AMPUTATION PERSONAL INJURY LAWYER CHICO CALIFORNIA (Amputation cases in California)

Amputation

An amputation is when a trauma crushes or severs (car wreck, dangerous piece of farm equipment, etc.) or doctors remove, a part of the body, such as an arm or leg.

Amputations are obviously very traumatic for the person (and family of the person) who has suffered an amputation. If the amputation is caused by the negligence of another, such as a car wreck, dangerous product, work injury, etc., you will almost always need a personal injury lawyer familiar with handling these cases.

Some of the cases we work on involve traumatic amputations where an arm or leg is severed in a high speed car crash, by a dangerous machine part, or some other traumatic event; other times there is a serious crush injury wherein the limb is injured but not amputated; but later, despite efforts by doctors, amputation is required because the limb is too badly damaged and must be amputated.

Why an amputation may be needed?

There can be various reasons, but our cases usually involve a trauma or complications after a trauma (like from a car collision or crushing injury) that directly or indirectly leads to an amputation.

Assessment before surgery

How amputations are carried out

Amputations can be carried out under general anesthesia (where you're unconscious) or using an epidural anesthetic (which numbs the lower half of the body).

Once the limb or portion of the limb has been removed, a number of additional techniques can be used to help improve the function of the remaining limb and reduce the risk of complications.

After the amputation, your wound will be closed with stitches or surgical staples. It will be covered with a bandage and a tube may be placed under your skin to drain away any excess fluid. The bandage will usually need to be kept in place for a few days to reduce the risk of infection.

Recovering after an amputation

After surgery you will be in the hospital, likely on an IV Drip, oxygen, pain medications, etc. The length of your hospital stay will depend on many factors, including your health, doctor decision, insurance coverage, etc. This time will be hard and difficult. The good news is that once surgery has taken place, you are hopefully on the road to recovery.

Compression garments

After surgery you may have swelling of your stump. This is usually normal and it may continue after you've been discharged.

Using a compression garment can help with swelling and the shape of the stump. It may also reduce phantom pain and help support the limb.

You'll be fitted with a compression garment once your wound has healed. It should be worn every day, but taken off at bedtime. You should be given at least 2 garments, which should be washed regularly. (Follow the instruction of your doctor).

Rehabilitation

Physical rehabilitation is an important part of the recovery process. It can be a long, difficult and frustrating process, but it's important as cases that seem impossible and hopeless can be anything but. After rehabilitation, the hope is that you can return to your normal life, work, recreation, etc.

Your rehabilitation should be tailored to your individual needs and requirements with the hope of trying to return you to your pre-injury status.

We can help you get treatment with physical medicine and rehabilitation doctors, physical therapists and occupational therapists who will discuss with you what you'd like to achieve from rehabilitation so that some realistic goals can be set.

Rehabilitation will usually start within a few days of surgery, beginning with some simple exercises you can do while lying down or sitting. If you've had a leg amputation, you'll be encouraged to move around as soon as possible using a wheelchair.

You'll also be taught "transfer techniques" to help you move around more easily, such as how to get into a wheelchair from your bed.

Once your wound has started to heal, you may start to exercise to try and gain strength and help you maintain your mobility and muscle strength.

If you have a prosthetic limb fitted (see below), your prosthetic expert will have you fitted, explain the options and the therapy behind it and try to figure out what your insurance (if you have insurance) will cover. They can teach and explain how to walk on a prosthetic leg, grip with a prosthetic hand and some of the techniques to get you independent.

Going home and follow-up

The length of time it will take before you're ready to go home will depend on the type of amputation you've had and your general state of health.

Before you're discharged from hospital, an occupational therapist may arrange to visit you at home to see whether your home environment needs to be adapted to make it more accessible.

Your house may need retrofitting (which is an element of recoverable damage in your case); for example you might need a wheelchair ramp or a stairlift.

It can take time before you're fitted with a prosthetic limb (if you're a suitable for one), so you may be given a wheelchair to help you get around if you've had a lower limb amputation; although hopefully you will meet your prosthetic specialist earlier to start planning for the prosthetic that will be so important to activity resumption and life quality.

