Appalling surgical failures cause woman’s permanent cauda equina syndrome - £4 million in compensation

‘Abbie’ a woman in her 30s

Abbie sought treatment for low back pain, and she was offered surgery. However, she wasn’t appropriately advised of the risks for the keyhole surgery recommended. Following the operation, Abbie began to suffer with red flag symptoms of cauda equina syndrome which were not investigated. Sadly, Abbie’s condition was made much worse and caused her to become permanently disabled. Abbie contacted the cauda equina specialist solicitors at JMW for advice and her case was taken on by Nicholas Young. Nicholas was able to secure a compensation settlement of £4 million for Abbie to help her to cope with her care needs.

What went wrong?

Abbie had been suffering with grumbling lower back pain for a couple of years before she was referred to a spinal surgeon. The pain now affected Abbie’s right leg and initially the surgeon planned to treat this with an epidural injection to her cauda equina region (the bundle of nerves at the base of the spine resembling a horse’s tail), followed by a follow-up appointment three months later to see how she was getting on. After the treatment, at the follow-up appointment, Abbie reported to the surgeon that her severe leg pain had returned to both legs.

An MRI scan had revealed that there was a herniated disc near the base of Abbie’s spine. The surgeon told Abbie that he was considering surgery to decompress the nerves. A meeting was then held with the surgeon and several of his colleagues to decide the best way forward. Abbie’s surgeon said that he wanted to refer her for a new surgical method by way of keyhole surgery that he thought would be more appropriate than the traditional method for Abbie. The surgeon obtained the support of others in the meeting to refer Abbie to a surgeon who had undertaken this different approach before and might be willing to do it again.

The new surgeon agreed to do the operation and saw Abbie for a preoperative assessment. The appointment was very brief, and Abbie was not examined or given any information about the different surgical options and what they involved. She was told the keyhole surgery recommended would not be too invasive and that she should be able to go home on the same day. Abbie was happy with this and believed that the surgery would be a very good option for her by offering a safe resolution to the terrible leg pain she was suffering. A few weeks later Abbie underwent the operation.

As soon as Abbie came round from the anaesthetic, she felt a lot of pain in both her legs, which simultaneously felt numb. Abbie needed to go to the toilet to pass urine but found that she was not able to do so, and she had to be catheterised. She was sent for a further MRI scan which showed that the cauda equina nerve roots were compressed. In other words, the condition of the disc and damage to her nerves had been made worse by the operation. Despite the worrying neurological symptoms Abbie had, no action was taken other than giving her steroids and pain relief.

Over the next few days Abbie’s condition did not get any better and the numbness in her legs and her inability to pass urine continued. By this point the surgeon had started to realise she needed corrective surgery, however despite the urgency of Abbie’s situation, other patients were prioritised, and the operation was postponed.

The corrective surgery was finally done a couple of weeks later but did nothing to improve Abbie’s condition and, due to the amount of the time that her cauda equina nerves had been compressed, she sustained permanent cauda equina syndrome. She was left with no bladder or bowel control, no sexual function and with numbness in her legs, feet, and saddle area. Abbie was unable to return to work, now finds it much more challenging to care for her children and is reliant on crutches or a wheelchair to move around.

JMW’s investigation

JMW’s Nicholas Young gathered Abbie’s medical records and analysed these closely. He instructed the best independent medical experts practising within the fields of cauda equina care and spinal surgery. The experts agreed that it had been negligent of the surgeon who operated on Abbie not to fully explain the procedure to her, its risks compared to the standard surgery, or discuss the benefits and risks of standard surgery compared to the keyhole procedure recommended. The experts also criticised the surgeon for failing to recognise and act on Abbie’s worrying symptoms following the operation and ensure that corrective surgery was done at the earliest opportunity. The combination of these appalling failures had caused Abbie to sustain permanent damage to her cauda equina nerves that could not be repaired.

The strength of the case and weight of the evidence gathered by Nicholas enabled him to begin negotiations over the amount of compensation that Abbie would need.

Cauda equina compensation awarded

It was determined by experts instructed by Nicholas that Abbie would no longer be able to work, required a house on one level adapted to her disabilities, and would require care, therapy, and other specialist equipment to manage her condition. The final compensation settlement awarded to Abbie so that she could pay for all this, plus achieve financial security for her and her family now and in the future, was £4 million.

Nicholas Young, a solicitor at JMW specialising in spinal injuries cause by medical negligence, said: