Diabetic amputation claims

Diabetes is a serious condition in which an individual’s blood sugar (glucose) level is too high. There are different types of diabetes, of which the most common are type 1 and type 2.

In type 1 diabetes the body's immune system attacks and destroys the cells that produce insulin, the hormone which controls blood sugar by moving it out of the blood and breaking it down to produce energy. Type 1 diabetics need insulin injections to control their blood sugar.

In the increasingly common type 2 diabetes, the body becomes resistant to insulin or does not produce enough of it to control the blood sugar. If caught early, type 2 diabetes may be managed with lifestyle changes. As the disease progresses over time, medication may be needed.

Diabetes is related to various other conditions, including thyroid disease, coeliac disease, dental problems and muscular conditions, such as Dupuytren’s contracture. Diabetes also has its own serious complications, including hypoglycaemia (low blood sugar), threats to eyesight from retinopathy and blindness, cardiovascular disease, nephropathy (kidney damage) and neuropathy (nerve damage). People with diabetes can reduce their risk of suffering these complications by controlling their blood pressure, blood glucose and blood fat levels, keeping active and maintaining a healthy body weight. Smoking and poor management of their diabetic health increase their risks. Good foot care is essential to reduce the risk of disability from lower limb amputation.

High blood sugar levels causes damage to the blood vessels and impairs the blood flow to the feet and legs. Uncontrolled diabetes is therefore a common cause of lower limb amputations. It has been estimated that someone with diabetes is 20 times more likely to experience an amputation than someone who is not affected by the condition.

People with diabetes should carry out visual foot checks daily. If their eyesight is impaired, they should seek help from someone who can check their feet for them, so that minor injuries are spotted and medical help sought as soon as possible after injury occurs. In addition to their own checks, people with diabetes should have regular check-ups with trained healthcare professionals, access to foot-care specialists and multi-disciplinary foot-care teams.

It is essential that people with diabetes see their GP immediately if they feel generally unwell or if their feet have:

• minor cuts;
• blisters;
• redness, warmth and swelling;
• discharge or fluid which oozes from the foot into socks or tights.

GP treatment might include:

• antibiotics;
• instructions to rest the foot;
• a review of their diabetic medication and management;
• referral to a foot-care specialist or multidisciplinary team;
• a personal care plan.

Signs of foot problems include:

• pain;
• wounds or sores that don’t heal;
• numbness or a tingling sensation (pins and needles);
• dull aching;
• shiny, smooth skin on the feet;
• swollen feet;
• hair loss on legs and feet;
• loss of feeling in feet or legs;
• feet that don't sweat;
• cramp in calves when walking or resting.

The following changes need urgent medical attention:

• changes in the colour/shape of feet;
• cold or hot feet;
• blisters and cuts that can be seen but not felt;
• foul smell from an open wound.

If you notice any of these problems, you must:

• take the weight off your foot
• immediately contact your GP or footcare team or go to the nearest out-of-hours healthcare service if the GP or foot protection team are not available.

However small the change, it is essential to get urgent medical treatment to avoid the risk of amputation.

People with diabetes can take these steps to keep their feet healthy:

• check their feet (or have them checked by someone else) every day;
• keep feet clean and dry, to avoid infection;
• don’t walk outside in bare feet, to avoid cuts;
• get help to quit smoking;
• manage blood sugar, cholesterol and blood pressure;
• check their feet every day;
• eat a healthy, balanced diet;
• stay active;
• watch out when cutting toenails to avoid cuts;
• wear correctly fitting footwear;
• use moisturising foot cream every day;
• avoid blades or corn plasters on their feet;
• attend regular footcare and diabetic healthcare check-ups and appointments;
• seek expert advice;
• keep useful numbers handy, to call for help if needed.

As with all diabetic foot conditions, the key to reducing the risk of Charcot foot is vigilant foot care, good diabetic health management, regular check-ups and prompt medical treatment of any injury (however minor).

The risk of Charcot foot is increased by:

• poorly controlled diabetes;
• reduced sensation (neuropathy) in the feet;
• impaired vision;
• existing ulceration.

Medical negligence is when a medical professional, such as a doctor, midwife, or nurse, or other healthcare practitioner is negligent if they act in a way that falls below any acceptable standard of care.

If someone is injured as a result of medical negligence, they are entitled to compensation for any injury that was caused and for the financial consequences of that injury.

Medical negligence claims that involve severe injury and disability should always be handled by specialist medical negligence solicitors. It takes experience and skill to successfully prove that medical negligence has caused a patient’s injuries, and to secure the highest levels of compensation.

Anyone who has suffered serious injury or disability as a result of negligent NHS or private medical care can make a medical negligence claim for compensation. Special rules apply to children, adults with mental incapacity, and claims arising from a fatal injury/someone’s death.

Children and teenagers under the age of 18, or anyone with mental incapacity, must make their claim via a ‘litigation friend’. This is usually a parent or guardian in the case of a child, or a partner or other adult family member in the case of an adult with mental incapacity.  The solicitor handling the claim takes instructions and works closely with the litigation friend whilst ensuring that decisions are made in the best interests of the child or mentally incapable adult who is making the claim.  You can find out more about making a claim for a child.

