Sensory Loss Series – Touch
Loss of Sense of Touch due to Medical Negligence
As part of our new series focusing on injuries caused to the senses as a result of medical negligence we explore how someone’s ability to touch and feel can be affected as a result of substandard care.
Touch is something we do not tend to think about until that ability has gone. We tend to forget how important our sense of touch actually is and that any nerve damage to our hands or feet put us at greater risk of injury and can change the way we go about our lives. The impact of sustaining injuries that affect our sense of touch such as peripheral nerve damage can be life changing.
Certain medical procedures carry a risk of injury to the nervous system, which unfortunately may occur even when the greatest of care has been taken. However when injuries to the nerves are found to be caused as a result of medical negligence, compensation can be sought.
Damage to Peripheral Nerves:
One of the main causes of losing your ability to feel sensation or to touch is when damage has been done to the peripheral (sensory) nerves. The peripheral nerves include motor nerves which control muscles, sensory nerves in the skin which send information about pain, touch, temperature etc and autonomic nerves which regulate automatic bodily functions such as bladder function.
Symptoms of Nerve Damage affecting Touch:
When sensory nerves have been damaged the following symptoms are common:
- Shooting pain or burning
- Warm or cold sensations
- Muscle weakness
- Reduced or increased sensation
When motor or mixed nerves are damaged there may also be weakness or paralysis of the muscles in that area.
Examples of Injuries that affect Touch:
The following are a few conditions affecting sensation which may result from by medical treatment.
- Sciatic Nerve Injuries and Foot Drop
Sciatic nerve injuries are caused most commonly when there has been incorrect or prolonged positioning of a patient during surgery mainly whilst on their side.Foot drop is often caused by compression of the nerve that controls the muscles that lift the foot (sciatic nerve). The nerves can be damaged during hip or knee replacement surgeries when there has been excessive tension or where they have been trapped and not identified.Damage to nerves during surgery may be a recognised complication, however if the sciatic nerve is over-stretched the treatment would fall below the standard expected of a competent surgeon.
- Ulnar Nerve InjuriesThis is one of the most commonly reported nerve injury. Damage to the ulnar nerve causes numbness in the fingers and weakness of the hand muscles.Damage can be negligently caused to the ulnar nerve from a misplaced injection or from a nerve block involving a hypodermic needle. It can also be caused as a result of using too high pressure when injecting a drug or anesthetic.The ulnar nerve can also be accidently severed during orthopedic surgery or during carpal tunnel surgery. The complete severing of the nerve would be substandard treatment.
- Brachial Plexus Injury
This is a severe injury which can be caused by damage to the nerves in the armpit and can affect sensation in the arm. This can also be caused by incorrect and inappropriate positioning during surgery.
- Median Nerve Injury
The median nerve is in the arm and is the only nerve that passes through the carpal tunnel in your wrist. The nerve acts as a pulley for the tendons that bend the fingers and if it is inured can affect the use and feeling in your hand.Damage to the median nerve can be caused by poor technique during surgery or when taking blood from the arm.
- Guilliain-Barre Syndrome
This is a rare but very serious condition of the peripheral nerve system. It occurs when the body’s immune system attacks part of the nervous system. The symptoms usually develop two to four weeks after a minor infection such as a cold. Symptoms initially include pain, tingling and numbness, muscle weakness and unsteadiness. The symptoms may get gradually worse over the course of several days. Most people with Guillain-Barre syndrome make a full recovery but the key is to diagnose quickly and sometimes the symptoms may not be distinguished from other brain and nervous disorders. Two tests should be done quickly and thoroughly to rule out other conditions. These are electromyography and lumbar puncture. Treatment should then be commenced as soon as the diagnosed is made and medication will be given to block the immune system when it attempts to attack the nerves.Patient’s may need to spend weeks or months in hospital or and it may take a year or more to fully recover. However the failure to diagnose can result in the patient’s condition from worsening and could mean the condition may never be cured. In these cases a loss of sensation in the limbs can occur and some sufferers may need to rely on a wheelchair for mobility. If the condition was not originally diagnosed and there was a delay in you receiving the appropriate treatment then you could potentially be compensated for this.
- Sciatic Nerve Injuries and Foot Drop
Negligent Causes of Nerve Damage:
Peripheral nerves can be damaged in a number of ways:
Stretching and Compression:
- During an operation a nerve can be stretched or squashed if you were placed in an incorrect position.
- Prolonged stretching of the muscles surrounding a nerve can also cause damage.
- Nerves can be compressed if the pressure of a tourniquet used to reduce surgical bleeding is not controlled carefully.
- Patients should be moved from a position after a prolonged length of time and especially following from surgery to relieve the pressure on the nerves.
- During surgery a surgeon may accidently cut or damage a nerve.
- Surgical instrument may also compress or stretch a nerve. Sometimes this may be unavoidable but the risks should be explained to the patient beforehand.
- There can be a delay in noticing and treating the damaged nerve.
Injections and Cannulas:
- Nerves can be damaged by the needles when a cannula is inserted into veins or arteries.
- Care as to the correct technique is essential.
- Diabetes: Peripheral nerve damage is one of the most common complications of diabetes however with careful monitoring and management of sugar levels and insulin the risk can be lowered. Doctors of patients with diabetes and loss of sensation in feet and legs should be doing regular feet checks to make sure the patient is not suffering from ulcers that they cannot feel. If these ulcers are missed then this could lead to devastating complications such as gangrene and loss of the limb and even death.
Preventing Damage to the Sense of Touch:
Whilst such damage can be a recognised risk of certain procedures or treatments, there is scope to potentially avoid or reduce the risk of injury by:
- Thoroughly identifying predisposing factors and any existing neurological conditions before any surgery or prescription of medication.
- Careful monitoring of diabetes patients.
- Careful positioning of the patient and movement after prolonged periods of time.
- Protective padding and avoidance of contact with surfaces applying direct pressure to susceptible peripheral nerves.
- Prompt relief of pressure on nerves following surgery.
- Ensuring patients are fully consented to the risks.
How We Can Help:
The medical negligence team at Bolt Burdon Kemp are experienced in dealing with claims where someone’s ability to touch has been affected by nerve injuries sustained as a result of poor treatment. If nerve damage occurs as a result of substandard care then you may have a claim for medical negligence. You may also be entitled to compensation where substandard care has resulted in a delay in diagnosing and treating the underlying condition and this has either increased the extent of your injury or reduced the extent of your recovery.
Losing your ability to touch or feel sensation can have a particularly devastating effect on a person’s day to day life if they are unable to hold or grip items or are unable to walk due to foot drop or altered sensation to the legs. There is the danger of suffering further injury if you cannot feel sensation of pain or temperature. Related nerve pain can also be particularly debilitating. It can prevent people from working or being able to do things around the home or enjoy the things they used to. The impact is extremely significant if nerves have been damaged which reduce the sensation in a dominant hand or your legs.
Compensation may not be able to provide a complete recovery but it may help with future treatment and rehabilitation, recovering any lost earnings and expenses and any equipment needed or adaptations to the home where nerve damage has altered a person’s mobility.