NHS Tayside staff failed to spot that a patient who had been the victim of a road accident had a broken back.
A report by the Scottish Public Services Ombudsman (SPSO) said medics had failed to assess and treat the patient, Miss A, and did not arrange for X-rays or scans to be taken of her spine.
Paramedics had taken Miss A to accident and emergency at Ninewells Hospital, Dundee, strapped to a spinal board.
Her father, Mr C, complained, saying the health board failed to adequately assess and treat Miss A, and said that she was not X-rayed at any point before she was discharged.
After the patient left hospital she remained in significant pain and discomfort and Mr C took her to her family GP who referred her as an emergency patient to a different hospital.
An X-ray there revealed a fractured vertebrae and a CT scan revealed two further fractures.
Upholding the complaint, the SPSO said that while the initial examination was of a reasonable standard, a second more comprehensive examination should have identified the need for an X-ray of the spine.
An NHS Tayside spokeswoman said: “We have written to the family involved in this case and apologised and we are taking action to address the recommendation.”