Consultant’s mistakes leave new mum with permanent cauda equina syndrome - £1.95 million in compensation

“Georgina”, a woman in her 30s

“Georgina” has permanent disabilities and is doubly incontinent after a doctor failed to recognise and act on her red flag signs of serious spinal injury cauda equina syndrome. Georgina also has a lot of pain in her legs and back and life is constant struggle due to having to manage her physical difficulties with caring for her young children. Although nothing could remove her daily battles completely, JMW was able to secure compensation totalling £1.95 million for Georgina so that she could afford to move into a house adapted for her disabilities, pay for the equipment and aids that she will need now and in the future, and have financial security given she can no longer work.

What happened?

Georgina had a history of back pain and when new symptoms started to occur, including a burning sensation in her right leg and heel, her GP referred her for an appointment with a doctor specialising in orthopaedics. Georgina was pregnant at the time, and although this made her treatment more complex, it was still possible to manage her care effectively with adequate planning.

A month later Georgina was seen by the consultant. By this point she was experiencing spasms down her right leg, pins and needles in her foot, and had also had two episodes in the previous week where she had a loss of feeling when she was having a bowel movement. The consultant ordered an MRI scan to be done in two weeks’ time but did not carry out a digital examination of Georgina’s perineum and rectum to check for loss of sensation. Given she had experienced bowel incontinence three times in the previous week this should have been done.

Two weeks passed and Georgina did not receive her MRI scan appointment. By this point she was unable to stand up unaided or walk and required a lot of support from her partner. After reaching out to her midwife, an MRI scan appointment was made for Georgina for two weeks’ time. The scan showed that a disc had slipped out of place in the lower section of her spine (disc herniation) and this was compressing her cauda equina nerves (those that control the bowel, bladder, sexual function, and sensation in the lower part of the body), putting them at risk of permanent damage.

Despite these findings, and Georgina’s worrying symptoms, the consultant did not diagnose her with cauda equina syndrome and did not put a plan in place for surgery with the support of her maternity team. When Georgina had an appointment with the consultant he told her that ideally she would have decompression surgery but he would not recommend this due to her being pregnant. This was incorrect advice and in accordance with NHS guidelines, the operation could have gone ahead safely.

The consultant offered Georgina an epidural to her lower back area, which she agreed to and this did remove the pain in her back and leg. She saw the doctor for a follow up appointment a few months later and was then discharged from his care. The doctor did not offer a further appointment or plan surgery to take place after Georgina had given birth.

Baby

Later that year Georgina’s baby was born and the day after the birth her back pain returned and was even more severe. After a GP appointment she was referred back to orthopaedics, with the aim of organising another epidural to treat the pain. However ,while awaiting the appointment Georgina deteriorated further and found her legs would not work. She managed to get to her GP who tested her reflexes and discovered they had gone in both knees and her right ankle. The GP told her to go straight to A&E, which with the help of her partner she did.

An MRI scan was done by the hospital early that evening which again showed the compression of the cauda equina nerves. However, she had to wait almost 24 hours for a bed to be found at a specialist spinal hospital so that she could have the surgery to decompress the nerves. By this time it was too late to prevent the permanent damage that had been caused. The surgery was unsuccessful in terms of allowing her to recover from cauda equina syndrome. After the operation Georgina found she had no ability to empty her bladder herself and no control over her bowel. Both her feet had developed a constant sensation of pins and needles and she also discovered that she had weakness in both her legs that significantly impaired her mobility. Unsurprisingly, Georgina’s poor physical condition has severely affected her mental health and has left her feeling very low.

JMW’s investigation

After researching cauda equina syndrome online, Georgina came across JMW’s specialist team and reached out for support. Her case was taken on by cauda equina specialist solicitor Nicholas Young for investigation.

Using the best independent experts working within the field of cauda equina syndrome care, Nicholas gathered reports on the treatment of the condition during pregnancy and whether earlier surgery should have been carried out. The experts agreed that decompression surgery is safe after the first trimester of pregnancy and this should have been done in Georgina’s case so that she could have lived the rest of her life without its disabling effects. If not, a further appointment should have been arranged or a plan put in place for surgery once Georgina had given birth.

Nicholas set out a strong case against the hospital trust responsible for the consultant’s errors and although it refused to admit that any mistakes had been made, the strength of the evidence obtained meant that compensation could be negotiated.

A careful assessment of Georgina’s needs now, and in the future, was carried out by Nicholas with the input of experts specialising in occupational therapy, housing requirements, and care. This ensured that the amount of compensation awarded to Georgina would be the correct amount and ensure her disabilities were catered for now and in the future.

Cauda equina compensation awarded

The compensation secured for Georgina by Nicholas totalled £1.95 million, and although this could not undo the damage done, it has gone a long way in improving her quality of life and has given her financial peace of mind. Georgina was very concerned about how her family would cope, not only with her additional care need, but with the loss of her earnings. Thankfully now, due to Nicholas’ input and expertise, she does not have to worry as much anymore.

Nicholas Young, a cauda equina syndrome specialist solicitor at JMW who handled Georgina’s case, said: