I was catapulted 10ft in the air and lost my leg after being ploughed into by a van in horror accident – here’s how my miracle NHS doctors got me to walk again
- In July last year Zoltan Szakacsi was crushed against railways which collapsed
- The 33-year-old underwent four high-risk operations and a year of rehabilitation
On July 26 last year, 33-year-old Zoltan Szakacsi, a maintenance engineer, was on his way to collect supplies from a hardware store when disaster struck, changing his life forever.
As he walked towards the store, a van driver veered onto the pavement, hitting Zoltan, crushing him against some railways, which collapsed before he was catapulted ten feet down into the lightwell of a Mayfair mansion.
‘It was very quick,’ recalls Zoltan, who lives in East London with fiancée Julia, 31, and daughters Zselyke, eight, and Zoe, three.
‘There was a huge bang, and within a second, I realised I was lying down and looking up; seeing my blood and flesh on the wall.
‘I couldn’t see my right leg and felt a lot of pain. I’m a trained First Aider so I knew it would be better if I didn’t move.
On July 26, 2022, a van veered onto the pavement, hitting Zoltan Szakacsi (pictured with his daughter Zselyke, 18 days after the accident), crushing him against some railways, which collapsed, catapulting him into the light well of a Mayfair mansion
Zoltan was blue-lighted to St Mary’s Hospital, one of the four major London hospitals involved in the London Trauma System, the largest medical emergency network in the UK. Pictured, Zoltan Szakecsi at St. Mary’s Hospital Paddington with Kirsty Harwood, major trauma rehabilitation coordinator and physiotherapist (left) Lucinda Thomson, team lead physiotherapist (middle) and Rebecca Ledger, specialist occupational therapist (right)
‘When the ambulance crew arrived, they gave me ketamine and I started to lose consciousness – but I fought to stay awake.
‘Then they decided to use my tie to close the blood vessels on my leg. I took a deep breath.
‘I heard one of them say to another: “Give him more,” and they gave me another injection.
‘At that stage I knew definitely I was going to lose my leg. But I wasn’t upset, I accepted my fate.’
Zoltan was blue-lighted to St Mary’s Hospital, one of the four major London hospitals involved in the London Trauma System, the largest medical emergency network in the UK.
It was one of a number of similar networks set up to streamline trauma response: the London Trauma System treats more than 12,000 people a year who may have been victims of road accidents or stabbings, for example, and have multiple injuries so need to be treated by a team of specialists, often operating together.
Trauma — where people experience multiple life-threatening injuries — is still one of the major challenges for our healthcare system, claiming 16,000 lives a year in the UK.
It is the leading cause of death in people under the age of 44 and numbers are rising as crime rates increase.
Read more: ‘Instead of saving people, the health system is now killing them’: NHS doctor reveals how every day in A&E ‘is like a war zone’ as he tells of 8-hour waits even in ‘quiet’ summer months and warns patients to get private medical cover if they can afford it
Set up in 2010 in the wake of the London bombings, the London Trauma System has increased the survival chances of patients over the past five years by a massive 50 per cent.
Now the network — made up of four major trauma centres: The Royal London, St George’s, King’s, and St Mary’s Hospitals, as well as 35 trauma units, ambulances, air ambulances — has allowed cameras behind the scenes to follow the medics who save lives in a documentary airing today on Channel 4.
Zoltan’s story is one of the main stories featured — and here, in a detailed diary of what happened after his accident, we see how paramedics, orthopaedic surgeons, plastic surgeons, physiotherapists, occupational therapists and prosthetists, worked around the clock — including four high-risk operations and a long rehabilitation journey until he was walking again.
Tuesday July 26, 2022
1.49pm
The incident is captured by CCTV. A male passerby dials 999 saying: ‘A pedestrian on the pavement has been hit by a van and he’s lying in a light well. His foot is very severely crushed. He’s barely conscious.’
London Air Ambulance Flight paramedic Jason Morris is in the Tactical Operations Centre at the London Ambulance Service, monitoring 999 calls when he receives an electronic message about Zoltan.
He uses the GoodSAM instant help App, which allows clinicians to remotely access the caller’s smartphone camera, to monitor the 33-year-old’s injuries.
‘Across London we take approximately 6,000 calls a day,’ he reflects. ‘We’re looking for that person requiring an advanced trauma team,’ meaning they require treatment for multiple injuries.
