Paul, 38

Paul was left with bowel, bladder and sexual dysfunction, as well as foot drop, after urgently needed surgery to treat cauda equina syndrome was delayed due to a non-emergency patient being prioritised. Paul’s case was taken on by Eddie Jones, a leading cauda equina solicitor at JMW, and he was awarded £220,000 in compensation to help him to cope with the financial consequences of the hospital’s negligence.

Start of ordeal

Paul’s ordeal began when he saw a return of the sciatic nerve pain he had suffered intermittently for several years. Originally he saw his GP about this and reported that he had been experiencing significant pain down his right side for the last two weeks.

A couple of weeks later, while Paul was visiting family, his pain worsened and he attended a local hospital Accident and Emergency department. X-rays were taken of his spine, which showed some degeneration. Once back at home, Paul returned to his GP as pain continued. The GP carried out a neurological examination of Paul but did not find any specific neurological problems at this stage.

Deterioration

About a week after his last GP visit, Paul called NHS Direct as in addition to the severe back pain he was suffering he had developed further concerning symptoms in his legs. The pins and needles and burning sensation he was experiencing had come on quite suddenly and Paul was advised to attend an urgent care walk-in centre later that day.

However, before Paul could attend the appointment, his condition deteriorated further. He lost power in his legs and found that he could not stand properly. Paul was put in touch with an out of hours GP who arranged for an ambulance to take him to hospital.

At his local hospital, Paul was diagnosed with suspected cauda equina syndrome (CES). As it was the weekend, the hospital had no facility to carry out an MRI scan to confirm the diagnosis and in addition there was no orthopaedic bed available. It was decided that Paul should be transferred to a specialist neurosurgical unit.

Paul arrived at the hospital at around 11.30pm that evening but was not reviewed by a doctor until 1am. It was noted that he required an urgent MRI scan and surgery to relieve pressure on his cauda equina nerves.

Non-emergency patient prioritised

Two hours later the MRI scan was carried out which confirmed that a large disc in Paul’s spine had herniated and was causing the nerve compression. Paul required immediate surgery to treat this severe injury.

However, an operation on another patient suffering from appendicitis was also required and a decision was made to delay Paul’s surgery to later that morning and prioritise the other patient.

There was another theatre that could have been opened to ensure both patients could receive the care they required, however this was not done.

An intensive care patient also required urgent surgery that morning so once the appendix removal had been done there was once again no theatres available to operate on Paul.

To complicate matters further, another patient requiring spinal decompression surgery was admitted. This surgery had been arranged following an MRI scan several weeks before which showed a problem with a disc putting pressure on the cauda equina nerves. However this patient had no symptoms of CES and was not facing an emergency situation.

At this point the hospital did open the second theatre, however it was the second spinal surgery patient who was operated on and not Paul, despite it being he who had the red flags of CES. Paul’s surgery was not performed until later that evening just after 6pm. This delay of many hours led to Paul suffering permanent CES and he has been left with ongoing bowel, bladder and sexual dysfunction. He has also lost power in his legs and has right-sided foot drop which causes him to stumble.

Successful medical negligence claim

Paul’s case was take on by Eddie Jones, a leading cauda equina syndrome solicitor and head of medical negligence at JMW. Eddie’s investigation revealed that it was negligent of the specialist neurosurgical unit to not manage its resources effectively to ensure all the patients requiring emergency surgery, including Paul, were operated on in a timely manner.Paul’s operation should have gone ahead at 8am, and at the very latest by 12 noon. To leave it until 6pm had caused irreparable damage to his cauda equina nerves.

Eddie was successful in securing compensation totalling £220,000 to help Paul purchase the aids and equipment he will need to manage his condition and to ensure he has accommodation that is adapted to his needs.

 

 

 

 

 

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