You'll probably need to attend a follow-up appointment a few weeks after being discharged to discuss how well you're coping at home and whether you require additional help, support or equipment.

At your appointment, you may also be given details of your nearest amputee support group, made up of both healthcare professionals and people living with an amputation.

Prosthetics

After an amputation, you may be able to have a prosthetic limb fitted.

Prosthetic limbs aren't suitable for everyone who's had an amputation because an extensive course of physiotherapy and rehabilitation is required (see below).

Adjusting to life with a prosthetic limb takes a considerable amount of energy because you have to compensate for the loss of muscle and bone in the amputated limb.

Motivation can be the key. One of my clients could run and climb within an incredibly short time after surgery. He was extremely motivated, physical and an inspiration.

If a prosthetic limb is not workable for you, a purely cosmetic limb is an option. The cosmetic limb looks real but is not functional.

It's possible to have a prosthetic limb that's both physically realistic and functional, but there may have to be an element of compromise between the two.

Preparing to have a prosthetic limb fitted

In our area there is an awesome and dedicated professional named Matt Daniels from Elite Bio-Mechanical design. He has helped several of my amputee clients. There are many other knowledgeable professionals as well. It is important to work with an experienced and passionate person (like Matt) to get the best results.

Before a prosthetic limb is fitted, the skin covering your stump may be made less sensitive (known as desensitization). This will make the prosthetic more comfortable to wear.

Your health care professionals can explain how this process works.

Your therapist will teach you a range of exercises to strengthen the muscles in your remaining limb and improve your general energy levels, so you're able to cope better with the demands of an artificial limb.

Depending on what's available in your local area, it can be several months before you get your first appointment with a prosthetist (specialist in prosthetic limbs).

Stump care

It's very important to keep the skin on the surface of your stump clean to prevent infection or irritation. It is very important that your doctors instructions are followed to the letter.

You may be instructed to gently wash your stump at least once a day (more frequently in hot weather) with mild unscented soap and warm water, and dry it carefully and to regularly clean the socket using soap and warm water.

Your doctor may advise that for bathing or swimming, avoid leaving your stump submerged in water for long periods because the water can soften the skin on your stump, making it more vulnerable to injury.

You may be instructed to use a moisturizer before bedtime or when you're not wearing your prosthesis.

Your doctor may advise that wearing one or more socks around the stump helps absorb sweat and reduces skin irritation. The size of your stump may change as the swelling goes down, so the number of socks you need to use may vary. You should change the socks every day.

Contact your doctor for advice if you think you may be developing a skin infection.

Caring for your remaining limb

After having a leg or foot amputated, it's very important to avoid injuring your remaining "good" leg, foot or arm. You can over-use your non-injured limb, step wrong, etc. Your doctor can explain techniques to help minimize this possibility.

Avoid wearing poorly fitting footwear and ensure that an appropriately trained healthcare professional, such as a podiatrist, is involved in the care of your remaining foot. You should also be offered a regular review of your foot by the foot care team.

Complications

Like any type of surgery, an amputation can have complications. It also carries a risk of additional problems directly related to the loss of a limb.

There are a number of factors that influence the risk of complications from amputation, such as your age, the type of amputation you've had, and your general health.

The risk of serious complications is lower in planned amputations than in emergency amputations.

Stump and "phantom limb" pain

Many people who have an amputation experience some degree of stump pain or "phantom limb" pain. This is one issue among many that go into the calculation of the pain and suffering money damages available in a personal injury amputation case.

Phantom limb sensations are sensations that seem to be coming from the amputated limb. Occasionally, these can be painful (phantom limb pain).

The term "phantom" doesn't mean the painful symptoms are imaginary. Phantom limb pain is a real phenomenon, which has been confirmed using brain imaging scans to study how nerve signals are transmitted to the brain.

The symptoms of phantom limb pain can range from mild to severe. Some people have described brief "flashes" of mild pain, similar to an electric shock, that last for a few seconds. Others have described constant severe pain.

Stump pain can have many different causes, including rubbing or sores where the stump touches a prosthetic limb, nerve damage during surgery and the development of neuromas.