Within six minutes Zoltan is rescued by the London Ambulance Service NHS Trust and is blue-lighted to St Mary’s Hospital in Paddington.
In the ambulance, Zoltan gives the crew his fiancée’s number: Julia, a hotel housekeeper (she’s since given up her job to care for Zoltan), asks the neighbours to look after their girls and rushes to the hospital.
3.01pm: One hour, 12 minutes after the accident
Zoltan arrives at St Mary’s Hospital three miles away and is rushed to the resuscitation bay in A&E, which looks after the sickest patients. He is conscious but bleeding profusely.
The major trauma team, led by Chris Jordan, a consultant orthopaedic and trauma surgeon, assesses his right leg.
‘It was evident very quickly when we looked at the leg that there wasn’t a reconstructive option,’ he says.
There is significant tissue damage to the lower leg – all that remains, he says, is ‘the Achilles tendon, which still attached the calf muscle to the heel bone’.
On top of that a significant amount of bone has been left exposed. A team of orthopaedic, plastic and vascular surgery consultants make the unanimous decision that the only option is to amputate the lower part of his leg, between the knee and ankle.
Zoltan is put back on the A&E trolley and goes for a head-to-toe CT scan to look for other injuries, while Kshem Yapa, a consultant plastic and reconstructive surgeon, scrubs up for the operation to amputate his leg.
Zoltan is monitored and given intravenous fluids and blood to keep his circulating blood volume up.
Zoltan arrives at St Mary’s Hospital three miles away and is rushed to the resuscitation bay in A&E, which looks after the sickest patients. He is conscious but bleeding profusely. There is significant tissue damage to the lower leg and a significant amount of bone has been left exposed. A team of orthopaedic, plastic and vascular surgery consultants make the unanimous decision that the only option is to amputate the lower part of his leg, between the knee and ankle
4.40pm: Two hours, 51 minutes after the accident
Immediately after his CT scan, Zoltan is whisked to Theatre 8, a dedicated emergency theatre at St Mary’s, which is on standby for patients who are in danger of ‘life or limb’. He is reassessed by the anaesthetists and then undergoes a 50-minute operation, where Mr Yapa performs the amputation, stemming the blood flow by tying off the injured blood vessels.
Tuesday July 26, 2022
8.10pm: Six hours, 21 minutes after the accident
Zoltan, now conscious following his surgery, is deemed stable enough to be moved to the major trauma ward where he is given a mixture of painkillers. The CT scan reveals the left side of his pelvis has been significantly damaged by the accident and he needs further surgery to stabilise it.
Zoltan facetimes Athenaeum general manager Joanne Taylor-Stagg, who witnessed the accident.
‘He started out the conversation asking if I was all right,’ she recalls. ‘Then he said he was ok and that he was going to get “a sexy leg”. He is a cyclist like me, so I said: ‘When you get your sexy leg, you and I will go for a bike ride around Hyde Park.’
Friday July 29, 2022
9.30am: Three days after the accident
Zoltan is taken back into theatre for an operation to stabilise his pelvis. There are breaks on both sides and the left side of the pelvic bone is barely attached to his spine.
‘The first stage of getting Zoltan back to work is to stabilise his pelvis,’ says Mr Jordan.
‘He’s got breaks at the front on both sides of the pelvic bone, and on the left side there’s a crack all the way through at the back.’
Mr Jordan leads the orthopaedic team for the four-hour operation, working in tandem with the plastic surgeons.
They insert screws and a rod to stabilise his pelvis.
‘The end game with Zoltan is that we get him back to being independently mobile and on a prosthetic leg. He needs a stable skeleton if we stand a chance of getting him walking again.’
Tuesday August 2, 2022
3.30pm: One week after the accident
Lead physiotherapist Lucinda Thomson and specialist occupational therapist Rebecca Ledgard visit Zoltan to try to get him sitting up and into a wheelchair – the first step in getting him mobile again.
He sits on the side of his bed for the first time, using his elbow to push him up. But he struggles to stay up-right and gets dizzy, so they abandon any attempt to get him into a wheelchair.
‘This is normal because when you start getting up your blood pressure drops a little bit,’ says Lucinda.
She adds: ‘With trauma patients it can be difficult sometimes to rein them in to what their body is capable of doing.
‘They want to be able to do it, they’re motivated to do it, but their body is just not quite ready yet.’
The next day Zoltan manages to get into the wheelchair for the first time.
