Medical


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appeared, been made in any previous cases in the UK. In spite of that, and to the insurer's credit, funding was agreed for the treatment. Mr B was deemed a suitable candidate for surgery and he flew


back to Sweden in June 2011. Stage 1 surgery was performed under epidural. Surgery


involved the titanium fixture being inserted into the residual femur with the skin then closed. Surgery was successful and he returned to the UK within 12 days. Mr B was under strict instructions not to weight bear in the


immediate period following his return home but at six weeks post surgery it was vital for him to weight bear again. He was able to use his previously provided prosthesis, albeit with the same limitations that existed beforehand. Stage 2 surgery typically takes place 6 months after Stage 1


surgery and Mr B flew out to Sweden in November 2011. Stage 2 surgery went well and involved the addition of an abutment to the titanium fixture, to which the prosthesis would eventually be attached. He was able to again return to the UK promptly having recovered from surgery. Four weeks later he was back in Sweden for his first rehabilitation appointment when he was fitted with a prosthesis enabling him to partially weight bear. Mr B immediately noticed the improved sensation of the prosthesis, commenting that it was "part of me" and did not feel as if it was attached to him. Additional trips to Sweden for further rehabilitation took place


in March, May and November 2012, by which time Mr B was fully mobilising using his previously purchased prosthesis. Though Mr B still faces many challenges in the future, from a prosthetic point of view he is now in a better place than he ever imagined whilst he was struggling with a socket-based prosthesis.


Litigation tactics Defendants are likely to question the need for such surgery during


the litigation given the lack of availability of osseointegration in the UK and the fact that the long term effects are still unknown. This should not prevent a claim from being made. A witness statement from the claimant setting out the reasons


why he/she wishes to undergo osseointegration, together with a statement from the instructed solicitor setting out the costings, process, and expert opinion advising the surgery is a reasonable option, should be enough to at least ensure that at any interim payment application, a favourable result is secured. An important consideration for trying to sell osseointegration


to a defendant insurer is that with a well fitting prosthesis, the claimant's ability to rehabilitate will be considerably improved. While the claim for medical expenses may increase due to the


above costs, other heads of loss should fall. The primary benefit of osseointegration is that it negates the need for sockets, which typically cost £4,500 to £6,000, to be replaced every five years. For a claimant with a long life expectancy, as most patients


that qualify for osseointegration will be, there can easily be a cost saving of £30,000+ as a result of no longer requiring sockets. ●


Costs Costs will vary from patient to patient but during the course


of Mr B's litigation the following costs were incurred:


• Flights/hotel accommodation for Claimant and mother for 12 separate trips – £27,500


• Initial Assessment – December 2010 – £1,207 • Pre Operative appointments (two in total) – £2,951 • Stage 1 Surgery – June 2011 – £27,745 • Stage 2 Surgery – November 2011 – £36,400


• Follow up Appointments (months 1,3,6,9,12 and 18, including adjustments to prostheses – £20,717


• Sub Total of cost of treatment during the litigation – £90,000


• Further follow up sessions are anticipated at 3,5,7,10 and 15 years post surgery and these were claimed for at a cost of £3,000 per session, to include travel and accommodation expenses.


• The total figure claimed for the surgery and associated costs was £132,500. This does not include the cost of


prostheses which need to be allowed for in the usual way. Claims Magazine/Issue 11/ 49


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