Charcot Foot: Andy’s Story
Andy was 53 when he developed Charcot Foot. Unfortunately doctors in his local Accident and Emergency Department failed to spot it on several occasions. As a result his foot became deformed, leaving him seriously disabled. He recovered substantial damages against the hospital. Damages cannot turn the clock back, but they can make life easier. In particular they have solved his problem of how to manage in a first floor flat.
Charcot Foot is unusual. It is most common in people with diabetes (like Andy). Poor blood supply leads to the nerve damage in the foot – neuropathy. People may not feel pain and may injure their foot without realising. The bones in the foot weaken. With walking, the joint collapses. The foot changes shape often with a ‘rocker-bottom’ appearance.
The signs of developing Charcot include warmth, redness, swelling and pain or soreness (for patients who still feel pain). It is important that people with diabetes check their feet and are alert to changes.
Andy’s Visits to Casualty
Andy had dropped a heavy bag of nuts and bolts on his foot in January 2015. His foot was not painful but it swelled. The swelling got worse. In March 2015 he went to Casualty at his local hospital, Russells Hall. He had x-rays. There was no sign of a fracture. He was given a protective boot to wear. His doctor planned to review him a week later but forgot to tell him. He was not sent an appointment.
The swelling spread to his calf. In late April 2015 he went back to Casualty. It was thought he might have a DVT (but investigations showed no sign of it) or cellulitis. He was given antibiotics.
He went back in May 2015. He was again told he had cellulitis. His antibiotics were changed.
His foot did get better. He went back again in early June 2015. This time he was told he had lymphoedema (the lymph system causing swelling). He was referred to a specialist clinic.
2 weeks later he went back. By then he had a rocker-bottom foot. X-rays showed a fracture. A podiatrist immediately recognised Charcot Foot. His foot was put in plaster. The plaster stayed on for 8-9 months.
Andy was left with a deformed foot. The skin kept breaking down and forming blisters. He eventually had an operation to try to improve the shape of his foot but it is still misshapen. There is a risk that he will need to have it amputated. He has deep-seated pain and relies on painkillers. He can only walk very short distances.
He was living on the first floor of a block of flats but struggled to go up and down stairs. He had to give up work. He struggles to do housework. He will need a wheelchair at times but there was no room for it in his flat, and the doorways were too narrow. He can no longer do the things he enjoyed – in particular going out for a walk and taking photos.
Based on the evidence of experts and with the help of his solicitors, Andy brought a claim. He alleged that the hospital had breached its duty by failing to call him back for review after the first appointment, and misdiagnosing him during the 4 further visits.
His experts gave evidence that had his condition been diagnosed when it should, his foot would not have got worse. It would have kept its shape. He would have been able to go back to work and enjoy his normal activities.
The claim succeeded. He recovered a large sum of money in damages. That enabled him to move from his flat to a house which is adapted so that he does not have to manage steps. He has space of a wheelchair. It also made good his loss of earnings.
Don’t Overlook Charcot!
Andy is very keen that the same should not happen to other people. He hopes the hospital will learn lessons and doctors will be more alert to the signs of Charcot Foot. Diabetic patients with problems with their feet should always be taken very seriously. Mistakes can be disastrous. Minor injuries can lead to infection and amputation. Swelling, heat, redness and pain may be signs of Charcot. He also hopes people with diabetes will take care over their feet and make sure they get urgent medical help if there are any concerns.