JMW has helped a man secure compensation after he was involved in a serious motorcycle accident.

The following case study discusses Mr S's treatment after his accident, during his instruction of JMW as his solicitors. Mr S’s healing period has stretched out for almost 10 years following the accident, in a period of time often fraught with difficulty. The length of the case was such because it was important for his legal expert at JMW to know his long term fate before a realistic settlement figure could be discussed and secured, enabling us to fight for a sum that could help him have a quality of life.

Accident and injuries

Mr S was riding his motorbike with his wife, and was overtaking a slow moving line of traffic when a car pulled out of the line to overtake the car in front, hitting Mr S’s motorbike, catapulting him into a telegraph pole and knocking him unconscious. His injuries were determined as:

• A fracture to the right femur at the junction of the middle and lower third
• A fracture to the right tibia and fibula
• A fracture to the left tibia and fibula
• A fracture to the left wrist
• A fracture of the fourth metacarpal of the left hand
• Chipped upper right incisor

Mr S underwent immediate surgery to both legs to insert metal rods into the bones to treat the fractures he had sustained. Two days after the accident, he underwent plastic surgery on both leg fractures to graft on muscle tissue from his stomach and calf and surgery to insert “K” wires on his left wrist to encourage healing. He then spent seven weeks in hospital before being discharged home.

Making a claim

Mr S instructed JMW Solicitors, where his case was taken on by Richard Powell, partner and joint head of the Personal Injury team.

Consequences of the injuries

As a result of the operation, Mr S was unable to bear weight on his left leg and was only able to manage small amounts of walking by using a zimmer frame. He undertook numerous physiotherapy appointments and visits to his consultant surgeons.

He underwent further surgery to switch the nail on his left tibial fracture. X-rays throughout the year gave cause for concern as they indicated that Mr S’s leg fractures were not uniting properly. He continued to be in considerable pain from the left tibia and right femur and despite further surgery in the October of that year to exchange the nail of the right femur and remove the locking screws in the left tibia, Mr S’s condition worsened.

Early court hearing

Due to the gravity of the case and its complexities, an early court hearing was arranged solely to conclude the question of where blame should lie for the injury and, with advice from Richard and Counsel, Mr S agreed to split liability 89/11 in his favour, meaning that the overall settlement figure he received was 11% less than the total determined amount for the claim. This agreement was on the basis that he did bear an element of responsibility for what had happened, but by far the majority of the blame lay with the other driver.

With this part of the case resolved, the claim could continue with the focus solely on working out an appropriate valuation for the claim, and advancing Mr S’s recovery. It also meant that interim payments on account of final compensation could be agreed and paid. As Mr S was unable to carry out any sort of work, it was important to secure part payments of his overall claim to ensure that he could replace his ongoing lost income.

After a difficult year in which Mr S was forced to use crutches and was, at most, able to walk 50 yards, Mr S underwent additional surgery, which removed a nail from his left leg and put a plate in using bone grafted from his hip. A month later, the treating consultant put a plaster cast on Mr S’s leg to encourage healing.

Mr S’s consulting surgeon felt that there was nothing further he could do to encourage the healing process and was preparing to refer him on when Richard was able to put him in touch with a specialist in trauma and orthopaedic surgery, Professor Saleh.

Reconstructive surgery

Mr S met with Professor Saleh. He proposed to effectively restart the recovery process by realigning bones and using an electronic device to encourage good blood flow and healing. While Mr S was made aware he would still be left with some permanent disability, he decided to proceed as the operation might help him regain some quality of life.

Professor Saleh undertook reconstructive surgery on Mr S’s legs in two surgeries. Mr S also had a left leg external fixator applied, which went from his left ankle to just below the knee. After discharge, Mr S was required to make use of an electronic stimulator; a strap that went around the left leg and gave off electrical pulses, which he wore for three and a half hours every day.

His right leg initially progressed very well, however he experienced aching in his right knee joint and discomfort from the wires in his left leg. Some time later, Mr S was able to bear weight on his right leg, albeit with pain and discomfort. He underwent an operation to remove the pin in his right leg. The bones were realigned and a new pin was put in. He then underwent additional operations to remove pins in his left leg.

Mr S had a follow up appointment, where he was advised that he would need further bone grafting operations to both legs. He had a bone graft on his left femoral fracture and underwent revision of the locking screws in his right femur the following month. The fixator was finally removed from Mr S’s left leg. At this stage, Professor Saleh thought that the left tibia was probably healed, and the right femur would be the main issue.

By June, Mr S was 50% weight bearing and walking using a walking stick for the first time since his accident. His next follow up appointment brought the news that his fractures had still not united. The recovery process was proving to be extremely difficult, presenting unexpected challenges at every turn. Mr S had a further operation to stabilise his left tibia.

