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On Friday 12 October we at Boyes Turner were delighted to welcome case managers, therapists and many others who work with brain-injured children to our Child Brain Injury Training Day. 

The aim of the day was to highlight the issues a child with a brain injury can face but with an emphasis on the wider impact this can have on the family.

We hosted a number of wonderful speakers including: 

• Sharmin Campbell - Director, Celsior Management - spoke about Care and Case Management reports - the legal perspective
• Lindsay Oliver - SLT, Independent Living Solutions - gave a 30 minute guide to Speech and Language Therapy with Children with Brain Injuries
• Marc Beale - Director, Malvern Solutions Ltd - spoke about how assistive technology can help increase independence for brain injured children and their families
•  Joanne Foster & Kate Correal - Case Managers, North Star Case Management - gave us an insight into case management on the ground
• Cheryl Newton - Consultant Paediatric Neuropsychologist - spoke about the invisible injury of children with brain injuries 

We are grateful to all who attended the day and hope the programme offered food for thought for all.

As part of the programme we were delighted to welcome Louise Wilkinson and Lucy Perkins from CBIT (Child Brain Injury Trust). This fantastic charity work closely with the injured child and their family, providing support and information, helping to access appropriate services and educating schools about their role in the rehabilitation process for a brain injured child.

The charity has regional family liaison and support coordinators all over the country who can help and support injured children and ensure as far as possible their needs are met. Lucy is the Thames Valley Coordinator and we were delighted she could join us to talk about the focus of her work with local families.

We are focused on providing treatment, care, and support to brain-injured children and their families but not all families will have the financial support of a claim and therefore CBIT coordinators play a vital role in trying to plug this gap and signpost children and families to local services.

We look forward to working with CBIT in the future and will be signposting clients to them for help where extra support is needed.

Our next fund raising event for the charity will be a GloZumba event held locally to raise awareness about their latest child safety campaign. Be safe. Be seen.

If you would like to support the event or join us please contact Claire Roantree for more information. 

Diabetes is one of the leading causes of amputation of the lower limbs throughout the world. Charity Diabetes UK notes that problems of the foot are the most frequent reasons for hospitalisation amongst patients who have diabetes. The NHS reports that people who have diabetes are 15 times more likely to undergo amputations than other people without the condition.

How can diabetes lead to an amputation?

Diabetes can lead to peripheral artery disease (PAD). PAD causes your blood vessels to narrow and reduces blood flow to your legs and feet. It may also cause nerve damage, known as peripheral neuropathy which can prevent you from feeling pain.

If you can’t feel pain, you may not realise you have a wound or ulcer on your feet and so it is likely that you will continue to put pressure on the affected area, which can cause it to grow and become infected.

Furthermore, reduced blood flow can slow wound healing and it can make your body less effective at fighting an infection. As a result, your wound may not heal and tissue damage or tissue death (gangrene) may occur and any existing infection may spread to your bone. If the infection cannot be stopped or the damage is irreparable, this is when an amputation may be necessary.

How can an amputation be prevented?

Many hospital admissions due to diabetes-related foot problems are preventable if the individual is aware and takes good care of their wellbeing.

Firstly, if you have been diagnosed with diabetes it is important that you maintain a healthy weight and blood pressure. Therefore, eating a healthy, balanced diet and exercising regularly is vital. It is also paramount that you take insulin and other diabetes medications as directed by your doctor and check your blood sugar levels regularly.

Secondly, good foot care as advised by the NHS may help you prevent wounds or ulcers from becoming problematic:

• Do a daily foot check of your entire foot. Look for redness, wounds, bruising, blisters, and discoloration
• Use a magnifying mirror to help you get a closer look at your feet
• If you are unable to check your feet, have someone else check them for you
• Regularly check your feet for sensation using a feather or other light object
• Regularly check to see if your feet can feel warm and cold temperatures
• Wear thin, clean, dry socks that don’t have elastic bands
• Wiggle your toes throughout the day and move your ankles frequently to keep the blood flowing in your feet
• Report any foot problems and neuropathy symptoms such as numbness, burning, and tingling to your doctor right away

What happens if I have had a diabetes related amputation?

Our specialised medical negligence team are experienced in acting for amputee clients who are living with serious disability caused by negligent medical treatment of diabetic complications.

If you would like to find out more about caring for your diabetes check out the Diabetes UK website.

If you have suffered or are expecting to undergo an amputation and would like to find out whether you have a claim, you can speak in confidence to one of our skilled amputation team at mednegclaims@boyesturner.com.

