How changing circumstances can lead to larger awards

June 26, 2024

Gerard Martin KC discusses how a complex set of circumstances led to a larger than usual award for a below knee amputee.

Summary: Claimant (C) with pre-existing psychological vulnerability, made worse by the accident, right below knee amputee in the accident, expected to become an above knee amputee within 5 years. Settlement £4.75.

This case was the subject of approval in June 2024, following a joint settlement meeting held in April 2024.

The Claimant (C) met with his accident at a pedestrian crossing a road in September 2018 when hit by the Defendant motorist driving at a speed in excess of 80mph in a 30mph speed restricted area. The right below knee amputation was largely sustained traumatically in the accident.

C was born in April 2000. He was 18 years old at the time of the accident and is now 24 years old. Settlement was in the sum of £4.75million.

C’s rehabilitation was complicated by a number of factors.

Firstly, the residuum was problematic, it was short in length for socket fit and weight bearing. Further, the residuum had required skin grafts to achieve a cover which then was insensate, and thus prone to skin breakdown and abscesses. Infection of the residuum was a continuing issue, which until each occasion of skin breakdown had resolved, compromised wearing the prosthetic.

In addition, C’s mental health deteriorated post-accident. He had no history of a mental health disorder pre accident, but was regarded by the experts as of a vulnerable personality beforehand. As a child he had witnessed physical abuse by his father of his mother, his father had been imprisoned for that reason, and subsequently whilst in prison committed suicide. Unsurprisingly these were matters that affected C’s mental health, he became anxious and depressed.

Whilst a child he had been excluded from school and had no academic achievements upon leaving aged 16. He was trying to attend college to gain work skills at the time of the accident.

Pre accident from about the age of 15 years, C had been a cannabis user. Post accident and post discharge from acute care, he became a heavy cannabis user such that he suffered cannabis induced psychoses and had to be sectioned for that reason on three occasions.

Post discharge from hospital, he went from being accommodated with grandparents, to living on his own in a mixture of supported and unsupported accommodation. His occupation of accommodation was often compromised by C’s drug consumption and association with undesirable others leading to his eviction.

When under the influence of drugs and or depression C’s self-care was poor and the cleanliness of the residuum became an issue, with consequent infections and skin breakdown.

A case conference was held between the experts for C – the rehab consultant, the orthopaedic surgeon and the vascular surgeon and it was their conclusion that within 5 years C would require an above knee amputation, his function, socket fit and skincare would all be improved in that event, but his need for sophisticated prosthetic equipment would increase.

An interesting argument we were pursuing in the case was that as a result of the accident – the pain, suffering, trauma and losses sustained therein, the pre-existing vulnerability which had shown clear signs of psychological vulnerability had become converted into a personality disorder, which made his ability to cope with the usual stressors of life very poor, such that daily support workers were needed to keep him safe. Without such help, C would find himself losing his temper and becoming confrontational, leading to exclusion from the usual sources of help, partners, family and friends, and from state support.

Thus, this case was far from the usual in terms of outcome. Usually with good prosthetic equipment, independence is achieved and care input reduced. In this case because of the added complexity of C’s pre accident vulnerability being converted into what we contended was a personality disorder, the claim for care and case management was substantial going forwards and likely to remain so. Because of the personality disorder we contended C had lost his capacity to manage his own affairs and thus there was a claim for deputyship and Court of Protection costs. The loss of capacity was not contentious, the reasons for that loss were highly contested with the Defendant arguing that it was as a result of drug consumption, a choice C was free to make but which would not sound in damages for reasons of illegality.

This was a larger than usual award for a below knee amputee because of all the above complexities, and that he would be a below knee amputee becoming an above knee amputee, plus his ongoing psychological issues requiring significant care, and a lack of capacity.

Throughout the case because C was in need of substantial input from our instructing solicitor Nick Pattichis of NPI Solicitors, Bolton, to keep C as safe as possible, to come to his rescue frequently and to liaise with landlords, social workers, the Police and C’s family.

Great skill and patience were required and deployed such that now aided by a deputy and the Court of Protection, C can hopefully expect a better future life.

Gerard Martin KC and Angela Georgiou, junior counsel.