Wound healing is complex and multifactorial. Patients often present with multiple comorbidities as well as complicated biopsychosocial histories. Neglecting patients psychological and social state can impede efforts to prevent amputation. Content: This case report involves a patient with a history of intravenous drug use and diabetes, and whose GP referred him to the podiatry service for claudication symptoms. During the following 18 months, the patient neither attended appointments nor engaged with therapeutic programmes, and his symptoms deteriorated. The patient was eventually hospitalised after treatment failed to prevent autoamputation of his left fifth toe. Conclusion: This report poses the question of whether the podiatry service could have prevented amputation if they had accounted for the patients biopsychosocial situation. The authors discuss the potential of colour flags for highlighting biopsychosocial factors.