Background
The Claimant had a history of low back pain and sciatica for which he had received physiotherapy, and this improved his symptoms until 2015 when both problems got worse again.
On 2nd June, the Claimant woke up in significant pain and attended the A&E department at the Defendant’s hospital where he was triaged and later seen by a doctor. When he was assessed by the doctor, the Claimant was suffering from numbness and pain in both legs, and during a rectal examination, he told the doctor that he felt tingling and numbness in his anus. The Claimant alleged that the doctor told him that all was fine and, despite his insistence that he be reviewed by a senior doctor for a second opinion, he was discharged and was not referred for an MRI.
The Claimant experienced faecal incontinence later that night, so he called an ambulance and was readmitted to the Defendant’s hospital. By this time, he had also not urinated for 24 hours. When he was examined again after being readmitted, cauda equina syndrome was suspected and an urgent MRI was requested. The MRI and clinical findings confirmed the diagnosis of cauda equina syndrome and the Claimant subsequently underwent urgent surgery to relieve the pressure on his spinal cord.
What is cauda equina syndrome?
Cauda equina syndrome is a rare but serious condition that is caused when the nerves in the lower back become compressed. Symptoms include sciatica on both sides, weakness and / or numbness in both legs, numbness or altered sensation around or under your genitals, or around your anus, and bladder and / or bowel dysfunction.
If it is not diagnosed and treated quickly, cauda equina syndrome can have a devastating and life changing impact on someone’s life. If it is not treated quickly enough, patients can suffer with bladder and / or bowel incontinence or dysfunction, severe pain, sexual dysfunction, and mobility problems, sometimes being unable to walk.
What happened in X’s case?
Moosa-Duke Solicitors conducted a thorough investigation into X’s claim and obtained evidence from experts in the fields of neurosurgery, A&E medicine, and radiology.
The claim was pursued on the basis that there was an inadequate and negligent assessment at the Claimant’s first attendance in A&E because he was not asked about his urinary function or any abnormal sensation in the genital area, nor was a full examination performed. It was the Claimant’s case that had he been asked to urinate, he would have had difficulty passing urine and that a proper examination of the perineum, perianal and genital areas would have shown evidence of sensory abnormality.
It was alleged that any of these abnormal signs should have led to a suspicion of cauda equina syndrome and the need for an emergency MRI scan, which would have confirmed the diagnosis. If cauda equina syndrome had been diagnosed during the first attendance, surgery would have been performed on the day the Claimant first attended hospital.
Further investigation also established that the surgery performed the following day was done so negligently. After the first surgery to relieve the pressure on his spinal cord, the Claimant needed a further operation and was left with significant urinary dysfunction requiring him to perform intermittent self-catheterisation. He also had impaired erectile function, bowel dysfunction and mild left foot drop. The consequences of his injuries also led to a psychological reaction as he adjusted to life with a disability. Whilst the Claimant was able to continue in his pre-injury occupation his duties had to be adjusted and he lost out on promotion prospects. It was alleged that the second surgery was performed negligently and that the Claimant should have avoided the majority of his ongoing problems.
What was the outcome?
This was a complex case because of the issues involved. Liability was denied throughout, and it was necessary for Moosa-Duke Solicitors to issue court proceedings to progress the matter for the Claimant.
Earlier this year, after the claim had been proceeding for several years, a settlement meeting took place and Moosa-Duke Solicitors negotiated a six-figure settlement for the Claimant, which will enable him to obtain the treatment, therapies, and care that he requires to ease his ongoing symptoms and help him in the future.
Moosa-Duke Solicitors are an experienced team of specialist clinical negligence solicitors. We specialise in cauda equina syndrome claims. If you have concerns about the care that you or a family member has received, please call us for a no-obligation discussion on 0116 2547456 or send us an email at enquiries@moosaduke.com.