Treating stump and phantom limb pain

Stump and phantom limb pain will usually improve over time, but treatments are available to help relieve the symptoms. As mentioned, I have had clients who made remarkable recoveries after amputations and there is every hope that you will as well.

Medications

Medications that may be used to help relieve pain include:

• Non-steroidal anti-inflammatory drugs (NSAIDs) – such as Ibuprofen
• Anticonvulsants – such as carbamazepine or gabapentin
• Antidepressants – such as amitriptyline or nortriptyline (these medications work directly on the nerves in your leg)
• Opioids – such as codeine or morphine (Addiction issues can happen).
• Corticosteroid or Local anesthetic injections

Self-help measures and complementary therapy

Some things that have been shown to help are:

• Checking how your prosthesis fits and making adjustments to make it feel comfortable (Somebody like Matt Daniels can help with this)
• Applying heat or cold to your limb, such as using heat or ice packs, rubs and creams
• Massage – to increase circulation and stimulate muscles
• Acupuncture – thought to stimulate the nervous system and relieve pain
• Transcutaneous electrical nerve stimulation (TENS) – where a small, battery-operated device is used to deliver electrical impulses to the affected area of your body, to block or reduce pain signals
• Positive thinking or imagery (see below)

Research has shown that people who spend time imagining using their phantom limb, such as stretching out their "fingers" or bunching up their "toes", experience a reduction in pain symptoms.

This may be related to the central theory of phantom limb pain (that the brain is looking to receive feedback from the amputated limb), and these mental exercises may provide an effective substitution for this missing feedback.

Another technique, known as mirror visual feedback, involves using a mirror to create a reflection of the other limb. Some people find that exercising and moving their other limb can help relieve the pain from a phantom limb.

Psychological impact of amputation

The loss of a limb can have a considerable psychological impact. Many people who've had an amputation report feeling emotions such as grief and bereavement, similar to experiencing the death of a loved one.

Coming to terms with the psychological impact of an amputation is therefore often as important as coping with the physical demands.

Having an amputation can have a considerable psychological impact:

• You have to cope with the loss of sensation from your amputated limb
• You worry that you can never work, recreate, socialize or live normally
• You have to cope with the loss of function from your amputated limb
• Your sense of body image, and other people's perception of your body image, has changed

Negative thoughts and emotions are common after an amputation. This is particularly true in people who've had an emergency amputation because they don't have time to mentally prepare for the effects of surgery.

Traumatic amputation can also cause post-traumatic stress disorder (PTSD).

Talk to your health care providers about what you are experiencing, particularly if you're feeling depressed or suicidal. You may need additional treatment, such as medications or counselling.

Help and support

Being told you need to have a limb amputated can be a devastating and frightening experience. Adjusting to life after an amputation can be challenging, but many people enjoy a good quality of life once they have managed to adapt.

There are support groups for people living with amputations that can be a good resource.

THE LEGAL CASE AND HOW YOUR LAWYER CAN HELP

As mentioned above, in many cases we can help find health care professionals experienced in treating amputation victims to help get you back as much as possible to your pre-injury state.

The basic avenues of recovery in a civil personal case are:

Past and future medical bills;

Past and future wage loss;

Past and future pain and suffering.

There are many strategies we employ to maximize the compensation you are entitled to. We utilize technology to put together a rendition of the trauma (Recreation of the motorcycle wreck, truck crashing into your car, etc.) as part of our job is to bring the trauma alive for either an insurance adjuster, defense lawyer, or jury.

We will also utilize technology to show your injuries, your surgery, your recovery period and any other important component of your case. We will interview friends, family, employer, police officer, etc., to get the best handle we can on what happened to you, the person you are, and the losses you have suffered.

A life care plan is mandatory in an amputation case. A life care plan is a list of all of the future medical treatment, medications, testing, etc., that will be needed to treat your amputation for the rest of your life. For example, prosthetics will wear out. How often must they be replaced?

We get the items, types, list, etc. of the treatment you will need from your doctors, doctors that we hire, and any other important source. The Life Care Planner then utilizes their expertise to put prices on the future medical care. This step is very critical in making the case work out.

Most amputation life care plans will cost several million dollars or more when forecasted outwards for the remainder of somebodies life.

