Cauda Equina Missed By Orthopaedic Specialist
After being referred to hospital by his GP, Jerry was told by an orthopaedic specialist registrar that he did not have cauda equina syndrome. He was back in hospital two weeks later undergoing decompression surgery for cauda equina compression.
Whilst carrying a heavy box one day, Jerry dropped it, twisting and injuring his lower back. The pain gradually settled with over-the-counter medication.
However, two weeks later he woke up one morning with severe lower back pain radiating to his right buttock. Over the following days he also became very numb around his anus and genitals, and found he was only able to pass small amounts of urine.
He went to his GP and explained his symptoms. His GP suspected a pudendal nerve lesion and told Jerry to go to hospital. He was given a referral later and advised to attend the emergency department for an urgent orthopaedic assessment.
In hospital Jerry was examined by the Orthopaedic Senior House Officer on call. The doctor noted it was necessary to rule out cauda equina syndrome and decided Jerry needed to be referred for an urgent MRI scan.
Nevertheless, the radiology department would not accept a referral unless Jerry had been seen by a senior trauma and orthopaedics doctor. Therefore later that day he was examined by an orthopaedic specialist registrar.
Unbelievably, the registrar failed to pay any heed to Jerry's red flag symptoms, including numbness around the perineum and genitals, difficulty passing urine and reduced anal tone. He decided Jerry did not have the clinical signs of cauda equina syndrome and discharged him home.
Jerry was then given an out-patient appointment for an MRI scan which occurred a week later. Two days later he began leaking urine, so his GP chased the hospital for the results. Jerry was told he required a discectomy which was finally performed nearly two weeks after he had originally presented to hospital.
Because of the delay in diagnosis and treatment, Jerry has been left with disturbed bladder function, sexual dysfunction and irregular bowel habits. He has become depressed, irritable and has struggled with is work, which is physically demanding.
The orthopaedic registrar was negligent in failing to carry out an adequate examination, in failing to recognise the symptoms of cauda equina syndrome and in failing to arrange an emergency MRI scan.
The hospital was also negligent in failing to report the results of the MRI scan. The radiology department should have contacted the orthopaedic team and advised them that Jerry had a cauda equina compression.
The failings of the doctor and the hospital meant that Jerry's treatment was delayed for nearly two weeks, causing him to suffer further nerve damage. We helped him make a claim against those at fault and he was awarded over £40,000 compensation.
(Details which might identify our client have been changed.)
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