The Health and Safety at Work Act 1974 requires employers to conduct their work in such a way that their employees will not be exposed to health and safety risks. They must also provide information about their workplace which might affect their health and safety. A key element of this duty is to ensure that any asbestos-containing materials in the workplace are managed effectively so that they do not put the safety of employees at risk. 

Why do employers need to manage asbestos?

Asbestos use in the construction and refurbishment of buildings is now illegal in the UK. However, it was extensively used in the 20^th century and, as a result, any buildings built before 2000 may still contain asbestos. 

If asbestos is disturbed or damaged, releasing fibres into the air, these fibres may be inhaled, leading to asbestos-related diseases, including:

• Mesothelioma
• Lung cancer
• Asbestosis
• Pleural thickening
• Pleural plaques

Workers who carry out building maintenance and repair are particularly at risk. 

Past exposure to asbestos currently kills around 4500 people a year, so it is crucial that employers protect their employees from the risk of these life-threatening diseases by ensuring that any asbestos in the workplace is managed properly.

What do employers need to do?

The duty to manage asbestos is detailed in the Control of Asbestos Regulations 2012. Employers need to manage the risks by:

• Finding out if there is asbestos in the premises and, if so, its location and condition
• Maintaining an up-to-date record of the location and condition of any asbestos-containing materials on the premises
• Assessing the risk from the material
• Preparing a plan to manage the risk from the material
• Taking steps needed to put the plan into action
• Reviewing and monitoring the plan and the arrangements made to put it in place
• Setting up a system for reporting on the location and the material to anyone who might work on it or disturb it

What should happen if there is asbestos in the building that represents a risk to employees?

Depending on its condition, some damaged asbestos can be dealt with by repairing it and either sealing it or enclosing it to prevent further damage. Once it has been dealt with, the area must be marked, and it must be included in the employer’s record of asbestos locations. 

If the asbestos cannot easily be repaired and protected, it will need to be removed. The work must be carried out by someone trained and competent to carry out the task, usually an HSE licensed contractor. 

What should happen if the asbestos in the building does not represent a risk?

If any asbestos-containing materials in the building are in good condition and the employer decides that it is safe to leave it in place, they must keep a record of the location and the condition it is in and ensure that this is kept up to date.

They must also ensure that everyone who needs to know about the asbestos is told about its presence. It is good practice to label the asbestos-containing materials with an asbestos warning sign.

Thereafter, it is important to continue to manage the risks from asbestos left in the building. Employers must regularly reinspect any asbestos-containing materials on the premises and keep their records up to date. They must also regularly check that the arrangements they have put in place to control the risks are working effectively.

Detailed information can be found on the HSE website: http://www.hse.gov.uk/asbestos/duty.htm

Boyes Turner’s asbestos-related disease team are specialists in recovering compensation for individuals and bereaved families affected by mesothelioma, lung cancer and other diseases caused by exposure to asbestos.

If you or a loved one have been affected by an asbestos-related disease and you would like to find out more about making a claim, contact us by email at idclaims@boyesturner.com

Last week the annual PACE Rehabilitation Conference took place in London.  Julie Marsh, a specialist medical negligence claims solicitor at Boyes Turner, attended the event to learn more about transforming the lives of amputees.  

The aim of the day was to demonstrate the importance of enabling an amputee to live an active life through effective physiotherapy intervention, a trial of a prosthesis, occupational therapy input and most importantly, a multi-disciplinary approach to the rehabilitation process. 
Together with the team of PACE consultants, the programme included presentations from leaders in the field of prosthetics. Representatives from two mobility and prosthetics specialists, Ossur and Ottobock, talked about the newest developments in prosthetic provision and gave the audience a glimpse of the future, with implanted microprocessors controlling a lower limb device. 

There was a more detailed look at the Michelangelo hand, with a demonstration from two PACE clients.  Both had only been working with the upper limb prosthesis for about 12 months or so, and it became apparent just how much hard work and practice is needed to get the best from a prosthesis.  It was inspiring to watch the patients demonstrate using the hand to perform a variety of tasks, from the mundane picking up and opening a tin of beans, to the more complex task of taking apart and re-building a Lego tower. 

It was also interesting to be reminded of the benefit of a pre-amputation assessment, and how this gives the team at PACE Rehab an advantage and the patient a head start in the rehabilitation process.  The patient can look forward and focus much more on the next steps in their rehabilitation journey rather than becoming fixated on the loss of the limb – an additional and important psychological consideration. 

