Friday, 30 May 2014

Bolt Burdon Kemp: Bringing Wheelchairs into the 21st Century

It has always confused me why wheelchair technology has not progressed with other mobility technology, be it prosthetics, cars or bikes, or at least to the same extent. Indeed in most mobility technologies, we have seen developments in the automotive industry reflected by developments in other mobility industries, and yet at first glance, it does not appear to have happened with wheelchairs.

If we look at the situation over the last 50 years, the car industry was focused on crude, heavy materials, with products built from a high volume of parts. Prosthetic limbs are another example, which were heavy, unwieldy and uncomfortable objects effectively alien to the user. However, the cutting edge of both these products now focus on customized carbon fibre, lightweight construction, reduced parts and ergonomic design. Bikes too, have moved from heavy steel frames to lightweight, streamlined carbon fibre units weighing only a few kilograms.

Why, therefore, has the mainstream wheelchair industry stuck to a concept of rigid steel frames with panels and sections attached to the frame, and not embraced new technology? I began to look into this topic and spoke to Andrew Slorance, Managing Director of Carbon Black wheelchairs. I discovered that in fact this is a question Andrew has been asking himself since the age of 14, when he suffered a paralysing spinal injury. He describes going into bike shops and wondering why you could order a fully customised carbon fibre bike, essentially an item purely for pleasure, and yet with an essential item such as a wheelchair, this was not an option.

It is a question that several years later in his adult life, led Andrew to leave his job to focus 100% on developing a new wheelchair, taking up these design considerations and attempting to bring wheelchair technology into the 21st Century.

There were two huge obstacles to Andrew’s vision. The first was the status quo. The development of wheelchairs is focused on keeping costs low, with the majority of parts made to one design at very low cost in China. These are then sold around the world with no real competition, and no investment in development. No one was willing to consider ‘reinventing the wheelchair’. The sole reason that any mobility industry has developed is because of competition, whether this be in the commercial market or in sports, such as bike racing or Formula 1 and other motorsports.

This led Andrew to the second key problem; finding someone with the experience to build a new wheelchair. Andrew was looking to design a fully customised carbon fibre wheelchair, using a monocoque structure to reduce parts and weight and to increase strength, with very low or no maintenance needs. In one instance working with a world rally championship car development team, they explained that Andrew’s product was the most difficult product they had worked on, because of the focus on fewer parts, with better design. However at high initial cost to himself, Andrew persevered.

Andrew’s journey to find a developer eventually led him to the pinnacle of automotive design, Formula 1, and a relationship was formed whereby his wheelchair could be developed and built to the ideals he had set out to realise. When you consider the way Formula 1 has influenced car technology over the years, this was clearly the right home for his ideas.

Now Andrew has designed the Carbon Black wheelchair, a fully customised, lightweight and ergonomic wheelchair that has the familiarity of a standard wheelchair, but without many of the drawbacks that Andrew felt were being ignored by the wheelchair industry. The wheelchair has been available for purchase since late 2013 and has received an overwhelming ‘Wow’ from wheelchair users.

As a clinical negligence solicitor, my particular interest in this product is not just what it does for wheelchair technology, but what it does for the injured user, and potentially what it can do for victims of clinical negligence who have suffered a paralysing injury.  

Firstly, the Carbon Black is very lightweight. Many new wheelchair users struggle with the energy and effort needed to use a standard wheelchair, particularly if there are secondary injuries. This can lead to users having reduced mobility and independence because the prospect of using the wheelchair is just too daunting. A lightweight carbon fibre wheelchair means that users are able to get back to regaining their independence as soon as possible, and continue with their lives.

In any clinical negligence claim, this must be the key focus. An injured person must be returned to the position of independence that they were in, as much as possible, before the injury. Not only does a wheelchair of this design improve the chances of this happening, but by increasing the ability to be independent, it also reduces the need for additional care.

Secondly, it is fully customised to the user. The focus is not on someone using the wheelchair as a piece of equipment, but on the wheelchair being a part of the user’s day in as unconscious a manner as possible, which again improves independence.

Finally, it’s aesthetically pleasing. In speaking to Andrew, we both agreed that it wasn’t clear why wheelchairs weren’t allowed to look good? As a piece of technology, and simply as a consumer product, it is very attractive. Andrew felt daunted when he was given his first wheelchair at 14, and didn’t want to leave the house with it. A wheelchair user doesn’t stop caring about aesthetics once they become paralysed (indeed they should not either), but the wheelchair industry needs to wake up to this issue. 

