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Peripheral ischaemia is a serious condition in which blood flow to a limb is restricted by narrowing or blockage of the arteries.
'Ischaemia’ means inadequate supply of oxygenated blood to an organ or part of the body. ‘Peripheral ischaemia’ refers to lack of blood supply to a limb.
Where a negligently caused severe injury leaves the individual at risk of needing an amputation in the future, a claim can be made for provisional damages, in which settlement is secured for the current injury, preserving the claimant’s right to return to court for more compensation in the event that the anticipated future amputation occurs.
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The classic signs of acute limb ischaemia are sometimes known as the six Ps.
This refers to when the limb is at rest. Pain on walking might indicate intermittent claudication which is an early, treatable sign of peripheral arterial disease.
Pallor means an unhealthy, pale appearance. An acutely ischaemic limb often appears white in comparison to the other limb. Other discolouration of the limb, such as abnormally pink, blue, mottled or black, suggests more chronic or advanced ischaemia.
Paraesthesia is an abnormal sensation, such as pins and needles, or numbness.
Paralysis is an advanced sign which suggests an element of irreversible ischaemia.
The limb feels very cold when compared to the other limb.
If there is no pulse and ischaemia is suspected, arterial Doppler signals should be checked.
Individuals with Type 1 or Type 2 diabetes, coronary artery and smokers of any age are at increased risk.
1 in 3 diabetics over the age of 50 are affected by peripheral arterial disease.
1 in 5 (20%) of all adults over the age of 60 are believed to have peripheral arterial disease to some degree.
Peripheral ischaemia is one of the most common types of serious medical negligence claim against general practitioners.
This is because delay or failure to diagnose the condition or inadequate or delayed treatment leads to devastating consequences for the sufferer, including ulceration, gangrene and the loss of the limb.
Limb ischaemia leading to amputation can also be caused by surgical errors or delays, such as:
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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:
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:
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:
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:
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.
The law states that, in most cases, someone who has been injured as a result of medical negligence has three years from the date of the negligence which caused the injury to issue court proceedings. If they fail to issue court proceedings within that time, their claim will be statute barred, meaning that they lose their right to bring a claim.
There are the following exceptions to the three-year rule:
Regardless of your time limit, we recommend that you contact our medical negligence solicitors as soon as you can, even if at that stage you are only considering whether to make a claim.
By contacting us early, it avoids later problems with deadlines and allows us to advise you on how to collect and preserve essential evidence. This enables us to ensure you have the best chance of securing your entitlement to full compensation for your claim.
If a baby, child, or teenager under the age of 18 makes a claim for compensation for injuries caused by medical negligence, their claim is made on their behalf by a ‘litigation friend’. This is usually a parent or guardian.
As the child’s solicitor, we have a responsibility to make sure that all decisions relating to the claim are made in the best interests of the child. To do this, we work very closely with the child’s family. Some important decisions, such as settlement agreements or the amount of money that is allocated to a child in a claim involving more than one claimant, must be approved by the court.
We are specialists in helping families obtain full compensation for children who have been very severely injured, leaving them with permanent disability and lifelong specialist needs. Our expert children’s claims service includes a dedicated Court of Protection team who help our clients protect, budget and access their compensation via deputyship and trusts, and an SEN team to ensure that their special educational needs are met. Find out more about how we help families, children, and teenagers with children’s claims.
If you think that you or a family member have received negligent medical treatment or have experienced malpractice, we recommend that you speak to one of our friendly, experienced clinical negligence claim solicitors as soon as possible.
You can contact us by telephone or by email. Your enquiry will be handled confidentially and preliminary advice in relation to pursuing a claim will be given free of charge.
Our medical negligence solicitors will ask you to tell us briefly what has happened, advise you about the limitation deadlines (time limits) which apply to your claim and whether we are able to help you investigate your claim.
Once our initial investigations have taken place, we will notify the defendant (hospital or doctor) of your intention to pursue a claim and invite them to respond, giving them an opportunity to admit liability, before court proceedings are issued.
If liability is admitted, we will enter judgment and apply for an interim payment as soon as possible to meet any urgent needs that you may have as a result of the negligently caused injury.
If liability is disputed, we will discuss with you the further steps that we need to take to progress your claim.
Our extensive guide on making a medical negligence claim explains the whole process, if you require any further information.
The duration of a medical negligence claim depends on the individual circumstances of the client’s case. The claim is likely to take less time to conclude where:
Circumstances which make the claim more complex and therefore take longer to resolve include:
Our medical negligence solicitors work hard to secure early admissions of liability and substantial interim payments so that we can begin to alleviate financial hardship and provide essential care, respite, specialist equipment, therapies and home adaptations long before the claim has settled. With liability judgments secured and interim funds in place, the individual and their family are able to focus on rebuilding their lives whilst we concentrate on valuing and negotiating settlement of the claim.
Compensation is carefully structured to ensure the best provision for the injured person’s needs. Our clients often benefit from different types of compensation, including:
Where healthcare is found to be (legally) negligent, then the claimant (the person making the claim) must prove that their injury was caused or significantly worsened by the negligent care.
This is important because the patient may already be very ill when they receive negligent medical care. In those circumstances, they must prove that their injury (and its financial consequences) would have been avoided or greatly reduced if correct treatment had been given. This aspect of the medical negligence claim is known as ‘causation’. Causation must be proven, even if negligence is admitted, for the claim to succeed and compensation to be awarded.