Another valuable reminder from the day was of how important it is to maintain awareness of the impact of a lower limb amputation on the remaining “good” limb, and the wear and tear that an amputee can place on that leg inadvertently through bad posture or altered gait. This highlighted the value of ongoing physiotherapy input to prevent the patient who successfully leaves the clinic room adopting bad habits to “make do” in an environment that challenges them with every step they take. 

Thank you to Scott Richardson and the PACE team for an interesting and thought-provoking programme. 

Our experienced amputation solicitors understand the importance of a multidisciplinary approach to rehabilitation and appropriate prosthetic provision. If you have suffered or expect to undergo an amputation caused by someone else’s negligence and want to find out more about how to claim, contact us at mednegclaims@boyesturner.com. 

Accidents at work are not uncommon in the UK and can lead to severe, lifelong, disabling injury, including amputation, whether caused directly in the accident (traumatic amputation) or indirectly as a later complication of the original injury.  

Losing a limb is always life-changing, affecting mobility and independence, and reducing earning capacity by limiting the amputee’s ability to return to work.  An employee who has suffered an amputation from a workplace accident may be able to recover compensation where the accident and injury were caused by the employer’s failure to provide safe working conditions and should have been avoided. 

The Health and Safety at Work Act 1974 says that employers have a duty of care towards their employees and are responsible for putting proper precautions in place to ensure that the workplace is safe for all employees. All equipment should be properly maintained, all employees should receive training and supervision on the proper and safe use of machinery and protective guards should be installed, where necessary, to prevent injuries.

Common accidents at work which may result in amputation

• Severing by machinery
  Working with machinery, tools or sharp objects poses an obvious and significant risk to workers across a broad range of industries, including agriculture, engineering, construction and woodworking industries. Amputations are most common when workers operate unguarded or inadequately safeguarded machinery, mechanical equipment and tools. 
   
• Crush injuries 
  Crush injuries can be caused by a heavy item falling directly onto a part of the body or when part of the body becomes trapped in machinery. Faulty equipment or lack of training in operating equipment is often the cause of a crushing injury accident. 
   
• Being struck by an object 
  Workplaces are full of objects which pose a risk to employees, such as falling construction material on a building site, pallets in a warehouse or moving objects or vehicles such as forklift trucks.  Regular inspections and effective management are essential to prevent accidents from occurring.
   
• Electrocution
  High voltage electric shock from unsafe working conditions can lead to impaired blood circulation, gangrene and amputation. 
   
• Laboratory accidents and explosions 
  Unsafe handling of materials can also result in burns, restricting blood flow to the limb or causing serious infection and consequent limb loss.

Boyes Turner’s personal injury team are experienced in recovering high-value damages awards for clients who have suffered serious disability from workplace accidents. Once liability is established we secure early interim payments to help pay for our clients’ essential care and rehabilitation, adapted vehicles, specialist prostheses and adapted accommodation, and to ease the financial hardship that often occurs after a disabling accident, restoring mobility and independence whilst we work on valuing and settling the claim. 

If you have suffered an amputation in a workplace accident and want to find out if you have a claim, contact us at piclaims@boyesturner.com.

Congratulations to the Boyes Turner Orbiteers and our very own Thomas Green who represented the Court of Protection team in abseiling down from the Arcelor Mittal Orbit. The Orbit is the UK’s largest freefall abseil from which you can see London 262 feet above the City. The structure is one of the most striking visual legacies of the London 2012 Olympic and Paralympic games.

Thomas has only been with us for two months but bravely stepped in at the last minute to fill the position of someone who reluctantly withdrew. You can see from the photos that the weather was very kind which was particularly welcome, bearing in mind the height that they abseiled down from.

Funds were raised for Headway which is a fabulous charity working to improve life after brain injury. A brain injury can challenge every aspect of a person’s daily life from walking, talking, thinking and feeling. As Headway state ‘it can mean losing both the life you once lived and the person you once were’.

In many cases a brain injury can be a ‘hidden disability’ so that it is difficult to tell from a person’s outward appearance that they do have a disability. One of the ways that Headway are trying to assist in such a situation is to produce a Brain Injury Identity card so that the police and anyone assisting a brain injured person can identify the fact that they have a brain injury and ensure that they receive the appropriate support. The card is personalised and explains the effects of the brain injury and the support required. These can be obtained from the Headway website www.headway.org.uk.

Headway help people rebuild their life following a brain injury and increase their confidence - hopefully the funds our team raised will assist with this. Thomas said

“It was a wonderful experience which raised money for a good cause and I would definitely love to do it again!”

There are many rewarding aspects to working in Boyes Turner’s mesothelioma and asbestos-related disease team. We are always humbled to be invited into our clients’ homes during the saddest and most vulnerable time of their lives, and regard ourselves privileged to be able to help them achieve justice, recognition and compensation for the asbestos-related injuries they suffered through exposure in the course of their employment.

We work hard to secure lifetime interim payments and settlements, knowing how important home comforts or specialist palliative care are to the dying and their loved ones who continue to support them whilst coping with their own feelings of sadness, anger and loss. With each additional experience and insight that comes from visiting a seriously ill client or talking to their family, our admiration for those who care for them professionally increases.

For this reason and to support important continuing education and research into asbestos-related disease, Boyes Turner offer an education bursary to help lung cancer nurses and other medical professionals caring for victims of asbestos-related disease meet the cost of updating their skills and knowledge.  Awarded selectively, on application, a limited number of education bursaries are available each year. Since 2015, Boyes Turner have sponsored nearly 100 healthcare professionals to attend courses and conferences, including the NLCFN Annual Conference, the Annual BTOG Conference, the International Mesothelioma Interest Group (iMiG) Conference and the World Conference on Lung Cancer.

Simon Bolton, a Mesothelioma UK and lung cancer nurse specialist in Harrogate used his Boyes Turner education bursary to attend iMiG 2018 in Canada:

“I was very fortunate to be able to attend the International Mesothelioma Interest Group (iMiG) conference in Ottawa early this year. Boyes Turner were kind enough to award me an educational bursary to support my attendance.

“iMiG brings together people from across the world who have in some way been affected by mesothelioma, either through personal experience or because of the work we do. The world’s leading mesothelioma experts share practice and learn from one another but also get the opportunity to hear from patient advocate groups.

“In a disease which is always considered to be fatal and with such a high degree of symptom burden you’d be forgiven for assuming that many sessions focussed on symptom control and palliative care. This is far from the case. Researchers from across the globe presented results from clinical trials and showcased future work programs.

“I was extremely proud to be part of a large contingent from the UK who descended on Ottawa for those few days in May. Our research using randomised clinical trials is considered to be the most robust in the world, however, it can be frustrating due to the length of time it takes to complete. Other healthcare systems adopt forms of treatment without fully answering questions about the overall safety and benefit of that therapy. This is particularly relevant in radical surgery for mesothelioma. It was fascinating to observe the heated debates between thoracic surgeons. The UK MARS2 study aims to find if there is a role for radical surgery whilst the rest of the world carry on operating with varying degrees of success.

“Immunotherapy continues to show early signs of promise and featured heavily throughout the conference. There’s still no overwhelming data to support the use of immunotherapy in mesothelioma on the NHS. Clinical trials continue to recruit well and at present remain the only way of accessing the drug other than via privately funding treatment.

“For me, the conference was an opportunity to share some of my own work. I presented three projects, all of which were completed using patient and carer involvement. I look forward talking more about those work streams when I join the team at Boyes Turner later in the year for their annual mesothelioma study day.

“Thank you for supporting my attendance at such an important conference.”

Simon Bolton, Mesothelioma UK and lung cancer nurse specialist, Harrogate, UK.

To find out more about our education bursary click here, or email the team at bursaries@boyesturner.com.

Charcot foot is a serious, limb-threatening complication of diabetes in which the bones of the foot or ankle degenerate and become deformed, leading, if incorrectly treated, to disability and amputation.  

The condition arises from a combination of factors associated with diabetes. Diabetics with neuropathy (loss of sensation) have less feeling in their feet and may also have reduced muscle control and tissue damage. This affects their sense of balance and their walking gait and increases their risk of knocks, sprains and cuts, particularly to the soles of their feet. Diabetic neuropathy also reduces their ability to perceive pain following a minor injury to their feet, which means they can remain unaware of an easily treatable injury, such as a blister, until it becomes infected and ulcerated. As they continue to walk and put pressure on the affected foot , this increases the damage to the bones and tissues and their risk of serious disability.

Charcot foot develops over time but is often triggered by a minor injury, such as a sprain or twisted ankle, which remains untreated because it goes unnoticed.

Who is at risk of Charcot foot and resulting disability?

Diabetics are at risk of developing Charcot foot.

Their risk is increased by:

• poorly controlled diabetes
• reduced sensation (neuropathy) in the feet
• impaired vision reducing the ability to carry out daily visual foot checks
• existing ulceration

How can I reduce my risk of developing Charcot foot?

The key to reducing the risk of Charcot foot and other serious diabetic complications is good management of the diabetes, including good foot care, regular check-ups and prompt medical treatment of any injury (however minor) which could lead to more serious infection.

If an individual with diabetes has reduced sensation in their feet they must carry out daily visual foot checks to ensure that they seek help as soon as possible after a minor injury occurs. If they have impaired eyesight they should ask someone else to check their feet for them.  

They should see their GP immediately if their feet have:

• Minor cuts
• Blisters
• Redness, warmth and swelling
• Discharge or fluid oozing from the foot into socks or tights
• Or if they feel generally unwell

Treatment from the GP might include:

• Antibiotics
• Advice to rest the foot
• A review of their diabetic medication and management
• Referral to a foot-care specialist
• A personal care plan

What are the symptoms and treatment of Charcot foot?

Charcot foot symptoms can include:

• Redness or swelling of the foot or ankle
• The skin feels warmer at the site of the injury
• A feeling of deep aching
• Deformation of the foot

If an individual has a suspected or diagnosed Charcot foot, they should be referred immediately to a multidisciplinary foot care team. Treatment will involve reducing the pressure (or weight-bearing) and immobilising the foot in a plaster cast to allow it to heal in the correct position. The condition will be monitored by x rays and at regular appointments with a podiatrist.

Sufferers of Charcot foot and tissue damage through reduced blood supply are at high risk of limb-threatening infection. At the first sign of a new ulceration, wound, swelling or discolouration, the patient should be referred within 24 hours to a multidisciplinary foot care team for urgent treatment of their infection. Any delay can lead to amputation.

Boyes Turner’s clinical negligence team are experienced in acting for amputee clients who are living with serious disability caused by negligent medical treatment of diabetic complications, including Charcot foot.

If you have suffered or are expecting to undergo an amputation and would like to find out whether you have a claim, you can speak in confidence to one of our skilled amputation team at mednegclaims@boyesturner.com.

We often get asked about asbestos-related lung cancer, what it is, can they claim even though they smoked? Because of this, we have tried to answer some of our most commonly asked questions! 

Q. What is asbestos-related lung cancer?

Apart from mesothelioma, there is no particular type of lung cancer which is exclusively caused by exposure to asbestos dust. Both non-small cell lung cancer and small cell lung cancer can be caused by exposure to asbestos dust.

Q. Can I succeed with a claim for asbestos-related lung cancer even though I smoked?

Even if you were a smoker, it is possible that asbestos exposure has contributed to your lung cancer. This is because of the risk of developing lung cancer increases in direct proportion to the level of your exposure to asbestos dust.

There is no clinical means of distinguishing between lung cancer caused by asbestos and lung cancer caused by smoking. However, there is clear evidence that if you have smoked and been exposed to asbestos dust your risk of lung cancer is significantly increased.

Q. Do I need to have asbestosis to have asbestos-related lung cancer?

The presence of other asbestos-related diseases such as asbestosis, asbestos-related pleural plaques or asbestos-related diffuse pleural thickening can indicate that the lung cancer has been caused by exposure to asbestos dust.

Historically, it was presumed that lung cancer could not be caused by asbestos exposure unless asbestosis was also present. However, research has confirmed that asbestos-related lung cancer can occur without the presence of asbestosis.

Q. Is there a minimum level of exposure to asbestos dust before asbestos-related lung cancer can be diagnosed?

Whether or not your lung cancer can be attributed to asbestos exposure will also depend upon the level of your exposure to asbestos dust. In order to pursue a claim for compensation for asbestos-related lung cancer you must be able to show very heavy exposure to asbestos dust for a short period of time, or moderate exposure to asbestos dust for a long period of time.

Q. How much compensation will I receive for asbestos-related lung cancer?

The amount of compensation awarded for asbestos-related lung cancer will depend upon the individual circumstances of the case. However, general damages for pain, suffering and loss of amenity are generally awarded at between £61,410 and £85,340 (JC Guidelines July 2018). On top of this, a claim can also be made for care and assistance, travel, loss of income and any other losses that have been incurred as a result of the lung cancer.

You should bear in mind that if you have also been a smoker, there may be a deduction to your compensation to reflect the fact that your smoking has also contributed to the lung cancer.

If you would like to talk to one of our specialist solicitors about the possibility of bringing a claim, with no obligations to take matters further then email the team at idclaims@boyesturner.com.