Cauda Equina Syndrome – Poor Quality Care
Cauda equina syndrome is a life-changing condition that frequently prompts legal action for medical negligence. It is also a condition that regularly produces six-figure compensation awards. What qualifies as medical negligence in cauda equina syndrome?
Cauda equina syndrome is a medical emergency. Once symptoms are present, the patient needs an emergency MRI for confirmation of diagnosis followed by emergency surgery. Where the patient still has some control over their urinary function, surgery is generally regarded as necessary within 48 hours. Delays can lead to permanent and devastating symptoms.
Consequently, there are a number of points in this process where medical care can fall below an acceptable standard.
Delayed Diagnosis
- If the GP or A&E medical practitioner fails to recognise the symptoms of cauda equina syndrome or misdiagnoses the cause of the symptoms, leading to a delay in referral for an MRI, they may have been negligent
- Likewise if a physiotherapist fails to make an appropriate referral the standard of care has probably not be adequate
- If the patient presents with lower back pain and sciatica-like symptoms but the medical practitioner fails to warn of the red flag symptoms of cauda equina syndrome and the need for immediate attendance at hospital should they develop, this may be regarded as substandard medical care
- If the patient calls NHS 111 for advice and is not warned of red flag symptoms or told to attend A&E within one hour if symptoms are already present, medical negligence may have occurred
- If there is a delay in arranging and carrying out an MRI once the patient attends at A&E, the hospital may have been negligent
Delayed surgery
Once a diagnosis of cauda equina syndrome has been confirmed with an MRI, the timing of surgery is crucial to achieving a positive outcome.
Where the patient retains some urinary sensation and control, evidence suggests that they have a far greater chance of a good recovery if surgery takes place within 48 hours of onset of symptoms. There is some suggestion that surgery within 24 hours can lead to an even better outcome.
Therefore, if surgery is delayed and the patient has a poor outcome because the delay has allowed their symptoms to deteriorate, then the hospital may have been guilty of a substandard level of care.
The significance of timing of surgery is less clear where the patient has already lost urinary control, but prompt surgery is still advised.
Post-operative care
Cauda equina syndrome has been known to develop following spinal surgery, such as surgery for a herniated or slipped disc.
Threfore, if cauda equina red flag symptoms are evident following surgery, prompt action is clearly required.
These symptoms might include:
- Lower back pain,
- Urinary difficulty or incontinence
- Bowel incontinence
- Loss of sensation in the 'saddle' area
- Sciatica in one or both legs
In this situation, an assessment of urinary function and sensation in the perineal area is desirable and an urgent MRI to identify the cause of the symptoms should be carried out.
Talk to a solicitor
If you believe that your cauda equina syndrome may have been negligently treated, contact a solicitor for an assessment of your circumstances. Glynns Solicitors are a team of specialist medical negligence solicitors with significant experience of supporting cauda equina syndrome compensation claims.
Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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