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#1 Posted : 05 October 2005 08:37:00(UTC)
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Posted By Steven Please can someone help me clarify a problem i have with the definition of amputation in conection with RIDDOR. Would you class slicing the top of your finger off as an amputation? No bone fractures were involved and doctors have said that the finger should heal back. Thank you in advance for your help Steve
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#2 Posted : 05 October 2005 09:16:00(UTC)
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Posted By peter gotch Hi Steven, If in doubt report ! Definition in online medical dictionary starts "Removal of part or all of a body part enclosed by skin. For example, removal of part of a finger or an entire finger would be termed an amputation...." RIDDOR 1995 unlike its 1985 predecessor does not include any minimum amount of tissue that requires to be cut off to fall within the definition of what amputations are reportable. Regards, Peter
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#3 Posted : 05 October 2005 09:23:00(UTC)
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Posted By Cr8r Steven I had exactly this last year with a guy who said he had amputated his thumb. By the time he reported the accident, three weeks had gone by as he apparently did it at the end of the day before he left to go on holiday. When I saw him, it turned out he had taken the skin off his thumb. At the time I sought advice on the definition of "amputation" and the unanimous conclusion from medics was that bone needed to be lost to qualify. A partial amputation would be some bone or down to a joint, a full amputation would be the whole thumb or finger. I therefore did not report my case, as we felt that slicing the skin off did not qualify in any way as an amputation. Hope this helps!
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#4 Posted : 05 October 2005 10:35:00(UTC)
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Posted By ITK Disagree with "if in doubt report", thats how RIDDOR stats become grossly over reported, if its not reportable don't report it, seek definitive advice from the Enforcing Authority. Not forgetting that if the person who has been injured is unable to do the full range of their normal duties for more than 3 days (including days off) then it becomes RIDDOR reportable anyway.
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#5 Posted : 05 October 2005 12:39:00(UTC)
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Posted By peter gotch ITK RIDDOR stats are grossly underreported [i.e. over 50% of reportables] as demonstrated by various research. Checking with the RIDDOR reporting hotline [or even an Inspector] ain't going to give you a definitive answer. That's for the Courts! You can be prosecuted for not reporting - you can't be prosecuted for taking an "if in doubt, report" decision. The advice that I [and many colleagues] used to give when I worked for HSE. Regards, Peter
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#6 Posted : 05 October 2005 13:27:00(UTC)
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Posted By ITK Peter, thanks for that, I work for a LA and see countless RIDDOR forms (particularly from the care sector) which are non reportable, but they go on the stats both with the LA and the ICC for example where an elederly person has fallen in a residential care home for no apparent reason, which as you know is non reportable. If a H&S manager cannot understand the legal requirements of RIDDOR and wont seek advice from the EA then I pity the organisation, furthermore if an Enforcement official (LA or HSE)cannot give a difinitive answer on legislative requirements then I question if they are in the right job. I still stand by the don't report for the sakes of it stance. Regards.
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#7 Posted : 05 October 2005 16:08:00(UTC)
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Posted By J Knight It is, and I quote, 'only a flesh wound'; you have to lose a bit more than some skin to talk about amputation, John
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#8 Posted : 05 October 2005 16:15:00(UTC)
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Posted By Steven The injury was such that the injuryed person lost about 5mm off the end of here finger, half of their nail. My original question did not have all the relevant information for people to decide whether it is reportable or not. The incident has been reported but what would you report it under - major injury or 3 day(as that is what it will be)
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#9 Posted : 05 October 2005 16:24:00(UTC)
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Posted By Mark Bywater Guys, I have to point out about a previous respondents idea that bone has to be lost for an amputation takes place. What happens in the case of the loss of the complete external part of the ear? Surely that is an amputation but has not "qualilfied" as no bone was lost. I don't agree with the previous respondent's definition of amputation, but I like the fact that stuff like this is debated so frequently. Regards, Mark
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#10 Posted : 05 October 2005 16:32:00(UTC)
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Posted By Cr8r Mark - it was me who said about the bone! I don't know about an ear and I guess that would qualify! I only enquired at the time in relation to a thumb! At the end of the day, we make the judgement on what we think is best - usually following a phone call to the HSE! Even if a previous respondent says this is inconclusive. Lots of us have further repercussions if we have a RIDDOR, and therefore reporting "just in case" is not always the most sensible outcome. In one company I worked for, a RIDDOR would result in at least a fortnight of endless phone calls, report writing and grillings. Believe me, you only end up reporting what you fully believe is required. More fuss is made over the fact that there's a RIDDOR that what actually happened to someone. I'm not saying this is right, just that it happens.
