It's not clear if the accident caused the fracture or if the rail was broken before the crash, the NTSB's Earl Weener said.

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He said Mr Budworth was due to have spinal surgery in a UK hospital later this week and also had two broken toes, while his wife also suffered a double fracture to her lower left leg.

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There were further claims from the families of a man whose ribs were broken while hospital staff tried to lift him and a great-grandmother whose hip fracture went undetected by doctors.

BBC: Alexandra Hospital, Redditch