Some important decisions, such as agreements to settle a child or mentally incapable adult’s claim, must be approved by the court.  Arrangements must also be made to safeguard the child or mentally incapable adult’s compensation, whether from an interim payment, lump sum settlement or agreed future payments. Depending on the claimant’s circumstances, this may be done by paying the money into a Court Funds Office account until the child is 18,  by appointing a Court of Protection deputy or setting up a personal injury trust.  You can find out more about Court of Protection deputyship and personal injury trusts.

If the claim is for bereaved family members and dependants after medical negligence caused someone’s death, the claim must be made by the deceased’s personal representative (executor or administrator of their estate) on behalf of all who are entitled to compensation as a result of the death. You can find out more about making a fatal injury medical negligence claim here.

The NHS has a responsibility to provide its patients with a safe and acceptable level of care. If a patient is seriously injured or their condition is made significantly worse as a result of negligent NHS care, the patient may be entitled to claim compensation.

Compensation can help meet the costs of care, therapies, equipment and home adaptations that are needed when an NHS mistake causes injury or disability that permanently affects the patient’s life.

We are experts at helping clients receive the compensation they deserve from the NHS. We understand the concerns that patients and their families sometimes have about claiming against the NHS. You can read our answers to many of the most common questions on our NHS claims page or speak to one of our solicitors about your own claim by contacting us.

Whilst we cannot guarantee that any particular claim will settle out of court, we take great care in investigating and preparing each claim that we take on. Our clients’ claims usually settle successfully without the need for a contested trial.

Occasionally, cases can only be concluded by a formal court hearing, such as where:

• NHS Resolution, the NHS’s defence organisation, decides to test the courts’ approach to a particular type of claim by taking a case all the way to court;
• there is a point of law in a claim which needs clarification to avoid confusion is future cases;
• where there is strong disagreement between the medical experts for each side about whether treatment amounted to negligence or caused the injury, needing the court to decide;
• where there is a factual dispute about what happened between the parties which must be decided upon by the court before liability can be determined.

Where our client’s claim is complicated by any of the above, we may advise our client that for the case to proceed, it must go to a court hearing. Our caring and highly experienced medical negligence solicitors and barristers ensure that our clients are always kept informed and supported.

Even in non-contested cases, there will be occasions when the case is brought for shorter hearings before the court, such as after a settlement for a child or brain injured adult without mental capacity takes place. In these cases, the lawyers for both sides present the agreed settlement to the court for the judge’s approval.

Each claimant’s compensation is calculated in accordance with mandatory rules based on their individual circumstances.

Compensation for medical negligence should put the injured person back in the position that they would have been in if the negligence hadn’t happened, in so far as money can.

In a medical negligence claim, the amount of compensation depends on:

• the injury or disability that was caused by negligent care, and its severity;
• the cost of meeting the individual’s needs arising from that disability in the past, present and future, e.g. for care, home adaptations, therapies and equipment;
• the financial losses that were caused by the injury, such as loss of earnings;
• how long it is expected that the person will have the need or suffer the loss.

Compensation for medical negligence usually includes a sum for the injury, and sums to compensate for financial losses and the cost of meeting the needs that arise from the disability.

Our medical negligence solicitors ensure clients receive their compensation in the way that is best suited to meet their needs.

Depending on our clients’ injuries, individual circumstances and needs, we can recover compensation to pay for:

• pain, suffering and disability;
• care (professional or provided by the family) and assistance;
• case management;
• therapies, such as:
  • physiotherapy;
  • occupational therapy (OT) ;
  • speech and language therapy (SALT);
  • psychological counselling;
  • pain management;
• assistive technology (IT);
• rehabilitation;
• home adaptations or additional costs of suitable accommodation;
• specialist equipment and aids;
• adapted vehicles, wheelchairs and additional transport costs;
• special educational needs;
• loss of earnings/pension;
• medical treatment and surgery;
• prosthetics (after amputation);
• Court of Protection costs;
• other losses and expenses arising from the injury.

Where medical negligence caused someone’s death, compensation may be claimed by the deceased’s dependants and on behalf of the deceased’s estate. Compensation in a fatal injury medical negligence claim can be paid for:

• the deceased’s pain and suffering and disability prior to their death;
• the deceased’s financial losses and expenses arising from their injury prior to their death;
• funeral costs;
• a statutory, fixed sum bereavement payment;
• a dependant’s loss of dependency on the deceased’s income;
• a dependant’s loss of dependency on other services provided by the deceased, such as child-care, driving, shopping and housework, DIY etc.

There are three ways to fund a medical negligence claim, legal aid, no win no fee, and legal expense insurance.

A medical examination is usually needed to assess our client’s injury. Where our client has suffered multiple injuries or both physical and psychological injuries, they may need to be examined by specialists in each area. This is important to make sure that our client’s injuries are fully assessed and understood, so that they can be properly compensated.

If a medical examination is needed, we instruct the specialist and make the arrangements. We ensure that they have access to our client’s medical records and are aware of the background to the claim. The hospital or doctor against whom the claim is being made may also ask for our client to be examined by their medical expert.