Physiotherapist Fails to Refer for Cauda Equina Syndrome
Despite describing her urinary difficulties, Barbara's physiotherapist did not act on this symptom of cauda equina syndrome.
Barbara had had a history of back problems when she awoke one day not only to pain in her back but also numbness and weakness in her right leg.
She went to see her GP who carried out an examination and decided to refer Barbara to a physiotherapist. An appointment was arranged for just over a week later.
At the physiotherapy appointment Barbara explained that she had now also been experiencing some urinary difficulties for a few days. This was such that, although she was aware of a need to urinate, it was difficult to do so. She was having to press on her abdomen to force urine out and would sometimes experience some leakage of urine.
Barbara was still suffering with severe lower back pain, and pain and numbness in her right leg, as well as some tingling around her right buttock.
The physiotherapist advised Barbara that she should go to A&E if her symptoms continued or worsened but she did not make an immediate referral.
By the time of the follow-up appointment a week later, Barbara's symptoms had unfortunately deteriorated. She now had numbness around her right buttock as well as in the perineal area between the legs. Her problems with urinating had also worsened.
The physiotherapist now recognised the severity of Barbara's symptoms and, instead of treating her, sent her to A&E.
Once at hospital, Barbara underwent a bladder scan after which a catheter was inserted. She also underwent an MRI scan which showed that she was suffering with a lumbar disc pressing on the nerves.
Barbara underwent decompression surgery the following day.
Unfortunately, Barbara has been left with a range of distressing symptoms which would probably have been significantly less severe had the physiotherapist referred her to A&E at her first appointment, a week earlier than in fact occurred.
Barbara's life has been dramatically changed by her cauda equina syndrome. She continues to experience pain and weakness in her lower back and legs and has to use a wheelchair or sticks outside the house. Her social life has suffered and she is dependent on her husband for assistance with dressing.
We supported Barbara in her claim against the relevant NHS Trust and she was awarded over £25,000 in compensation for the additional pain she has suffered due to the delay in diagnosis and surgery.
(Details which might identify our client have been changed.)
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