Shoosmiths has extensive experience in amputation cases, acting for people who have lost limbs through medical negligence, road accidents or accidents in the workplace.
The complexity involved in dealing with amputation claims and identifying the impact is outlined in the following case example.
Twisted ankle and infection led to below knee amputation
Nine months after suffering a twisted right ankle, Mrs James, a 53 year old married woman, underwent a right below the knee amputation. The circumstances that led to the amputation are noted below:
On 8 April 2012 Mrs James fell and twisted her right ankle at home. She attended the Accident and Emergency Department at Ashford Hospital, where an x-ray was taken. She was advised the ankle was swollen and to take painkillers and rest.
On 9 May 2012, Mrs James was still experiencing problems with her ankle, so she attended the Emergency Department of Medway Hospital and a further x-ray was taken. On this occasion a foreign body was identified. Unfortunately, because the foreign body had not been noted and removed after the first x-ray it had caused cellulitis (a skin infection) around her ankle. She was admitted for a short course of intravenous antibiotics.
The foreign body was removed two days later, although Mrs James was advised they were unsure they had managed to get it all out. She was discharged but, unfortunately, her health deteriorated and on examination she had a swollen right foot, which was bleeding. She was found to have an infected post-operative wound and a possible diagnosis of osteomyelitis (bone infection) was made. She was referred to the orthopaedic team who, following another x-ray, ruled this out.
By 1 June 2012 Mrs James still had a very painful, swollen right ankle and an open wound. She was admitted to Medway Hospital a few days later with a high temperature and to have her wound washed out and drained. She was discharged on 15 June 2012 but had to be readmitted around three weeks later with an abscess over her right ankle. She was put on a further course of intravenous antibiotics and discharged home.
Mrs James had to return to Medway Hospital on 12 July 2012, with a noted episode of unconsciousness, complaining of an infected ankle, pain and itching in the ankle and hands. Samples were sent off for testing and it was later confirmed she had developed osteomyelitis.
She subsequently underwent several operations to clean out the wound, but these failed to resolve the infection. Sadly the only treatment option left was a right below knee amputation which she underwent on 23 January 2013.
Due to the complex circumstances surrounding her case, reports from experts in radiology, orthopaedics, and microbiology were needed to ascertain whether the amputation could have been avoided, had appropriate treatment been provided.
The experts concluded that had Mrs James received the appropriate amount of intravenous antibiotics at the outset, then she would have avoided her significant infection, osteomyelitis, repeat surgeries to clean out her wound and the amputation.
Identifying Mrs James’ needs to assist with calculating compensation
Having established negligence caused her injuries, matters then turned to what needed to be put in place to assist her with adapting and coping with her new physical disability. Mrs James advised that:
- Her NHS prosthesis rubbed and caused blisters;
- She found it difficult to get to her first floor flat;
- She found it difficult to use her wheelchair indoors as her flat was too small;
- She wanted to maintain her independence outside and did not want to rely on someone else coming with her;
- Performing day-to-day activities took longer and took more energy.
It was therefore concluded she would need the following:
- Care to assist with day-to-day activities, particularly as she aged;
- Aids, such as grab rails, wheelchair, scooter and adapted vehicle;
- Treatment such as physiotherapy and hydrotherapy to improve her overall condition;
- New and better fitting prosthetics;
- To move to ground floor accommodation. Before her amputation Mrs James lived in a small first floor flat with an unreliable elevator. Therefore, it was important that she was moved to ground floor accommodation to enable her to access her property more easily. The accommodation also needed to be bigger to provide space for her to use her wheelchair on the days she struggled to use her prosthesis, and to store the additional equipment she needed to assist with her day-to-day needs.
Denise Stephens heads the Thames Valley Serious Injury team and routinely deals with cases against hospitals and GPs and acts for clients who have suffered a range of injuries including; brain injury, misdiagnosis or delayed diagnosis of conditions, surgical injury, birth trauma, orthopaedic injury and claims against care homes. She said,
“ We have helped many clients come to terms with their life after an amputation. Every client has a unique set of requirements, and it is so important that they are all taken into consideration. In Mrs James’ case, a better fitting prosthesis and her accommodation needs were very important, and we were so pleased she was able to move to more suitable accommodation following the settlement of her claim.”
This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2023