Amputation Injuries

• According to the Amputee Coalition, roughly 2 million Americans presently live with limb loss:
• 54% due to vascular disease (includes diabetes and peripheral arterial disease)
• 45% due to trauma
• < 2% due to cancer
• Approximately 185,000 amputations are performed each year in the United States and over 500 Americans lose a limb each day
• In 2009, hospital costs associated with amputations exceeded $8.3 billion

Many accidents can cause amputation. Blunt force trauma, however, is a major cause of limb loss. According to the Amputee Coalition, 45% of American amputees lose limbs due to trauma. Below are some types of trauma that can cause an amputation:

• Workplace accidents
• Truck accidents
• Car accidents
• Motorcycle accidents
• Pedestrian accidents
• Boat accidents
• Construction accidents
• Dog Bites
• Product defects
• Product design defects
• Product manufacturing defects
• Premises Liability
• Medical Malpractice

When you have suffered an amputation as the result of an accident, it is important to get an experienced attorney to guide you through the legal process and help you establish a legal strategy based on the specific facts of your case. It also helps to get an experienced attorney to assist with the additional burdens that come with an amputation case, such as speaking with insurance adjusters, establishing social security assistance, resolving outstanding medical bills and, if applicable, dealing with Medicaid/Medicare. Each step can be complicated, and it is important that you hire someone who is well versed in the area of law to be an ally by your side.

The most important part of an amputee case is demonstrating liability and the damages or costs associated with the injury. An experienced lawyer will be able to clearly show the damages incurred from medical treatment, counseling, physical therapy, prosthetics, home modifications, future treatment, etc. It is important to have an attorney that truly understands the future care that an amputee will need to ensure they are fully compensated for the loss and covered moving forward. Only attorneys who have extensive experience with catastrophic injuries can do this.

Losing a limb is more than a one-time injury. It lasts for the rest of a victim’s life. Usually there is extensive follow-up care that comes after an amputation, such as rehabilitation or psychological care. A person who loses a limb may require medical attention and prosthetics for the rest of his or her life and may lose the ability to perform daily functions without assistance. Thus, the physical toll adjusting to the new normal may extend well beyond the time of the catastrophic accident itself.

Losing a limb can restrict an amputee’s ability to live independently. An amputee may not be able to bathe, dress, or use the restroom without assistance. Losing a limb makes it difficult to perform routine daily functions and household chores alone, such as washing dishes or carrying in groceries. When an amputee loses an upper or lower extremity, such as an arm or a leg, his mobility and balance can decline. If you lose an arm, you may have difficulty protecting yourself. If you lose a leg, your gait may be affected.

An amputee can suffer from loss of sensation, deficient skin integrity, lower endurance and poor health status due to an amputation. Additionally, after an amputation, an individual can still suffer from residual limb pain. This pain can be associated with post-surgical complications, swelling, infection, pinched nerves, bone spurs, abnormal bone growth in soft tissue, or the prosthetic itself. Many amputees suffer from ongoing painful sensations coming from the limb that is no longer there, referred to as phantom limb pain. According to the Amputee Coalition, victims can feel sensations of phantom limb pain up to years following the amputation. Other physical complications that come with losing a limb include disuse or atrophy, overuse of the other “intact” limb, gait disturbance, or injury.

Where a prosthetic is required following an amputation, there are many factors that must be considered. In an amputee’s initial consultation with a Prosthetist, physical factors that are considered are the length of the limb, condition of the skin following amputation, pain level, strength level, range of motion, cognitive and physical ability of the amputee and the amputee’s overall rehabilitation goals.

An amputee’s goals regarding rehab and the prosthetic may be mobility, self-care, function within the home, function within the community, cosmetic restoration following amputation, socialization, recreation, vocation, care for the residual limb and sound limb, prevention of over-use.

The financial impact of losing a limb can include the cost of medical bills and treatment, homecare bills, physical therapy and rehabilitation bills, prothesis bills, lost income (you may never be able to return to work) and lost earning capacity (you may never be able to make the same money you were making before the amputation), home and vehicle modifications.

Losing a limb can affect an amputee’s ability to do his or her job. As a result, the amputee can incur lost wages while he is out of work during treatment or because he can no longer work. When returning to work, an amputee may require retraining or job modifications to continue to perform the daily tasks required of him to earn an income. Additionally, an amputee may have a claim for loss of earning capacity, if he can no longer do the same job he was performing prior to the amputation.

Depending on the nature of the amputation, an amputee’s home may need to be modified to assist with daily living. Where an amputee has lost an arm, he may require items to compensate for “one-handed function” or limited reach. This can include things such as accessible storage, cabinets and drawers, lever door handles and faucets, knee/foot pedal operated faucets, walk-in shower, bidet toilet and keyless entry to the home. When an amputee has lost a leg, his home may need to be modified to accommodate one-level living. The home will need be made wheelchair accessible to allow for function without the use of a prosthesis on and using a wheelchair. These modifications may include wheelchair accessible bathroom and kitchen, accessible storage, ramped entries and protected parking. Home modifications such as the ones listed can be costly, adding even more of a financial burden on an amputee.

Following limb loss, daily activities can be more difficult to perform. For example, an amputee may have difficulty climbing and reaching overhead. An amputee may be unable to kneel or crawl. An amputee may have difficulty carrying items, especially when ascending or descending stairs. An amputee may struggle styling hair, applying makeup, brushing teeth, shaving. An amputee may not be doing daily chores such as vacuuming, making the bed, or carrying out trash.

