous defender, a great leader”, adding: “He’s going to be a top player for us and he’s got the character and the attitude that a Man United player should have.”
New pain
In December 2020, Tuanzebe told United he was suffering hamstring pain after sprinting. Despite concerns at the start of the year, the lower spine “was not imaged on this occasion”, the lawsuit says.
The lawsuit says: “By allowing the claimant to train and play as normal from February to March 2020 and thereafter, he suffered more serious symptoms than he would have if he had been diagnosed promptly and treated appropriately with rest.”
It claims an “appropriate treatment plan” was only put in place three years later – in April 2023.
The lawsuit says: “Appropriate treatment plans would, on the balance of probabilities, have resulted in the claimant avoiding the pain and discomfort set out below and would have resulted in him being able to play professional football at elite level without restriction or impediment.
“As it is, although he continues to play at an elite level, this has impacted his career and earnings.”
On loan in Italy
It was while on loan at Napoli in January 2022 that left-sided lower back pain led to the Italian club sending Tuanzebe for scans.
United were informed by Tuanzebe of difficulties getting out of bed and into his car.
But Dr Steve McNally, United senior club doctor and head of sports medicine and science, who left the club after 16 years in December 2022 to take a role with the PGMOL, is alleged to have “indicated no urgency” for him to return home for an examination.
Dr McNally is alleged to have told Tuanzebe it was “most likely” he had “disc irritation or change in posture mechanics rather than a stress problem” and that it “usually resolves with physio” rather than being serious.
The lawsuit highlights the period from January 2020 to January 2022 – claiming United “failed to properly assess, record or attempt to treat the claimant’s fracture in the acute phase” when further regular medical examinations were required and appropriate rest from training and playing was needed.
Examinations continued into the following month, February 2022.
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The lawsuit says while a stress fracture was excluded by Dr McNally following a CT scan, there could be an “inflamed facet joint between the vertebrae”.
But Napoli’s club doctor said an analysis of a CT scan showed a potential stress fracture, described as “chronic incomplete lysis of the isthmus of L5 with intact superior cortical profile”.
Dr McNally is alleged to have responded by saying that it was already visible on a CT scan from 2017, so “don’t think that would cause your current pain”.
Based on a referral by United, Tuanzebe was recommended pain relief injections in March 2022.
Despite reporting pain in June 2022, Tuanzebe went on United’s pre-season tour to Thailand the following month, but then asked to return to England for treatment.
After further MRI and CT scans, a stress fracture of the spine was reported in medical reports in August 2022.
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He was able to return to full training by January 2023 and joined Stoke on loan until the end of the season, but ongoing discomfort limited him to five appearances.
United then released Tuanzebe rather than triggering a one-year contract extension.
The lawsuit says: “By allowing the claimant to return to training and playing, including an intense strength and conditioning and running programme following 17 August 2022, this has caused him to suffer more serious symptoms than he would have if he had been diagnosed promptly and treated appropriately with rest.”
The “particulars of claim”, which sets out the basis for the case, was filed after being signed by Tuanzebe on 27 October.