A further follow up appointment was scheduled at the end of April, when it was hoped that Mr S was close to being fully weight bearing, however, on the two weeks leading up to the appointment, Mr S was in considerable pain in both legs. Professor Saleh took further x-rays which showed that neither fracture had united and had to apply a full left leg plaster. He underwent a further operation a few weeks later. Mr S had four screws applied to his left tibia and another fixator applied.

Mr S underwent further surgery. He had a different fixator applied to his left tibia to lengthen the bone, a process he had to assist with over the course of five weeks, tightening the top of the fixator three times a day and loosening the bottom.

Continued pain

The pain in Mr S’s lower left leg and right thigh remained constant and the external fixator remained in place on his lower left leg. A further follow up appointment with Professor Saleh showed that the right femur fracture remained un-united. The external frame on Mr S’s left leg was removed in September and a leg plaster put in place. Mr S underwent a further review in November, which showed that the left fracture had united sufficiently to mobilise and remove the plaster. He was able to try bearing weight on it, but was advised to be very careful.

Several weeks after the fixator was removed, Mr S noticed discomfort in his lower left leg and stiffness in his ankle when he was walking and he underwent a course of physiotherapy to help with the mobility and strength issues, as well as encourage his left leg to have maximum strength before undergoing another operation to aid the union of his right femoral fracture.

Mr S had an unpleasant surprise; pain he had been experiencing in his left leg for two days, which was leaving him unable to walk, was found to be a re-fracture at the point where the bone had been re-sected in the last operation. Effectively, the bone had fractured at the place of weakness as a result of too much force being applied upward due to a lack of flexibility in the ankle. He was placed in a temporary plaster and had to have a full leg plaster applied before the end of the year.

Reassessment of condition

This was a devastating blow. It had seemed to that point that all was going well, and finally Mr S was in a position where he could start to plan for his future, and we could also begin final settlement negotiations. However, this further breakdown meant a whole new reassessment of his condition. Mr S and Professor Saleh discussed the four options that were available to him, and after a long and hard decision-making process, Mr S decided to have his lower left leg amputated.

Mr S had decided that he wanted to prevent further prolonged, painful treatment. It was clear that over the past eight years, everything had been tried to achieve recovery, without success. After the decision, we arranged for him to have counselling with a consultant in rehabilitation medicine so that Mr S could be prepared for what to expect. The operation was carried out.

Following the operation, Mr S spent four days as an inpatient and two days in bed after he was discharged. He was initially fitted with a full length cast which went over his stump to the top of the thigh. In the same month, an elasticated support was fitted over the stump and Mr S trialled a blow up prosthetic. He began to have physiotherapy and was using crutches and a wheelchair to move.

Mr S had a prosthetic fitting. He was able to walk on the prosthetic by the end of April, although he was still using crutches and kept on having problems with phantom pains in the lower limb and in the left knee. Mr S had two additional prosthetic legs fitted.

The right leg remained a problem, and the final challenge was to see if a satisfactory outcome could be achieved on the right leg – with all that had happened, nothing could be taken for granted and we could not exclude the possiblity of a double amputation. Mr S underwent the operation to aid the union of his right femoral fracture, involving insertion of a custom nail. He was discharged with crutches and a wheelchair. Following a review a month later, Professor Saleh was pleased with the healing of the right leg.

Mr S was able to walk unaided for the first time since the accident. He was still getting phantom pains and was having pain in both knees, but was advised that this would resolve over time.

Professor Saleh and Mr S had a follow up appointment, where he unfortunately delivered some bad news; 90% of the bone in his right femur had died. The pin was still in place, but was too strong.

Another review was scheduled, and a CT scan showed signs of healing where the custom made nail had been inserted into the right femur. Mr S had a follow up appointment, where he was advised that the right femur seemed to be healing well. CT scan results indicated that the fracture had healed.

Settlement figure agreed

Despite a full and comprehensive preparation by JMW, Mr S’s case did not go to trial and a settlement figure was agreed in a joint settlement meeting. The case was settled for a substantial figure, to reflect the years during which he had been unable to work, and had been reliant on care and assistance due to his limited mobility. These losses were set to continue. He had endured years of pain and discomfort, and a huge number of operations and treatment sessions. His whole life had been altered, and he had missed much of the enjoyment of seeing his grandchildren grow as he could never play with them properly.

Richard and JMW are pleased to have been able to work on the case and assist Mr S. This case took a long time to conclude as it was clear we needed to wait and see how Mr S’s injuries and their healing progressed before a realistic final settlement figure could be agreed. The nature of his injuries were such that no-one could say for several years what his long-term outcome would be, and even after undergoing one amputation he still faced the possibility of double amputation right up until the very late stages of the claims process. The priority was to address his treatment needs and to know for sure what his medical situation would be in the long term, and this settlement finally gives him the financial freedom to plan his life.