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07 October 2013

The Unluckiest Bin Man In The World

On 12th June 2008 C, who was then 33, was working for D as a refuse collector when he somehow became caught by one of the wheels of D’s refuse lorry and his lower left leg was run over. Thereafter, perhaps because he didn’t understand the shouts and gestures of his colleagues, D’s driver put the refuse lorry into reverse and ran over C’s lower left leg for a second time.

The precise circumstances of the incident were a matter of dispute between the parties and although D admitted primary liability it was agreed that damages would be discounted by 17.5 percent to take into account the risk of a finding of contributory negligence on the part of C.

In any event, C remained conscious throughout his ordeal and suffered severe crush injuries to his left foot including extensive degloving of his left great toe and forefoot and significant skin loss over the area of his left heel.

On admission to hospital C’s initial treatment included surgical exploration and debridement of the damaged tissues of his left foot and thereafter surgical amputation of the great toe and associated forefoot. A split skin graft was also applied to the affected area of his left heel.

Unfortunately, however, and despite further surgical debridement of the damaged tissues, the prognosis in respect of C’s left foot remained very poor. In particular, C was advised that even if his foot could be saved it was likely to be a source of constant and severe pain and would be of no functional benefit to him.

In the circumstances, and after seeking a second medical opinion, C decided to undergo a below knee surgical amputation of his left lower leg, which was performed 30 days post-accident.

Thereafter, C made only slow progress. In particular, although the amputation wound healed without complication, his stump was frequently painful and swollen and he started to suffer significant phantom limb pains.

Unfortunately, C’s difficulties were further compounded by the development of a cyst over his stump which made his already ill-fitting NHS prosthetic even more uncomfortable to wear.

Matters did improve for C to some extent when he used part of an interim payment to fund the purchase of a bespoke prosthetic lower limb, although he could still only walk for a maximum of 200 metres with the aid of a stick and could still only tolerate wearing this prosthesis for around 50 percent of the time. At home C preferred to manage without using his prosthesis, mobilising instead with the aid of elbow crutches or his wheelchair. It was not expected that C’s mobility or tolerance of his prosthetic limb would further improve over time.

In addition, C also suffered an open book fracture of his pelvis, which included a fracture of the right inferior pubic rami that extended into the articular surface of his right acetabulum. It was agreed that as a consequence of this injury C was at increased risk of developing osteoarthritis within his right hip joint, which C’s orthopaedic expert thought was inevitable but D’s orthopaedic expert thought was no more than a 10 percent risk. Both agreed, however, that if C did develop osteoarthritis in his right joint he was very likely to require a right-sided total hip replacement and, depending on when the need for this arose, there was also an additional risk that he would later require right-sided hip revision surgery.

In terms of mobility, it was agreed that as a consequence of the combined effect of his left lower limb injury and pelvic injuries C was likely to become increasingly dependent on his wheelchair from the age of about 50 onwards.

Further, as a consequence of his reduced mobility C, who had previously been a fit young man, had become clinically obese and his overall life expectancy had thereby been reduced by in the region of 4 to 7 years.

Although C’s pelvic injuries did not include any damage to the bladder or urethra he did experience episodes of urinary incontinence at night, urinary urgency, some minor leakage and urinary dribbling, which was likely to be due to damage to the nerves running through the pelvis.

C also suffered from erectile dysfunction, which affected the quality and duration of his erections and C found that vaso-active drugs, such as Viagra, made no significant difference to his condition.

In addition, C also suffered more straightforward orthopaedic injuries, including a fracture of the mid-shaft of his right femur, a fracture of his right ankle and soft tissue injuries to both knees.

Perhaps not surprisingly, C also developed moderately severe PTSD arising from the “devastating” impact that his physical injuries had had upon his life.

At a joint settlement meeting total damages were agreed in the sum of £1,481.229.00 (on a full liability basis) and took into account the Defendant’s valuation of general damages for PSLA of £160,000.00 and the Claimant’s valuation for PSLA of £175,000.00.

Article Source: Tim Grover – Counsel for the Defendant

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