At least for now, Andrew and the Carbon Black wheelchair are seeking to move wheelchairs forward to a point they deserve to be at, and improve wheelchairs not just for the sake of development, but for the sake of wheelchair users.

Tom Gough is a solicitor at Bolt Burdon Kemp and specialises in clinical negligence claims. Tom has years of experience of acting for seriously injured clients.  If you think you may have a legal claim, contact us online or call 0808 1596 075 for expert advice from our dedicated team.
Tom Gough

DDI +4420 7288 4819
Mobile: +447557 804713
Bolt Burdon Kemp
Providence House, Providence Place, Islington, London N1 0NT
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As a clinical negligence solicitor, my particular interest in this product is not just what it does for wheelchair technology, but what it does for the injured user, and potentially what it can do for victims of clinical negligence who have suffered a paralysing injury. 

Thursday, 29 May 2014

Bolt Burdon Kemp: Polytrauma: Supporting individuals with both a brain and spinal cord injury

As a personal injury solicitor with a special interest in brain and spinal cord injury, I recently attended the Headway and Spinal Injuries Association annual conference which was a very interesting day.

The day was filled with fascinating and informative talks from an array of speakers ranging from medical professionals to lawyers working in the field of serious injury claims. The most insightful and inspirational talks, however, came from the speakers who had sustained serious life changing injuries themselves.

One of the speakers was a gentleman who had been involved in a catastrophic road traffic accident and as a result suffered a severe brain and spinal cord injury. He gave a truly moving and inspiring talk on his personal experience as a brain and spinal cord injury survivor living with the effects of these lifelong injuries.

Polytrauma is a term used to describe the condition of a person who has suffered two or more traumatic injuries in at least two areas of the body, such as the brain and spinal cord, which can endanger the life of the injured person.

Polytrauma patients require emergency treatment to ascertain possible life threatening injuries. Intensive, coordinated care by teams of interdisciplinary medical professionals working together is vital. While some patients may be able to return to their daily routines with assistance and support, others will continue to require more intense supportive services and care. The fact that two serious injuries have been sustained, may affect where the person will be treated. Typically those who sustain a spinal cord injury may be able to access a specialist spinal injury unit. If someone has also sustained a brain injury, treatment for this injury may take priority and take place within a specialist neurological department. Wherever the treatment takes place, it is vital that both injuries are addressed together and not in isolation, to ensure the optimal outcome for the injured person. This can be very hard to achieve if someone has sustained a severe brain injury which may impact on their ability to engage with rehabilitation and understand how to manage their spinal cord injury.

Support and assistance for these individuals and their families is crucial when dealing with the overwhelming long term effects of two life changing injuries, such as brain and spinal cord injury.

Charities such as the Spinal Injuries Association (SIA), which is the leading national user-led charity for people who sustain a spinal cord injury (SCI), offer support and services required for those with a SCI to lead healthy, social and fulfilling lives. The charity works incredibly hard to raise awareness and campaign to provide invaluable services and create opportunities for people to make the most of their abilities and skills. The SIA offers support and advice by people who have suffered a SCI who can offer their own personal experiences of SCI to other survivors and their families so that those who are newly injured have the support and information to live full and independent lives. The effects of SCI are long term, and the fantastic services provided by the SIA are able to support individuals from the moment their life changing injury occurs, and for the rest of their lives.

Thankfully, polytraumas are relatively rare, but when they do occur it is important that specialist advice is sought from specialists who understand the complexities of each injury. As a Trustee for Headway East London, a charity providing support services to brain injury survivors, their families and carers, it is great to see two leading charities working together through a conference to better inform lawyers, other professionals and the public of the immediate and long terms effects of brain and spinal cord injury.

A polytrauma can impact on every aspect of day to day life, so compensation needs to reflect the amount of treatment, care, support, equipment and accommodation these individuals require. At Bolt Burdon Kemp our specialist solicitors understand how important it is to access immediate and ongoing support for clients and their families who have sustained life changing injuries to ensure our clients’ futures are safeguarded as best as possible. 

Marilene Antoni is partner at Bolt Burdon Kemp and has years of experience of acting for clients who have sustained life changing injuries. If you or a loved one have suffered a spinal cord injury, as a result of someone else’s negligence, contact us online or call 0808 1596 075 for expert advice from our dedicated team. 

