Case Study: Negligent Treatment of Cauda Equina Syndrome

Compensation: £357,516

Donna, 35 years old, Chesterfield

JMW has obtained over £350,000 in compensation for a woman following negligent treatment of cauda equina syndrome.

Donna attended her GP with lower back pain and sciatica in her left leg worsening over the previous 2 weeks. She was referred to an orthopaedic consultant at her local hospital.

Two weeks later, before she was able to attend for her appointment, she felt a sudden snapping sensation in her left hip followed by shooting pain in her back and down her left leg. She went immediately to her local A&E and by the time she was examined she was complaining of both numbness and pins and needles in the leg.

On examination anal tone was absent with loss of anal sensation on the right side and a working diagnosis of cauda equina syndrome was made. Donna was then assessed by an orthopaedic SHO whose findings were somewhat different. His view was that although peri-anal sensation was reduced the anal tone was preserved. A diagnosis of prolapsed intervertebral disc was made, Donna was admitted and it was recommended that an MRI scan be performed the next day.

The following day Donna was examined again and a rectal examination confirmed that there was loss of both peri anal tone and sensation. By this time she was also complaining of incontinence of urine although the pain was improving a little. Donna remained in hospital but, for reasons that are far from clear, no arrangements were made for the MRI scan to be performed.

4 day wait for MRI and surgery

4 days after an MRI scan was first recommended. Donna was seen by a senior doctor. Her ability to raise her legs was reduced and she had crossed leg pain, which is a sign of a large disc prolapse. She had saddle anaesthesia and absent anal tone.

Donna was rapidly transferred to the neurosurgical department at the regional hospital for an urgent MRI scan, which showed a massive L5/S1 prolapse occupying most of the spinal canal . A diagnosis of CES was confirmed. An emergency discectomy was carried out the following morning; 121 hours after the initial prolapse.

Lasting effects

Donna continues to suffer from back pain, leg pain and numbness and bladder dysfunction with dribbling incontinence. She has total lack of sexual sensation and cannot tell when her bladder is full except by palpating her abdomen. She becomes constipated and has to manually evacuate her bowels once or twice each week and constantly uses laxatives.

Donna suffers from a depressive illness and her marriage and family life have come under severe strain. It is unlikely that her symptoms will improve or that she will be able to return to full time work.

The claim

JMW Solicitors claimed that the care and treatment received by Donna was negligent in that staff failed to appreciate the significance of, or act upon, the ‘red flag' signs of cauda equina syndrome. If a MRI scan been performed on the day she attended A&E or even the following day the prolapsed disc would have been diagnosed and Donna would have had surgery to remove the disc thereby avoiding the majority of her disabling symptoms.

Settlement

The hospital admitted that the care that Donna received had been negligent and shortly before the case was due to go to trial Donna was awarded £357,516 compensation for her claim.

Have you also suffered negligent treatment of cauda equina syndrome?

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