CES diagnosis delayed after discharge from A & E twice

Our client, Ms C,  attended A&E on the advice of her physiotherapist for bladder problems but she was discharged twice. 

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Ms C attended Arrowe Park Hospital where she spoke to an out-of-hours GP who noted her complaints of left thigh and lower leg pins and needles and numbness. She was also noted to have pain in the left leg and some weakness in the ankle. Alongside this, she had very little urine output over the previous two weeks and almost constant loss of sensation to the buttocks and genital area for two weeks. The out of hours GP discussed her condition with an orthopedic doctor who felt her symptoms were not in keeping with cauda equina syndrome but warranted a referral to a spinal surgeon. Our client was discharged without orthopedic assessment or an MRI scan. 

Ms C consulted her GP again who referred her for an urgent lumbar MRI scan and opinion from a spinal surgeon. Before this could be arranged, she attended her GP again 2 weeks later, with disabling, worsening symptoms and persisting loss of sensation to the buttocks and genital region. She was referred back to A&E at the Arrowe Park Hospital where she was once again advised that her symptoms were unlikely to be cauda equina syndrome and was discharged without an MRI scan.   

Around 1 week later, our client underwent an MRI scan. 

A week after the MRI scan, our client was seen by a neurosurgeon at the Walton Centre who had reviewed the MRI results and advised her that she had ‘impending if not actual cauda equina’ and arranged for her to be admitted for surgery. The following day, our client underwent an L5/S1 hemi laminectomy and discectomy. She was undertaking a PHD at the time and had to extend the time to complete this. She was left with persisting back pain, neuropathic pain in the leg, numbness of the buttock and genital area, weakness of the left leg, reduced sexual sensation, difficulties with voiding urine, urinary incontinence during intercourse, and constipation.