Marilene Antoni 
DDI +4420 7288 4836
Mobile: +447912 248624
Bolt Burdon Kemp
Providence House, Providence Place, Islington, London N1 0NT
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Wednesday, 28 May 2014

Bolt Burdon Kemp: Pursuing a Legal Claim for Compensation for Cauda Equina Syndrome

Is there anything different about pursuing a legal claim in relation to Cauda Equina Syndrome (CES)? Let's take a closer look at the condition itself and some key information about pursuing a legal claim for medical negligence

What is Cauda Equina Syndrome? 

CES is a neurological condition and a spinal cord injury, which may initially be referred to as having a ‘slipped disc’. It occurs when the nerves of the end of the spinal cord become compressed. The term "caudal equine" actually means 'tail of horse' and refers to the nerve roots at the end of the spinal cord resembling a horse's tail. CES is a relatively uncommon condition and is considered a medical emergency if it occurs.

CES can affect people of any age. Depending on the severity of nerve compression and where the nerves are compressed, the condition can cause a number of injuries including lower back pain, sciatica, numbness, loss of feeling, and bladder and/or bowel dysfunction.

What are the symptoms? 

CES usually starts with lower back pain. Other symptoms can include numbness or pins and needles around the lower back or buttocks, weakness in the legs and difficulty controlling your bladder and/or bowels.

How is it diagnosed? 

Doctors should ask patients about their symptoms. If patients have one or more of symptoms listed above, further investigations should be undertaken to exclude CES, which can include a rectal examination to test for sensory loss. The syndrome can be confirmed using imaging, most commonly an MRI scan.  

How is it treated? 

Most patients are treated with decompression surgery which should be carried out urgently, to reduce the possibility of long term symptoms. 

Legal claims relating to Cauda Equina Syndrome 

1.    The majority of claims are against hospitals 

Whilst claims are sometimes pursued against GPs or even physiotherapists, the most common claim, if you receive treatment under the NHS, is against a hospital. 

This is because of the way that the condition usually progresses:  A patient will usually have one or more symptoms of CES, however as the symptoms at the start of the condition are not severe, patients initially tend to go to their GP, who will refer them to a hospital if they suspect Cauda Equina Syndrome. Should the referral be made promptly, a claim for a later delay in diagnosing CES will usually be made against the hospital. 

2.    Initial symptoms often fluctuate  

As the spinal cord nerves are being compressed, patients usually report initial symptoms of lower back pain which then seem to resolve. It is common to hear that patients do not become concerned and seek medical attention until sometime later (either hours or days) when further symptoms occur. In fact, what patients initially feel as the pain going away is actually nerve damage occurring; the pain is still there but patients cannot feel it due to compression of the nerves. As a result, once their symptoms deteriorate and the condition is diagnosed, it has usually been there for some time already. 

3.    Most claims relate to a delay in diagnosis

Claims for compensation for medical negligence tend to arise when a patient has presented with symptoms of CES but there has either been a delay in diagnosis and treatment, which may be  because the right investigations were not undertaken. CES can progress very quickly and every minute matters - therefore any delay in diagnosing and treating the condition can leave patients with lifelong injuries.  

4.    You need to prove that the negligence caused further inury

In order to succeed with a medical negligence claim, the person bringing the claim needs to prove two things: 1) That the medical treatment provided to them fell below the standard which they reasonably could have expected, and 2) that this caused an injury which would not have otherwise occurred. 

In the majority of claims relating to CES, proving what injuries were caused as a result of the negligence that would not have otherwise occurred is the more challenging aspect of the claim. This is done using the expert opinions of independent doctors. CES progresses very quickly and even with appropriate treatment it may already have been too late to make a difference to the patient's condition and overall outcome.  

5.    Specialist solicitors should be instructed

CES is a complex medical condition which can leave patients with lifelong injuries, requiring significant changes in both their personal and professional lives. It can result in patients suffering serious physical and psychological injuries. 

A legal claim can assist patients in obtaining financial compensation. It is vital that anyone who wants to pursue a legal claim relating to CES instructs a firm of solicitors who not only specialise in medical negligence claims, but who also have experience of handling such complex spinal cord injuries.

Ipek Tugcu is a solicitor at Bolt Burdon Kemp and specialises in medical negligence claims. She has experience of acting for clients who have been injured due Cauda Equina Syndrome. She can be contacted on 0207 288 4849 or by email on 

 If you think you may have a claim for medical negligence, contact us online or call 0808 1596 075 for expert advice from our dedicated team.  

Ipek Tugcu
DDI +4420 7288 4849
Mobile: +447584 280945
Bolt Burdon Kemp
Providence House, Providence Place, Islington, London N1 0NT
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