On August 13, 2022, Zoltan is ready to get into a wheelchair and see his daughters for the first time since his accident. Describing his reunion with his daughters, Zoltan says: ‘I was so happy. There were no tears, just a huge celebration’
With physiotherapist Kirsty Harwood, the major trauma rehabilitation co-ordinator, guiding him, he slowly swivels onto the edge of the bed and heaves himself into the chair. ‘We’ve been working towards getting him out of bed,’ she says. ‘Today is the first time that Zoltan’s going to see his daughters, so there’s a lot riding on today for him. Zoltan has been through a huge emotional rollercoaster while he’s been with us, but family members help motivate people to keep pushing through those dips along the way and stay positive’
Saturday August 13, 2022
11.59am: 18 days after the accident
Zoltan is ready to get into a wheelchair and see his daughters for the first time since his accident.
With physiotherapist Kirsty Harwood, the major trauma rehabilitation co-ordinator, guiding him, he slowly swivels onto the edge of the bed and heaves himself into the chair.
‘We’ve been working towards getting him out of bed,’ she says. ‘Today is the first time that Zoltan’s going to see his daughters, so there’s a lot riding on today for him.
‘Zoltan has been through a huge emotional rollercoaster while he’s been with us, but family members help motivate people to keep pushing through those dips along the way and stay positive.
‘When a patient reaches their goal it gives you a huge sense of fulfilment, but Zoltan has still got multiple orthopaedic and plastic surgeries ahead of him and at least a nine to 12 months’ rehab, so it’s just the start of his journey. He has got to literally learn to walk again.’
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Describing his reunion with his daughters, Zoltan says: ‘I was so happy. There were no tears, just a huge celebration.’
Thursday August 18, 2022
10.00am: 23 days after the accident
It is the day of Zoltan’s third operation – to ensure his stump is suitable for a prosthetic limb – which takes a mammoth four hours.
Ed Matthews, a consultant trauma and orthopaedic surgeon, and Mr Yapa work together.
They trim the remaining part of his fibula — the smaller bone on the outside of his lower leg, so that it doesn’t interfere with the mechanics of his prosthetic — and insert two small screws to stabilise the bone.
‘We’d like to keep the bone part of his stump about 15cm long,’ says Mr Mathews.
‘If we make his stump shorter, then it’s very difficult to wear a prosthesis and that will mean that his life will be harder in the future.’
Mr Yapa also performs myodesis, a technique in which muscle is secured to the bone, to provide padding for the stump; and muscle reinnervation, which involves cutting and re-routing the nerve ends to prevent neuromas, painful lumps that can form at the ends of the cut nerves.
Afterwards he uses acellular dermal matrix – a material used to replace deficient or missing skin, which acts as scaffold so that the patient’s own cells or a skin graft can take hold around the wound.
‘My role is to try and provide some soft cushioning for the bone end,’ explains Mr Yapa.
‘The nerves need to be positioned and shortened in such a way that they don’t lie at the end of the stump because that can become a pressure point and cause pain down the line.
‘There’s still a lot at stake: if there is infection or if the skin doesn’t heal, Zoltan may still need an amputation at a much higher level, and this can have a huge impact on his ability to walk in future.’
2.00pm
Julia visits her husband after his surgery — she has been at the hospital every day during visiting hours.
‘It’s a long way to go for sure,’ she says, explaining that her fiancé’s rehabilitation will take time.
‘He’s trying to stay positive for me and for the girls. He’s not showing it, but it’s hard for him.’
Saturday August 27, 2022
3.50pm: Four weeks and four days after the accident
Zoltan is discharged from hospital on his fiancée’s 31st birthday in a wheelchair, having pushed the doctors to be able to do so.
‘They didn’t want me to go home because of my upcoming surgeries,’ he says.
He however was ‘determined’ and his children are delighted.
‘I got home late afternoon and they were waiting for him and my girls wouldn’t leave me alone.
‘They even wanted to sleep with me but Julia said: “You have your own bed. You do. Daddy’s mine”.’
In October 2022, ten weeks after the accident, Zoltan continues to attend the exercise programme and graduates from the parallel bars to a PPAM Aid (a Pneumatic Post-Amputation Mobility Aid), which is shaped like a metal leg, with an air-filled cushion bag
This is designed for partial weight bearing and is used to prepare him for wearing a prosthetic leg and re-educate his posture, balance and gait
Tuesday August 30, 2022
10.00am: Five weeks after the accident
Zoltan begins an outpatient exercise rehabilitation programme at Charing Cross Hospital by Laura Burgess, lead physiotherapist for vascular and amputee rehabilitation at the hospital.
