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Amputations
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Erb's Palsy
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Amputations

Amputations result when a part of or entire limb is severed from the rest of the body.  Approximately 25% of amputations in the United States are linked to industrial, machinery, farm, or motor vehicle accidents.  Some amputations are the result of birth injuries or medical negligence.  Some amputations occur as a result of medical malpractice even though the underlying injury occured on the job (whether it was due to inadequate guards on machinery, ineffective tools and equipment, improper repairs or lack of training necessary to operate machinery and equipment) if the limb was removed to do medical error.

Although not common, sometimes amputations are caused by negligence or intentional misconduct.  In such situations, the person who acted negligently may be held responsible to the injured party.  This list of people includes, but is not limited to, doctors, hospitals, product manufacturers, vehicle drivers, and construction site operators.

If you or someone you know has been injured due to an amputation, you may be entitled to monetary compensation.  Please fill out the form below for a free evaluation of your claim by an experienced personal injury attorney.  There is no cost or obligation for this service.


Free Amputations Consultation

Title:
First Name: *
Middle Name:
Last Name: *
Home Phone: *
Cell Phone:
Work Phone:
Email Address:
Address: *
City: *
State, Zip: *    *

What is the best way to reach you?
Please provide the best place, time and
method for contacting you.


Injured Person Information:

Date of Birth / Age:
(ex. mm/dd/yyyy or 54)
Were you injured? Yes    No
If not, who are you 
inquiring on behalf of?
If you are NOT inquiring on your own behalf,
what is your relationship to the injured person?
Is the person deceased? Yes    No
If deceased, what is the cause of death
as stated on the death certificate:
Date of Death:
(ex. mm/dd/yyyy)
Was an autopsy performed? Yes    No
If not deceased, does the 
injury prevent you or the 
victim from working?
Yes    No
If yes, when did you/victim stop working?
What is the approximate lost wages
due to the injury?


Accident / Injury Information:

Name of Doctor:
Date of malpractice:   *
City where malpractice occured: *
State where malpractice occured: *
What type of procedure, surgery or treatment
was performed?
Why do you believe malpractice occurred?
Describe injury resulting from malpractice:
Name and address of Doctor, Hospital, Nursing
Home or Healthcare facility:


Case Description*
Please explain exactly what happened, trying to state
as thoroughly as possible who you believe was responsible
and why you believe that person was negligent:
Please explain the full extent of the victims injuries:
Comments / Additional Information
Is there anything else that would assist us in
understanding the facts of your case?


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