Boyes Turner’s amputation specialists have secured a liability judgment for a 40-year-old diabetic man who suffered a below knee amputation after the nurse practitioner at his GP’s surgery failed to refer him to a multidisciplinary foot care (MDFC) team in accordance with National Institute for Health and Care (NICE) guidelines. Our client attended the nurse practitioner complaining of a painful, warm, potentially infected, swollen and discharging right foot, having stepped on glass the day before. He hadn’t felt the injury at the time as he had diabetes-related reduced sensation in his foot. The nurse failed to comply with NICE guidelines which stated that a known diabetic claimant with a foot-care emergency should be referred to a MDFC team within 24 hours and administered antibiotics without checking the patient’s systemic health. If the referral had been made and our client had received the correct treatment he would have been seen by a MDFC team the same day, admitted to hospital for intravenous (IV) antibiotics and further treatment, and would have avoided sepsis and amputation. Our client attended A&E three days later, where they also failed to check his medical history, his diabetic health and his blood glucose. He was sent home and his foot continued to deteriorate. A further three days later, his wife called and pleaded with the surgery for a home visit as her husband’s foot was painful, black and blistering. The GP visited a day later and found our client’s foot to be necrotic, requiring admission for IV antibiotics and surgical debridement (removal of dead tissue). He was taken to hospital by ambulance and a below knee amputation was carried out. He has undergone eight operations and has extreme stump pain which means that he can’t tolerate a prosthesis without further surgery. He is wheelchair dependant, unable to work in his former job and has suffered a psychiatric injury. Boyes Turner’s amputation specialists pursued the claim. The defendant nurse admitted negligence but denied causation of our client’s amputation, referring to past non-attendances in his medical history and requiring him to prove that he would have accepted a referral, attended the appointment and cooperated with treatment. They argued that he had contributed to his own injury by delaying seeking further medical advice after seeing the defendant nurse. Boyes Turner served statements from witnesses and reports from experts in microbiology, diabetic medicine and vascular surgery in support of our client’s case. The defendant failed to serve any witness or expert evidence to support his denial of causation. Our experts in orthopaedics and prosthetics advised that the client should undergo a “trial of prosthesis” to assess his ability to use a prosthesis and his need for higher level amputation surgery. This will help establish whether the client’s mobility and independence can be restored in the hope of optimising his physical and psychological recovery before assessing the extent of his future care and accommodation needs. Boyes Turner negotiated an adjournment of the trial and secured a full liability judgment for the claimant, together with an interim payment of £100,000 for pay for the trial of prosthesis. We are now working with our experts to value the claim. You can read more about our client’s interim payments and final compensation settlement here. If you have suffered an amputation through a delay in treatment email our specialist lawyers firstname.lastname@example.org.