Negligence and causation must be proven by supportive opinions from medical experts. We instruct experts in the same field of medicine as the negligent care to tell us whether the care that was given was of a reasonable standard. If negligence is proven, we ask medical specialists in the type of injury suffered, to confirm whether our client’s injury was caused or made worse by the negligent treatment, or would have been reduced or avoided with correct care.
In a medical negligence claim, compensation will only be paid for injuries and loss that we can prove were caused by the healthcare provider’s negligence. Once we know what mistakes were made, the next step (causation) is to identify the extent of the injury or disability that was caused by those mistakes.
Proving causation in complex medical negligence cases requires both medical expertise and understanding of the law. We often succeed in claims where NHS Resolution (the NHS’ defence organisation) has denied ‘causation’. You can read more about how we overcome difficulties with causation in complex birth injury cases.
The NHS defines amputation as the surgical removal of part of the body, which could be a leg or an arm, fingers or toes There are two main situations where an amputation can happen:
Traumatic: A sudden and catastrophic accident can result in the immediate loss of a limb. Some of the most common causes include motorbike accidents, cycle accidents or accidents at work, for example on a construction site or involving dangerous or heavy machinery.
This is known as traumatic amputation. In the immediate aftermath, it can be a life-threatening injury due to the loss of blood involved. It is not fatal in many cases – but long-term effects can be particularly distressing.
Surgical: Some injuries suffered in a serious accident can be so severe that doctors – as well as patients – must consider amputation as a last resort. There are numerous reasons why this may be the case in your experience, which can include:
It is not only injuries suffered in an accident that can result in a surgical amputation. It can also be one of the most serious consequences of medical negligence or mistreatment. Conditions such as sepsis or diabetes are a common cause of surgical amputations in the UK.
How is a surgical amputation performed?
An amputation is usually carried out under a general anaesthetic or an epidural anaesthetic.
There may also be times when additional techniques are needed during surgery to help improve the function of the residual limb and reduce the risk of complications. These include:
Amputations are relatively rare – but that is little consolation if you are coming to terms with the loss of a limb or another part of your body.
For 2018-9, there were nearly 18,000 finished consultant episodes (FCE) in NHS hospitals across England where an amputation was performed. The total number was up 3% on the previous year and covers a variety of causes – including serious trauma and accidents.
The most common type of amputation performed involved the lower limbs.
But data from NHS hospitals in England does also show a 5% drop in the number of FCEs dealing with traumatic amputations. This figure was, however, still more than 4,700 – with 90% of these involving the wrist or hand. Men appear more likely to experience amputation than women too.
The loss of a limb has a major impact – and not just physically. Effects are also often emotional, psychological and financial. Here are some of the common ways that you may be affected:
Physical: After an amputation, the remaining limb takes time to heal and may be painful. How long you must stay in hospital will depend on the type of amputation and your overall health. It can also affect:
Psychological: An amputation can also have an impact that is often unseen. If you lose a limb or another part of the body, you may experience a range of emotions such as:
No matter how the loss of a limb affects you, our amputation solicitors can help you to find the rehabilitation and counselling you need to rebuild as part of the claims process.
It can take several months before a prosthetic limb can be fitted. But one might not be suitable for you – especially if it is a lower prosthetic limb. This will depend on:
You can – and a prosthetic expert can recommend an alternative prosthesis for you. The cost of a suitable, custom-made limb – plus any cosmetic covering – will be included in the amputation claim. We will seek an interim payment to fund the best limb for you as quickly as possible.
A prosthetist can also consider extra prosthetics specific to your interests and hobbies – such as running, cycling or swimming, as well as replacement prosthetics
Two of the most common types of amputation include:
Lower limb amputation
Upper limb amputation
An amputation can also be performed on other parts of the face and body, such as the nose or breast. For more information about the different types of amputation, the Limbless Association has created a factsheet.
Doctors as well as patients generally consider amputation as a last resort. Some of the reasons that amputations can be beneficial are:
Like any surgical procedure, an amputation is not without its risks. In the immediate aftermath of your surgery, this can include post-operative pain, bleeding or phantom limb pain – the feeling of pain or sensation in the limb that is removed.
Later risks can include muscle contractures, infection or pressure sores caused by a lack of mobility or unsuitable prosthetics/liners/sockets, hip or back strains and pains, as well as the need for further surgery, deep vein thrombosis or heart problems.
It is important that the medical experts in your case identify any likely risks in the future to ensure that this is taken into account when settling your claim.
The remaining limb will take time to heal and may be painful. The length of the hospital stay will depend on the type of amputation carried out and general state of health.
After recovery of the surgery, a number of different health professionals, such as an occupational therapist and physiotherapist, will help to form a care plan before the patient is discharged home.
It can take several months before a prosthetic limb can be fitted if one is appropriate. The residual limb will change in shape and size over a period of 12-24 months. This means that fitting the prosthesis is likely to be an evolving process over this period of change.
People who have had an amputation often experience a psychological impact of the procedure. They may suffer from depression, or grief and a form of bereavement that has been recognised as similar to experiencing the death of a loved one.
Our medical negligence and personal injury teams have been nationally recognised for over 20 years because of their expertise, empathy and commitment to securing maximum compensation for our clients.