She says: ‘We have to do a lot of work with people before they get the prosthesis.’
They assess how much movement he has and the strength of his muscles.
‘We look at all of those things and do lots of things to remove swelling such as fitting compression socks.’
At first he visits three times a week but gradually the visits lessen to twice a week.
Friday September 9, 2022
4.00pm: Six weeks and three days after the accident
Zoltan returns to St Mary’s for a fourth operation, a skin graft, under general anaesthetic.
In a 90-minute operation, Mr Yapa takes a thin shaving of skin from his thigh and applies it to the stump, stitching it into place.
‘There is still a risk of infection,’ says Mr Yapa, ‘So a special dressing called a VAC (vacuum-assisted closure) dressing is applied, which seals the grafted area and applies suction to it via a pump.
A week later the grafted skin has healed onto the tissue beneath it and blood vessels are growing into the graft; a significant milestone in his recovery.
‘This is the first step,’ says Mr Yapa. ‘The skin graft will still be fragile. It is likely to become more robust in the following weeks in order to tolerate a prosthetic.’
Wednesday October 5, 2022
1.30pm Ten weeks and one day after the accident
Zoltan continues to attend the exercise programme and graduates from the parallel bars to a PPAM Aid (a Pneumatic Post-Amputation Mobility Aid), which is shaped like a metal leg, with an air-filled cushion bag.
This is designed for partial weight bearing and is used to prepare him for wearing a prosthetic leg and re-educate his posture, balance and gait.
Thursday October 27, 2022
10.00am: 13 weeks and two days after the accident
It is two weeks until Zoltan will be fitted with a prosthetic limb and he attends a multi-disciplinary meeting with Laura Burgess and senior prosthetist Jack Murray, who takes a cast of his leg, to create his artificial limb.
Thursday November 10, 2022
1.30pm: 15 weeks and two days after the accident
Zoltan visits the limb fitting centre, below the gym at Charing Cross, where he is fitted with his prosthetic limb by Jack Murray.
This involves fitting the prosthetic socket onto Zoltan’s leg, checking the fit, advising how many prosthesis ‘socks’ he should wear (over the end of his limb), adjusting the length and alignment of the prosthesis, to make sure he is comfortable.
With Laura Burgess’ guidance, he takes his first faltering steps.
‘Today will definitely be one of a real milestone because this will be the first time that Zoltan’s taken some steps since he lost his leg,’ says Laura.
‘It was an amazing feeling to be able to move again,’ says Zoltan. ‘I was not allowed to stand up for six weeks after my pelvic operation so it was very emotional.’
In November 2022, 15 weeks after the accident, Zoltan was able to take his first steps since having part of his leg amputated. Pictured, Zoltan at Charing Cross Hospital with Chris Jordan, consultant orthopaedic surgeon (far left), Jack Murray, prosthesist (left), Kshem Yapa, consultant plastic surgeon (right) and Laura Burgess, clinical specialist physiotherapist (far right)
Monday November 28, 2022
10.00am: 17 weeks and six days after the accident
After graduating to a walking frame and later a walking stick, finally Zoltan walks without any aid.
Tuesday January 3, 2023
8.00am: 23 weeks after the accident
Zoltan is well enough to go back to work sat this job at the Athenaeum Hotel and Residences.
‘I turned up an hour early to get ready for the day,’ he says. ‘I took the tube which was very challenging.
‘He can’t yet cycle as I couldn’t cycle at the movement in his leg is still restricted and he can’t bend his knee.’
Monday May 1, 2023
4.23pm: 10 months after the accident
Zoltan cycles for the first time near his home in Stratford. ‘The stopping and starting is difficult,’ he says but he vows to practise.
Wednesday July 26, 2023
7.00am: One year after the accident
It’s the anniversary of his accident, Zoltan sets off from the Athenaeum for the London to Brighton Cycle Ride alongside ten colleagues.
He arrives in Brighton at 5pm having cycled 90.16km.
‘I enjoy the freedom and the fresh air when I am on the bike,’ says Zoltan.
‘I knew at the moment of my accident that I would cycle again even if I lost my leg. Cycling makes me feel less disabled than walking. I enjoy it the same as before.’
Emergency airs on Channel 4 at 9pm on August 15
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