Cauda Equina Syndrome Red Flag Failings
Although clearly at risk of developing cauda equina syndrome, Mark was given no red flag warnings and, even when his symptoms deteriorated, no emergency action was taken.
Mark's symptoms of lower back and right leg pain worsened after a fall, prompting him to attend a minor injuries unit. He was advised to go to the Accident and Emergency facility at a nearby hospital where it was noted that Mark had already been diagnosed with a slipped disc.
Following an examination, a consultant identified that Mark was not experiencing the cauda equina red flag symptoms of saddle anaesthesia or urinary difficulties, and recommended that he be discharged.
Unfortunately, although Mark was recorded as having a slipped disc in the lumbar region of the spine and was suffering from symptoms which might be the early stages of cauda equina syndrome, the consultant did not advise Mark as to the red flag symptoms of this appalling condition. Equally important, he failed to emphasise to Mark that, should any of these symptoms develop, Mark should attend Accident and Emergency immediately as he might require emergency surgery.
Almost immediately after discharge, Mark did, indeed, begin to experience some of the red flag symptoms of cauda equina syndrome.
He began to find it difficult to control urination and, a day later, found that he was having difficulties with his bowel function as well.
Although Mark's symptoms continued to deteriorate, he did not visit Accident and Emergency as he had been told to follow-up his hospital appointment with his GP. He had not been made aware of the urgency of his situation.
Consequently, it was over a week before Mark saw his GP again, when he explained the increase in his pain and his new bladder and bowel symptoms. Despite the fact that Mark was now exhibiting symptoms which might indicate cauda equina syndrome, his GP did not examine him nor did he make an emergency MRI referral. If he had, it is likely that Mark would have undergone emergency surgery and recovered much of his bowel and bladder function.
Instead, Mark was sent home with laxatives and a promise by the GP to chase an orthopaedic referral.
Over the next week, Mark noticed that he was now losing sensation around his anus and that his right foot was starting to drop, both indicators of cauda equina dysfunction.
Eventually, ten days after his GP appointment, Mark attended hospital for an MRI scan. Another five days later, he received a telephone call to say that he needed surgery urgently to relieve pressure on his cauda equina nerves. Mark attended hospital and his surgery was carried out the following day.
Sadly, in the time between his GP appointment and his decompression surgery, Mark's symptoms had continued to deteriorate, starting to affect his left leg as well as his right.
Mark had been failed twice in the course of trying to understand his distressing symptoms. Had he been warned of the red flag symptoms of cauda equina syndrome by the consultant, he would have attended hospital immediately when he began to experience urinary problems.
Furthermore, had the GP recognised that Mark was suffering from probable cauda equina syndrome symptoms, an immediate referral for an MRI scan could have brought about surgery more than a week earlier than actually occurred.
Instead, Mark has been left with both bowel and bladder incontinence issues as well as mobility problems and loss of sexual function.
Mark approached Glynns for help in pursuing a claim for compensation and we instructed medical experts to investigate the quality of his care.
As a result, he has been awarded in excess of £150,000 in compensation for his pain, suffering and financial losses.
(Details which might identify our client have been changed.)
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