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August 27th 2021

GP Negligence

Failure to diagnose Charcot foot leaves patient with deformity and risk of amputation

Lauren Dale

Lauren Dale

Solicitor, Clinical Negligence

Failure to diagnose Charcot foot leaves patient with deformity and risk of amputation

Failures in the care provided to a patient who developed Charcot foot have highlighted the importance of diagnosing the condition as early as possible in order to increase the chances of successful treatment.

Failures in the care provided to a patient who developed Charcot foot have highlighted the importance of diagnosing the condition as early as possible in order to increase the chances of successful treatment.

A delay in diagnosing the patient with Charcot foot – a condition that causes the bones to become weakened that is common in diabetics – has led to them having a permanent deformity in their right foot and an increased likelihood of amputation in the future.

The patient, who has suffered with Type 1 diabetes since adolescence, instructed Hudgell Solicitors to make a medical negligence claim after the issues with their foot were instead treated by their GP as a skin infection for four months.

They had telephoned the GP surgery complaining of ankle pain while out walking, which worsened in the days after this, while swelling and redness also developed.

The GP initially believed the patient had twisted their ankle, but after two appointments they commented that it was likely to be an infection and prescribed antibiotics.

The swelling and discomfort in the patient’s right foot persisted and it was not until four months after initially complaining of being in pain that they were diagnosed as having Charcot foot, which is also known as Charcot arthropathy.

Client’s own online research led to them finally getting Charcot foot diagnosis

Lauren Dale, a solicitor in our expert medical negligence team who represented the patient, said: “Our client was extremely frustrated with their continued symptoms and as such conducted some research online, this caused them to question the possibility of Charcot foot.

“They attended the GP surgery again to raise concerns and X-rays carried out the following day confirmed a diagnosis of Charcot arthropathy and noted probable fractures.

“An orthopaedic surgeon treated our client with offloading, however the extent of the arthropathy meant the treatment was unable to prevent the foot from becoming permanently deformed and it was commented an amputation may be required in the future.

“Any person treating diabetic patients should be aware of Charcot arthropathy and in this case there was a failure to refer our client urgently to a diabetic foot clinic. This was in contradiction to the NICE guidance and amounted to sub-standard care.

“The failure to refer our client to a diabetic foot clinic and consider Charcot arthropathy at the outset caused them a permanent level of deformity.

“Had they been urgently referred to the diabetic foot clinic as they should, the foot would have been offloaded and been protected. This protection would have continued until the Charcot arthropathy had burnt out and no significant deformity would have occurred.”

The GP practice admitted failure to consider Charcot foot and a delay in referring our client, as well as admitting the patient would have had a more favourable outcome if the foot had been offloaded earlier.

As a result of these admissions during the medical negligence claim, Ms Dale successfully secured compensation in excess of £100,000.

What is Charcot foot?

Those who suffer from diabetes may be aware of the risk of developing Charcot foot but may be unaware what the condition actually is and its impact in day-to-day life.

Charcot foot, also called Charcot arthropathy, is a bone deformity in the foot that causes the bones to become weakened.

Charcot foot graphic

Due to the severe weakness in the bones, it is common for those with Charcot foot to suffer from fractures. Although not noticeable straight away, if the condition progresses, it can deform the shape of the foot.

It is more likely to occur in those who suffer from neuropathy. It is common for diabetics to suffer from peripheral neuropathy, a condition that damages blood vessels in the legs and feet causing numbness and loss of balance and coordination.

This loss of sensation and balance in the feet can cause the sufferer to walk unnaturally, causing the joints in the foot to collapse. It is common for the sufferer to be unaware of the pain from this collapse as the neuropathy can cause a lack of feeling in the feet.

What are the symptoms of Charcot foot?

Someone suffering from Charcot foot may experience the following:

  • Swelling of the foot
  • Warmth of the skin – The affected area will feel warm to the touch
  • Foot and ankle pain
  • Redness in the affected area of foot/ankle

The condition is usually diagnosed through an examination of the ankle and foot, as well as the use of X-rays in some cases.

How do you treat Charcot arthropathy?

It is important that Charcot foot is diagnosed as early as possible in order to increase the chances of successful treatment. Common treatments are:

  • Special footwear: Custom inserts and braces can be used to hold the foot in place once healed to ensure that a collapse does not reoccur.
  • Reducing mobility: In order to alleviate pressure on the foot and allow for it to heal correctly, a plaster cast may be applied.

How can I reduce the risk of developing the condition?

It is imperative that those with diabetes are aware of the ways in which they can reduce their chances of developing Charcot foot, also known as Charcot arthropathy.

These simple pointers can help you to significantly reduce your risk:

  • Regular checks: By regularly checking your feet for injuries, you can receive treatment before you begin to develop issues such as neuropathy and Charcot foot.
  • Maintain blood sugar levels: This is vital should you wish to reduce the damage to your blood vessels and prevent neuropathy.
  • Avoid injuries: It is important to be aware of any activities that could cause damage to your feet and to avoid them. These activities could include sports or just day-to-day exercise.

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