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Clinical Negligence Claims Arising out of Cauda Equina Syndrome

Woman in wheelchair

Cauda Equina Syndrome is a serious spinal condition. The Cauda Equina is a collection of nerves, in the spine, which look like a horse’s tail. When these nerves become compressed (often by a prolapsed disc) this causes Cauda Equina Syndrome.

Cauda Equina Syndrome often involves bilateral sciatica, leg weakness / numbness, urinary symptoms and altered “saddle” sensation. Unless treatment is provided urgently symptoms can worsen and become permanent.

Cauda Equina Syndrome is rare, with around 1 to 3 people per 100,000 being diagnosed each year. However, the consequences of the condition, particularly if it is left untreated, can be significant.

Delays in recognition, diagnosis and treatment of Cauda Equina Syndrome can give rise to a medical negligence claim.

Case study

James Braund, specialist clinical negligence solicitor with Trethowans LLP, based in their Bournemouth and Poole offices in Dorset, has recently concluded a claim relating to a delay in diagnosis and treatment of Cauda Equina Syndrome.

Mr E suffered an injury to his back in late Summer 2019. He hoped the pain would resolve, but it continued. He attended his GPs on 3 separate occasions in Autumn 2019. On each occasion, he stated that he told the GPs about the pain in his back, including bilateral sciatica, neurological symptoms and worsening urinary symptoms. On the last occasion Mr E stated that the symptoms had worsened further. The medical records recorded some of these symptoms, but not all of them.

In late November 2019, Mr E started to experience a complete loss of feeling in his legs, which appeared to be spreading up his body. He was rushed to Hospital and diagnosed with Cauda Equina Syndrome. He underwent surgery to address the same, the following day.

Despite the surgery, Mr E was left with significant pain (both mechanical and neurological) and other symptoms, which prevented him working and led to him requiring significant care and assistance.

Mr E approached James to investigate a potential medical negligence claim against the GPs. James obtained Mr E’s medical records and instructed both an expert GP to address breach of duty and an expert spinal neurosurgeon to address causation.

The expert GP considered that, at all 3 appointments, red flag signs of Cauda Equina Syndrome were ignored by the GPs. The neurosurgeon agreed that signs were missed and considered that, had appropriate referrals been made Mr E would have received urgent surgery. If that had happened, Mr E would still have experienced some symptoms (such as the mechanical pain) but not other symptoms (such as the neurological symptoms). Despite this, liability was denied by solicitors acting for the GPs. It was also alleged that Mr E was not suffering from Cauda Equina Syndrome at the time of the 3 GP appointments.

Matters were highly complicated by factual disputes regarding exactly what was discussed in the appointments and also due to the complexity in apportioning symptoms attributable to the delay in treatment.

James obtained further evidence as to condition and prognosis and losses were obtained from an expert urologist, an expert pain consultant and an expert vocational psychologist. Input was also obtained from a barrister.

A Round Table Meeting took place between the respective legal teams, with a view to narrowing the issues. Extensive discussions took place regarding the same.

A Schedule of Loss was prepared and, despite liability continuing to be denied, negotiations took place between the parties. A number of offers were made by both parties and, eventually this claim, was settled for a significant 6-figure sum.

Mr E commented “I would like to thank James for getting my case resolved without the need to go to Court. It’s been a long battle to get here, although the compensation can never put right the damage caused by the delay in diagnosis, but it can certainly help going forward in the future.”

Cauda Equina medical negligence claims require specialist input and it is important that, if you have such a claim, you approach a lawyer who has experience of such claims. Trethowans have a long-standing association with the Spinal Injuries Association and are specialist in all spinal injury claims, including Cauda Equina claims.

If you have any queries or you require advice on a spinal injury claim, please do get in contact with James Braund ([email protected])

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