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Posted on 18th February 2019

Avoidable Amputations

Amputations are required for a whole host of reasons, some are due to a negligent act but some are not.

There are various medical conditions which may cause parts of the body to require amputation though usually amputation is the last resort. In some cases amputation is required because a doctor or consultant didn’t provide the correct treatment for your condition of the treatment you received was delayed

When a patient is incorrectly diagnosed, this often can lead to a delay in receiving treatment. If your diagnosis was delayed or if your treatment was started later than it should have been, you could have a claim for medical negligence

In order to bring a claim for clinical negligence, a specialist solicitor will have to prove two things:

Breach of Duty

  • This is where a healthcare professional didn’t follow procedures correctly

Causation

  • This is where the breach of duty caused either an injury to the patient or it made the condition worse

Common conditions which can cause the need for amputation include:

Cancer

Amputations due to cancer happen commonly when bone cancer is present. It is often the only course of action left for sufferers to completely excise the cancer. It is of upmost importance that cancer is caught and treat at the earliest opportunity in order to achieve the best possible outcome for the patient. Unfortunately misdiagnosed cancer claims are common.

Infections

The most common reason for an amputation is poor circulation. Poor circulation occurs because of damage to, or narrowing of arteries. This is also called Peripheral Arterial Disease (PAD). When blood flow is restricted, cells are starved of oxygen and the tissue starts to die off causing an infection.

If you have an infection and it does not respond to antibiotics, amputation may be the only solution left to medical experts.

You may also need an amputation because of a significant injury sustained in an accident or because of cancer in the bones or muscles. You may have thickening of nerve tissue (neuroma), this is also a reason that you may require an amputation.

Surgical errors

Surgery to any part of the body carries a risk but when the part of the body contains a major artery, should that artery become damaged, the problems it may cause can be life changing. Damaging a major artery can lead to tissue death and eventually amputation unless the flow of blood is restored quickly.

On occasion, amputation of an incorrect body part happens. Hospitals call this type of incident a “never event” because it should never happen.

Compartment Syndrome

Commonly occurs in arms and legs when the pressure in muscles builds. The pressure can build to such an extent that it presses against arteries and reduced blood flow. There are two classifications for Compartment Syndrome, Acute and Chronic. Compartment syndrome is classed as a medical emergency if it reached the level of acute whereas chronic is not an emergency because it is usually caused by exercise.

Conditions that can bring on acute compartment syndrome include fractures, a badly bruised muscle, blocked circulation becoming unblocked suddenly, injuries sustained in a crush, steroid use or even bandages and casts being too tight.

 Compartment Syndrome

 

Osteomyelitis

Is an infection in a bone, typically in legs or arms and is bacterial in nature. It has two classifications, Acute and Chronic. Acute osteomyelitis occurs when an infection starts after an injury or infection whereas chronic osteomyelitis is when the condition keeps coming back.

NHS Choices say that 30 to 40% of diabetic sufferers who have a puncture injury to their foot will develop this condition.

Peripheral Vascular Disease (PVD)

A condition related to blood circulation which causes blood vessels to narrow or block. The causes of PVD include hardening of the arteries (arteriosclerosis) and blood vessel spasms.

Arteriosclerosis is where cholesterol builds up in arteries causing narrowing and hardening. As well as PVD, Cholesterol plaques are commonly the causes of heart attacks and strokes because the plaque can rupture suddenly. The blood clot that forms where the rupture occurred can break off and cause a blockage, this is in the same way that a scab forms when we cut or graze ourselves.

Arterial Embolism

Arterial meaning “of the artery” and Embolism meaning “clot” is where blood flow to a body part or organ is suddenly stopped. The clot has formed in a different part of the body and has travelled to the new location via the arteries. Arterial embolisms are usually found in legs but can be found in other areas such as in the brain (stroke) or heart (heart attack).

Foot Ulcers / Infections

Are commonly caused by peripheral neuropathy (nerve damage), circulatory problems or abnormalities in bones or muscles.

