Settlement reached for delay in diagnosis of cauda equina syndrome

Posted by Gemma Osgood on

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In May 2011 Mr A was referred for physiotherapy by his GP following continual lower back pain. He confirmed he had no incontinence but had pins and needles in his feet. He was then referred to a spinal specialist and told he had sciatica. No MRI was performed despite Mr A asking for one.

On 9 August 2011 Mr A was working in his garden when he felt a sudden onset of extreme back pain. He was unable to move. He spoke to his GP who prescribed Solpadol. The next day the pain was no better. On 12 August Mr A began treatment with a private chiropractor. He returned to the chiropractor on 17 August 2011. After that session he returned home and was unable to move. The pain continued to get worse and that afternoon Mr A called an ambulance.

He attended the Medical Assessment Unit (MAU) at the local hospital. At the MAU Mr A was assessed by 2 doctors.  Mr A informed them of his symptoms of pins and needles in his leg, problems passing urine and shooting pains in his foot. An x-ray of his back was ordered, but not an MRI scan.  The first doctor queried a diagnosis of cauda equine, but the second doctor recorded that Mr A's symptoms had resolved (they had not). He was discharged home that night.

The following day (18 August) he was still in considerable pain and called the out of hours doctor. He had an appointment with his own GP the next morning. When he arrived at the GP practice his GP advised Mr A's wife to get Mr A to hospital immediately. He was admitted to hospital that morning. Still no MRI scan was done. Mr A called his wife in the early hours of the following morning to say that he was scared as his could not feel anything below his waist.

When an MRI scan was eventually requested, the scanning facility at the hospital was closed so Mr A was transferred to another hospital for a scan. The scan was carried out on 20 August 2011 and showed that Mr A had cauda equina syndrome (this is a disorder where there is pressure on the nerves at the very bottom of the spinal cord. It requires urgent investigation and treatment to prevent the nerves to the bladder and bowel from becoming permanently damaged).

Mr A was operated on immediately. Despite the surgery Mr A was left with constant pain; reduced mobility; numbness to his leg and foot; and bladder and sexual function problems.

Mr A contacted BL Claims Solicitors as specialist clinical negligence solicitors. He alleged that his diagnosis at the first hospital had been delayed and that if the diagnosis had been made earlier his surgery would have had a better outcome and he would not have suffered such devastating and permanent injuries. 

Expert evidence was obtained into the care that Mr A had received and a formal Letter of Claim was sent to the hospital Trust.  The Trust solicitors denied liability and despite negotiations between parties the case was listed for Trial in the High Court. However, the Defendant made an offer to settle the matter prior to Trial and Mr A accepted £87,500 as full and final settlement of his claim. 

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About the Author

Gemma is a Senior Associate in our Clinical Negligence team with extensive experience in all areas of medical negligence claims.

Gemma Osgood
Email Gemma
023 8085 7248

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