In addition, there is, of course, the emotional toll of physically losing a part of you. Following limb loss, there is generally a period of depression and mourning, not only for the limb itself but also for the life you had before the injury. An amputee may require recurring psychological treatment and care following an amputation to deal with the new normal that comes from losing a limb. An amputee may need counseling to cope with changes in body image, functional limitations, pain, role changes, cultural factors, socialization issues, or perceived vulnerability. If the limb was lost because of a traumatic accident, an amputee may suffer from PTSD reliving the trauma that caused the limb loss. Therapy costs can add an additional financial strain on an amputee, especially when an amputee will require ongoing psychological support for years to come.

A Life Care Plan is an in-depth report that details an amputee’s current and future financial needs and expenses associated with his care following an amputation. The report opens with information about the amputee, such as his background and his pre-injury status. It then outlines the amputee’s current status, describing the amputee’s functional deficiencies and changes to his life following the amputation.

A Life Care Plan must consider multiple modalities of an amputee’s life. The Life Care Plan must consider an amputee’s treatment and subsequent medical surveillance. It must consider the need for surgery, or any distinctive symptoms or characteristics from which the amputee suffers. It must consider subsequent pain management and medications that must be taken following an amputation and for the rest of an amputee’s life. It must consider the physical therapy and rehabilitation required following an amputation and how long that must continue. It must consider any psychological counseling required after the limb loss. It must consider any equipment or prosthetics the amputee may need. It must consider the costs of attendant care and replacement services. It must also consider any housing modifications that must be made following an amputation.

Following an amputation, an amputee will be required to meet with several types of specialists for treatment and surveillance during the healing process. A treatment plan will be developed that is tailored to the health needs and interests of the amputee. Follow up care will include a focus on maintenance, prevention, and crisis intervention, if necessary. An amputee can meet with orthopedic surgeons, psychiatrists, vascular surgeons, and prosthetists. An amputee will require clinical evaluations, MRIs, x-rays, and CT scans during the healing process. It’s also possible that an amputee will require surgical revisions of the amputation. All these visits add to the medical expenses incurred as a result of the accident, adding to the damages of the plaintiff-amputee.

Through the entire process, from the traumatic accident that caused the amputation to the years of healing following the amputation, an amputee suffers from different stages of pain. These stages can be distinguished as postoperative pain, phantom pain, and phantom sensation. Consequentially, each stage requires a different pain management strategy and must be carefully monitored. Postoperative pain tends to require short-term narcotics. Phantom pain, as described above, is ongoing painful sensations coming from the limb and can require pain medication to resolve the nerve pain. Phantom sensation requires no pain medication but merely reassurance that the feelings are normal and a part of the process of recovery. Phantom sensation can include cramping, moving of missing limb, burning, stabbing, shooting, tightening, squeezing, twisting, gnawing pain of the missing and remaining limb.

Pain management is an important factor in an amputee’s recovery. For example, if the pain is not properly managed in the limb, it can result in serious consequences such as over-use of the non-injured limb. Follow up pain management can be a significant cost, further impacting a plaintiff’s damages and ultimate recovery.

Depending on the nature of the injury, the specific physical and occupational program may vary. An amputee may require intensive therapy or maybe only a short-term program. The therapy may be for maintenance or for crisis intervention. Most amputations will require a home exercise program to rehabilitate the limb. Such programs are intended to improve range of motion and strength. The intention will be to assimilate the amputee to performing the activities of daily living and prevent over-use of the contralateral limb. Much like pain management, follow-up therapy comes at a significant cost and may substantially impact a plaintiff-amputee’s damages depending on the frequency and the duration of the treatment.

Following an amputation, an amputee will require the use of varying equipment to assist the amputee with daily life. That equipment may be for mobility, such as a wheelchair, cane, crutches, scooter or stair-glide. For self-care, an amputee may require certain items for bathing and hygiene, such as a shower chair, hand-held shower head, toilet mount, or bidet. An amputee may require reachers and wheeled carts for daily living activities or an environmental control unit to control their home’s climate. An amputee may also need automobile modifications such as foot pedals, keyless entry, hand controls, scooter lifts or accessible van. These pieces of equipment and modifications add to the cost incurred by an amputee following a catastrophic accident, increasing an amputee’s ultimate damages.

Obviously, the exact prosthetic required following an amputation will be specific to the amputee’s case. That being said, there are certain prosthetic supplies that can generally be anticipated for amputations of both upper and lower extremities. In both instances, an amputee will require liners, socks and sleeves to protect the remaining portion of the limb. If an amputee lost a leg, the surviving portion of the limb will require a shrinker to fit into the prosthetic. An amputee may also require skin care products to heel the skin on the limb. Additionally, the prosthetics themselves will require replacement sockets. Much of these supplies will need to be replaced multiple times over an amputee’s remaining lifetime, adding to the incurred cost resulting from the amputation.

Very often an amputee requires counseling following an amputation. Counseling assists the amputee with the process of mourning the lost limb and dealing with the subsequent changes in body image. Additionally, it can be hard for an amputee to cope with the new functional limitations he or she faces on a daily basis in addition to the recurring pain following an amputation. It also can be difficult for an amputee to adjust to their new role in their home environment and cope with the perceived socialization and cultural issues that are assumed following an amputation. Recovery from the emotional impact of an amputation can take as long a physical rehabilitation, sometimes even longer. That is why counseling can be an important factor in the recovery process and can impact the damages that an amputee incurs.

Finch McCranie, LLP has been around for over 50 years practicing in catastrophic personal injury. As a boutique firm, we ensure we provide undivided and individualized attention to each client that hires us. Our firm follows the golden rule and will help you through your case as we would want someone to help us through our own. If you want a team that will back you up and passionately represent your case, you will want Finch McCranie, LLP to represent you.