Adequate insurance on the part of the tort-feasor (at fault careless person) or with your own coverage is essential to making these cases work out.

CONCLUSION

Amputation cases are very serious. You need a lawyer with experience in handling these cases and who has represented amputees in similar cases.

(The above may be construed as attorney advertising. No guarantee or result promised). This article is also not to be construed as medical advice; rather it is for informational purposes only. Only take medical advice from your doctor or health care provider.

Attached below is a previous blog article pertinent to amputation cases. Please give it a read if you have time.

YOUR CHOICE OF A LAWYER CAN COST YOU $1,000,000.00.

I am sometimes asked “Who is the best personal injury lawyer in Chico” or “Why should I hire you”?

In response to a question like this I could talk about the fact that I am an ABOTA member (only about 1% of all lawyers worldwide are. You must be invited to join, have completed in excess of a certain amount of civil trials, etc.), all of the trial experience I have, more than 25 years of experience practicing law, results produced, etc.; however, a case I handled this year provides a good example of what an experienced personal injury lawyer can do for their client (and in this case an actual example of why hiring me brought my client an extra million dollars).

A man was riding his motorcycle on Esplanade when a van tried to make a left turn and hit him. His lower leg was seriously injured at the scene. The ligaments were re-attached at the hospital and the man was later sent home. Unfortunately the damage was too great, and he later had to have part of his lower leg amputated.

The van that hit the man was a regular looking unmarked van. It did not look commercial and did not have any company logo, etc.

When I first met with the man, I was very sorry to see what had happened to him, but was amazed at his strength, determination, and positive outlook (he was ex-military; God Bless our service men and women).

The van was insured by one of the well-known car insurance companies. After some initial game playing, they finally disclosed that the insurance policy limits were $300,000. (Please see my last two Blog articles on Insurance Primer and What in the world is policy limits).

The insurance company offered to send the closing paperwork and a check for $300,000 (out of which would be paid medical bills, attorneys fees, etc.). I knew $300,000 would not be enough to compensate this nice man and would not come close to providing the help he would need going forward with a below the knee amputation.

The problem facing us was that you are normally stuck with accepting a policy limits settlement, unless there is under-insured motorist coverage or another insurance policy (Personal assets can be pursued but often does not make economic sense).

Before thinking about settling, I wanted to make sure nothing was being missed. A little research revealed that the at-fault driver was self-employed as a courier. Most self-employed people are considered independent contractors, so the fact that the at-fault driver had his own small business did not seem to help (it was a really small business run out of his home).

I also received confirmation from the courier’s insurance company that there was no other insurance available and again offering to send a check for $300,000; however, the fact that the van driver operated a courier business got me thinking. Maybe he was delivering packages for a larger outfit when this collision occurred? If so, then there may be a Non-Delegable Duty which would allow legal responsibility on the company for whom the courier was delivering?

Suit was filed (in order to gain subpoena power and to initiate discovery).

After working on the case for a while, I was able to tell my client (Who placed his faith in me and told me he trusted me and to please give it a shot if I thought there might be another way to help him besides taking the $300,000 settlement) that the courier was delivering packages on behalf of another larger courier company. I contacted the new company and was told I had no case because the courier who caused the collision was an independent contractor.

Nonetheless the new company was added to the lawsuit. The new company disclosed in discovery that they carried a $1,000,000.00 insurance policy. The new company hired a very excellent and experienced lawyer. That new lawyer looked into the case, took some depositions and did his due diligence.

I prepared an extensive brief on the subject of the non-delegable duty exception to the normal Independent Contractor rule of non-liability for the hirer of an Independent Contractor. Not long after, the new company tendered the new $1,000,000.00 insurance policy and the case settled for $1,300,000.00.

An additional One Million dollars in settlement made a vast difference in the final compensation amount to my client, allowing him to get back on his feet, purchase a home and change to a new business that he can do with his amputation.

I have asked many lawyers how the non-delegable duty exception works, and many do not know what I am talking about.

(Caution: Each case is different. No result promised. Past performance not a guarantee of future results. Result discussed in this article was dependent on the facts of this particular case and the results may differ if based on different facts).