Diabetic injury claim? What are the associated failures…
These claims tend to fall into 3 categories, those that involve a delay either 1. a failure to diagnose a condition, 2. those that involve a failure to refer onward for more specialist care and 3. those where specialist practitioners have erred and or not taken the severity of the situation into full account. Contact us to to discuss if you have a compensatable diabetic injury claim or even if you believe that your care has been substandard.
As a consequence of the work of the Diabetic Unit, we have gathered a great deal of expertise in ophthalmic and optical claims.
In particular actions for delay in treatment of detached retina, misdiagnosis of intra-ocular pressure and subsequent vision distortion / defect, premature or avoidable partial vision loss, blindness or other permanent vision defects.
Delay in treatment for a Diabetic Condition
Breaking down the sections of diabetic injury is no easy task. Ultimately many of the injuries associated with diabetes are those that can cover all of the headings in one way or another. However, the most commonly recurring issue is probably delay. This can be a delay in making a referral, especially to ophthalmic or foot care but could also be a delay to appropriately diagnose and medicate.
Failure to Refer
The issue of onward care usually occurs at the primary care level. In other words, it is usually a failure of the GP to recognise the seriousness of symptoms. In many ways this is a delay action that never occurred. Usually and sadly, something goes wrong before the referral is made. The resultant diabetic injury claim was entirely avoidable.
Diabetes is a chronic illness that requires significant continuing primary medical care as well as good patient self-management. It is also necessary for primary care givers to ensure that the patient is educated to prevent acute complications. This will also help avoid or reduce the risk of long-term problems.
There is no doubt that diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. Failure to account for changes in condition and or risk, is likely to bring about a poor perhaps even catastrophic outcome resulting even in avoidable amputation.
The Diabetic Conditions and why they require careful clinical managment.
It is a generally accepted fact that more people than ever have blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes. This borderline condition has become known as pre-diabetes. If your blood sugar level is above the normal range, your risk of developing full-blown diabetes is increased. If you suffer chronic, that is prolonged blood sugar levels then the deterioration of the bodies systems for secretion of insulin can become compromised.
It’s very important for diabetes to be diagnosed as early as possible because it will just get progressively worse if left untreated.
Diabetic eye screening
Everyone with diabetes and is aged 12 or over should be invited to have their eyes screened once a year. Those with diabetes, are at significant risk from diabetic retinopathy, a condition that can lead to sight loss if it’s not treated. Screening, which involves a 30-minute check to examine the back of the eyes, is a way of detecting the condition early so it can be treated more effectively.
It is of course important to state that it usually takes several years for a progresive condition such as diabetic retinopathy to reach a stage where it could threaten your sight. The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical signals. The retina requires a constant supply of blood, which it receives through a network of blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels in 3 main stages:
- background retinopathy – tiny bulges develop in the blood vessels, which may bleed slightly but don’t usually affect your vision
- pre-proliferative retinopathy – more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye
- proliferative retinopathy – scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina, this can result in some loss of vision
However, if a problem with your eyes is picked up early, lifestyle changes and/or treatment can stop it getting worse.
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Further Diabetic Complications and Managment
Apart from the above documented issues of diabetic retinopathy, there are other issues associated with diabetes that both primary care and specialist care teams need to be conscious of. In particular:
Having diabetes means that you’re more at risk of serious foot problems and which can lead to amputation if untreated. Nerve damage can affect the feeling in your feet and raised blood sugar can damage the circulation, making it slower for sores and cuts to heal. That’s why it’s important to tell your GP if you notice any change in how your feet look or feel.
Heart Attack and Strokes
When you have diabetes, high blood sugar for a period of time can damage your blood vessels. This can sometimes lead to heart attacks and strokes.
Kidney problems (nephropathy)
Diabetes can cause damage to your kidneys over a long period of time making it harder to clear extra fluid and waste from your body. This is caused by high blood sugar levels and high blood pressure. It is known as diabetic nephropathy or kidney disease.
Nerve damage (neuropathy)
Some people with diabetes may develop nerve damage caused over time by high blood sugar levels. This can make it harder for the nerves to carry messages between the brain and every part of our body so it can affect how we see, hear, feel and move.
Gum disease and other mouth problems
Too much sugar in your blood can lead to more sugar in your saliva. This brings bacteria which produces acid which attacks your tooth enamel and damages your gums. The blood vessels in your gums can also become damaged, making gums more likely to get infected.
What is a community nurse?
Community nurse roles and responsibilities
A community nurse is responsible for performing many of the same duties as a district nurse. These include basic care (checking temperature, blood pressure and breathing), wound management, administering injections, setting up intravenous drips and assisting doctors with examinations and medical procedures. Community-based nurses are also able to provide vital information to clients, their families and carer/s, much in the same way as district nurses, while emergencysupport may also be required in cases when a patient is suffering cardiac arrest or a stroke. This demonstrates the many hats a community nurse must don in their line of care.
So what is the difference between community and district nurses?
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