Amputation Complications

Amputation is one of the most traumatic medical treatments anyone can face. Amputation is the surgical removal of a limb or body part and the loss of the limb is permanent. An amputation may be required to deal with a serious infection, save the patient’s life in an emergency, or remove cancer. However, even when amputation is necessary, negligent treatment can cause pain, additional harm, and even death.

Amputation Procedures and Treatment

Amputation is a surgical procedure and the type of treatment may depend on the limb or body part to be removed. Amputations can involve any section of a limb or extremity, including leg, hand, nose, and breast (mastectomy). The need for amputation is generally related to an already existing or advancing disease, infection, trauma, or medical condition. An amputation may be necessary with:

Foot or leg ulcers related to diabetes
Peripheral artery disease
Infection and peripheral necrosis
Cancer
Traumatic injuries

Amputation is an invasive procedure that may require general anesthesia, controlling blood loss, smoothing bone ends, creating a muscle cuff, and sewing the skin back together. During the procedure or after the amputation, the surgeons may determine that not enough of the damaged, diseased, or necrotic tissue was removed and recommend further tissue removal.

An amputation may also involve a number of medical professionals attending to the patient before, during, and after the procedure. This includes surgeons, plastic surgeons, anesthesiologists, and nurses. As with any complex procedure, there are a number of things that could go wrong if all the professionals are not complying with the standard of care of others in their position.

Negligence in Amputation Procedures

When a medical professional breaches the standard of care and causes injury to a patient, the medical profession may be liable for damages. When treating a patient, a doctor must use a degree of care that would ordinarily be exercised by a similarly positioned doctor in the same profession. If the doctor makes a mistake, fails to properly warn a patient, or fails to properly monitor the patient’s progress, they may be committing malpractice. There are a number of ways a doctor may be negligent in treating an amputation patient, including:

Infection after amputation
Wrong site surgery
Unnecessary amputation
Anesthesia problems
DVT or stroke
Amputation beyond informed consent

Infections After Amputation

As with any surgery, there is a risk of infection. A wound could become infected during surgery where the surgical team is not properly cleaning and sanitizing instruments, their hands, or the surgical area. The body can be very vulnerable during surgery and it does not take much bacteria or fungus to develop into a serious infection.

In addition to following proper sterilization protocols, a surgical patient should be monitored for signs of infection in and around the surgical site. Surgical site infection may require extra time in the hospital to treat, and if treatment is delayed or unsuccessful, it could lead to sepsis, infection shock, and death.

Wrong Site Surgery

It seems almost impossible to believe but it has happened to a number of amputation patients where they wake to find the doctor cut off the wrong limb. When a surgeon amputates the wrong foot, leg, or removes the wrong teeth, the patient permanently loses healthy tissue and limbs. In addition, the patient needs to return to have the correct side amputated.

There is a similar problem with wrong patient surgeries, where a doctor thinks they are operating on someone else for a separate procedure. According to one study, doctors in Colorado had performed at least 25 wrong patient surgeries over the course of 6 ½ years.

Anesthesia Problems

Most amputations involve general anesthesia where the patient is put under by the anesthesiologist so they don’t have to feel the pain and remain immobilized. Anesthesia drugs are powerful and too much may result in an overdose. If the patient is not returned to a stable level, they can suffer anesthesia brain injury or death.

DVT or Stroke

Surgeries also carry a risk of blood clots. Patients who normally take blood thinners may have their prescriptions stopped or reduced to allow the wound to heal and prevent a hemorrhage. However, patients should be closely monitored for blood clots, including deep vein thrombosis (DVT). A blood clot can come loose and make its way to the lungs, brain, or spinal cord, causing a pulmonary embolism, stroke, or spinal stroke.

Amputation Beyond Informed Consent

Informed consent allows a patient to understand the treatment they will be receiving in order to consent to the procedure, given the risks and benefits. If a doctor does not explain the risks of a procedure or does not get informed consent before a procedure, the doctor may be violating their duty of care. In an amputation, lack of informed consent may involve removing more tissue than was originally proposed. For example, if a doctor says to a patient that they have a toe infection and the toe has to be amputated but the patient wakes up with an above-the-knee amputation, that may be beyond the level of consent given by the patient.

Complications After Amputation and Recovery

An amputation may require extended or lifelong care and treatment. Medical issues may continue to follow an amputation for the rest of the patient’s life. After recovery from the surgery, the patient may have to go through therapy to learn to function without the limb, including:

Physical therapy
Occupational therapy
Counseling
Education
Home and work modifications
Vocational rehabilitation

Stump Care

Stump care is an important and continuing requirement for most amputees. This includes regular washing and cleaning of the stump and carefully drying. With a prosthetic, individuals also need to keep the prosthetic socket clean. The skin can be vulnerable to damage if it is too wet or too dry. At any sign of infection, the amputee should seek medical care, this includes swelling, warm and tender skin, or discharge.

Phantom Limb Pain

Phantom limb pain and stump pain are continuing complications for many people after an amputation. The stump can be sensitive to outside contact, rubbing, or be caused by nerve damage during surgery. Phantom limb sensations feel like they are coming from the body part that has been removed. The pain is real, and is not imagined. Some individuals suffer mild tingling, flashes of pain, or constant and severe pain. Treating phantom limb pain may involve multiple therapies, including:

Anesthetic injections,
Pain medications,
Prosthesis adjustments,
Massage,
Mental imagery, or
Transcutaneous electrical nerve stimulation (TENS) device.

Emotional Complications

The loss of a limb can be difficult to cope with. Many patients express intense feelings of guilt, grief, anxiety, anger, or depression. The psychological impact of amputation should not be underrated. Loss of a limb can be similar to the loss of a loved one or develop into post-traumatic stress disorder (PTSD). Counseling and medication can help an individual cope after the loss of a limb.