Nerve damage is most commonly caused by diabetes. Nerve damage means that the sufferer may not feel pain in the feet. When damage to the skin on feet happens and the diabetic does not feel pain, ulcers form.

Poor circulation in legs is called peripheral artery disease (PAD) and is linked with atherosclerosis. Because of reduced blood flow, cells receive less oxygen making skin more susceptible to injury.

Diabetic Amputations

Diabetics are 15 times more likely to require amputation at some part during their life though with adequate treatment and care routines, amputations are avoidable. Diabetes.org say that there are more than 20 leg, foot or toe amputations each day and four out of five are preventable if the appropriate checks and care was provided. Around 20% of diabetics do not get annual foot checks.

Diabetes affects many areas of the body but in regards to the nerves specifically, diabetes can cause nerve damage (neuropathy). Nerve damage causes a loss of feeling and when this occurs in the feet or hands, diabetes sufferers do not know when they have sustained a cut or a blister. Often these minor injuries go on to cause serious infections and then amputation.

In diabetes patients, nerve damage, poor circulation and numbness in legs and feet are often a precursor for more serious problems and could indicate that the patient is poorly managed.

The next step is when ulcers start to form. When nerves become damaged, numbness is often experienced. When a diabetic cannot feel pain because of nerve damage, they are more susceptible to injury. For example, if a diabetic were to get a small stone in their shoe, that stone can rub and cause foot ulcers. Because of numbness, that person wouldn’t know they had an injury unless they carried out foot checks regularly.

It is when foot and leg checks are not carried out that amputations are necessary. The ulcers could have caused gangrene making amputation the only course of action available.

See our article on diabetic care plans here

An audit in 2015 showed 29% of diabetic inpatients had foot checks within 24 hours of admission to hospital. Any diabetic patient with a foot infection or ulcer should be urgently seen by a member of the diabetic multi-disciplinary team (MDT).

The MDT should include physicians, nurses, podiatrists, dieticians and clinical psychologists however 31% of hospitals do not have a diabetic MDT.

In 2014, a report found the following experts were used in MDTs

Medical speciality Patients with diabetes Patients without diabetes
Vascular Surgeon 101 96
Orthopaedic Surgeon 11 21
Interventional Radiologist 79 71
Anaesthetist 29 27
Diabetologist 12 51
Geriatrician 6 4
Podiatrist 17 36
Diabetes nurse specialist 5 24
Vascular ward nurse 36 34
Physiotherapist 46 42
Occupational Therapist 34 31
Prosthetic representative 7 12
Representative for immediate care 3 3
Other 8 11
TOTAL 143 143

In general

Amputation negligence claims are not always as a result of any medical condition, there are instances classed as “never events” where the wrong body part was amputated in error. A person could have been seriously injured in an accident or fire and the treatment given was substandard resulting in amputation being unavoidable.

How can we help?

Here at Negligence Claimline our friendly team are here to help you get the support you need. Working with a panel of specialist medical negligence solicitors, we can assist you with your potential claim.

Sometimes an apology is enough, but in other cases compensation will be the only solution to help you get your life back on track.

Our service, putting you in contact with one of our expert panel members, is free and you are not obliged to take the advice the solicitor gives you, or to progress your claim any further if you do not wish.

Can I sue the NHS?

The NHS was created so that good healthcare should be available to all, and it is one of the country’s proudest achievements. However, if something goes wrong during your treatment you deserve answers and, where necessary, financial compensation.

We do not treat your claim lightly. However, the treatment you consider negligent must be considered unreasonable, irresponsible, and harmful.

When someone suffers an injury that impacts their live, or that of a loved one, then it is vital that the NHS has the procedures in place to both compensate the patient and learn from their mistakes.

Find out more about negligence in our Advice Centre

Call Us

If you believe that you, or a loved one, have suffered an injury as a result of medical or clinical negligence then call our friendly team on 0330 355 9210* where they will take some details and pass them to a team of specialist solicitors.

 

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