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#11 Posted : 05 October 2005 16:38:00(UTC)
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Posted By J Knight Fair comment, and ears and noses which as you point out don't have bone (well, noses have bone at the base but cartilage at the tip) did cross my mind but I meant the comment about bones in the context of fingers and toes, sorry for the ambiguity, John
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#12 Posted : 05 October 2005 17:13:00(UTC)
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Posted By Brian Hagyard Was beginning to think I was in the wrong job (thanks ITK), cannot find any definition in the regulations themselves the guidance LACs or HSE web site! Then eventually found the following. www.hse.gov.uk/statistics/statnote.pdf Achieving the Revitalising Health and Safety Targets Statistical Note on Progress Measurement Health and Safety Executive Epidemiology and Medical Statistics Unit and Economic and Statistical Analysis Unit June 2001 On page 21 of this report on accidents it states: Amputations of fingers, thumbs or toes were only reportable if the joint or bone was completely severed; Not definitive I know, and I don’t know where ears fit in but as this is an HSE report I would suggest that skin and nail off the end of the finger look to be none reportable. Brian
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#13 Posted : 05 October 2005 18:13:00(UTC)
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Posted By Paul Oliver "Amputate" means to remove, so if you remove a bodily part then this is classed as amputated. As previously said, you do not need to lose a bone in order to be classed as having had something amputated. (remember Mr Bobbit!)
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#14 Posted : 06 October 2005 09:13:00(UTC)
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Posted By Brian Hagyard Come on people, Stevenon asked for a RIDDOR definition of amputation, and how much of a finger needed to be lost for it to be an amputation. So far I have seen peoples personal opinions but no definitive definition in the regulations or guidance. I have seen insurance policies for injuries that will pay out different sums depending on how many joint of the finger you lose, if no joint is lost its not classed as an amputation, but that does not make it a RIDDOR definition. If its not defined in the legislation or guidance then my understanding would be that it would only be down to the courts to interpret. Medical definitions may give guidance to a court but they are not always followed, how long did we refer to RSI before court cases made us switch to WRULD? So I challenge you to find a definition in an HSE document or a court ruling that makes this case clear and let us not get confused about other parts of the body. My personal thought is still that this would not be a RIDDOR major injury but needs reporting as an over three day injury, as Stevenon has indicated he has done. Brian.
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#15 Posted : 06 October 2005 18:27:00(UTC)
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Posted By Jay Joshi The guidance to RIDDOR explains amputation as:- AMPUTATION means either traumatic amputation at the time of the accident or surgical amputation following the accident (but the latter is more likely to be covered by 7(c) ie an injury where the person is admitted to hospital for more than 24 hours) Not at all helpful as we have to interpret the term "traumatic amputation" !!
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#16 Posted : 06 October 2005 22:43:00(UTC)
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Posted By George Wedgwood I would not recommend to my Board that we report it, as 'trauma' was not involved - i.e. the need for immediate intensive care was not required. If the bone was involved, then I would be sympathetic but will continue to classify such as a Minor injury. I have seen worse being treated with 'Lasso tape' and the IP continued working after the bleeding had stopped!!
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#17 Posted : 07 October 2005 09:31:00(UTC)
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Posted By John Lewis Hi Guys I had a chap last summer who de-gloved his thumb in a pulley wheel. Almost led to a prosecution, but there was no loss of bone; not initially anyway. The surgeon took the big toe and grafted it on! Of course, it was a RIDDOR anyway due to unavailability for work. Regards John
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#18 Posted : 07 October 2005 10:18:00(UTC)
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Posted By J Knight Really can't agree with George that it's only reportable if a visit to hospital was involved; nowhere in the major injury definition does it say or imply that the injured party should have to visit hospital. I too have been delving into the HSE website and have found a reference in the 2000 version of the HSC's enforcement policy a statement to the effect that all RIDDOR reports of amputations below the first joint should be investigated. While this doesn't define amputation it does imply that an amputation above the first joint would still be reportable, though not automatically investigated, John
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#19 Posted : 07 October 2005 10:32:00(UTC)
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Posted By J Knight To muddy the water; in Farm Child UK, a report prepared in 2003, amputation is given as 'Removal of part of the body by surgery or accident'. Not entirely helpful as we then have to define 'part of the body' (nostril hair? zit?). Will keep looking as it helps me get through reading the draft HTM-05.02, but for me an amputation has to involve removal of something which won't grow back on its own; so removing the fleshy tip of the finger isn't an amputation, as it will grow back, but taking an ear or the tip of the nose or the bony part of a digit away, or indeed performing a bobbit, would be an amputation as it would need surgical repair, if indeed repair was possible. So once again, to refer to the original post, it ain't an amputation, John
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