Cauda Equina Syndrome: A Medical Negligence Claim Case Study
Back in August we shared five facts about Cauda Equina Syndrome including the causes, symptoms and life changing complications that can happen when there is a delay in diagnosing and treating this rare but serious condition.
In this blog we want to share the success story of a client who brought a cauda equina syndrome claim with the help of one of our panel solicitors and was awarded £2 million in compensation. His story shows that although it's impossible to turn back the clock, a successful claim can bring some light at the end of the tunnel - through compensation, specialist support and access to rehabilitation.
Our panel firm represented a 37 year old man (DS) who suffered catastrophic injuries following a series of failures to diagnose and treat his developing cauda equina syndrome. Had the doctors acted on clear 'red flag' warning signs when he first went to hospital, he would have been treated before any permanent damage had occurred. Our solicitors were key to him getting his life back on track and making the most of his new life.
So how did his problems start?
DS started to experience lower back pain – something that people across the country experience daily. However, after a couple of weeks, the pain moved to his left leg and he was worried, so he went straight to see his GP. The GP didn’t think there were any "red flags" (serious warning signs) and diagnoses sciatica. He prescribed pain relief and made a referral for physiotherapy.
Later that evening, things quickly took a turn for the worse. DS's pain became so bad that he called for an ambulance and was taken to hospital. Over the next few hours his right leg also became painful. In addition, he felt numbness in his bottom and was finding it difficult to go to the toilet. He was seen by a doctor in A&E in the early hours of the morning. He told the doctor about his symptoms and the doctor examined him. The doctor recorded in the medical notes, that he had reduced feeling around his bottom. However, he was examined 15 minutes later by a more senior doctor who recorded that the feeling around DS's bottom was normal. This doctor diagnosed sciatica (pain in the sciatic nerve, which runs from the spine through the buttocks and down both legs) and sent him home. The doctor advised that if he started to get any bladder or bowel problems, he should return to hospital immediately.
Later that night DS woke up to find he had wet the bed. He had no control over his bladder and was numb below the waist, so he could not feel that he was wet. He phoned the hospital, explained that he had been seen by doctors at the hospital earlier that day and that since then, he had wet himself without realising. Rather than telling him to return to A&E, he was told that the Emergency Department was very busy and so he should wait and come in the following morning, when it would be quieter.
He went back to hospital the following morning and the doctors correctly diagnosed possible cauda equina syndrome (which is a medical emergency requiring urgent surgery) and DS was advised he needed an urgent MRI scan. As there was no MRI scanner at the hospital he was told he would be transferred to a different hospital, but there was a delay in transferring him and in the end he was not transferred until 17 hours after he had arrived that morning. He was finally taken for an operation at 21.45 that night, more than 48 hours after his first visit to hospital. By this point it was too late - he had already suffered permanent damage which could not be reversed.
So what SHOULD have happened?
The independent medical experts in the case were clear that the doctors who saw DS on the first morning should have thought about the possibility that his problems were serious and due to a developing cauda equina syndrome. Numbness in his bottom and pain and weakness in both legs were crucial signs, which should have raised the alarm in the minds of the A&E doctors. The doctors should also have arranged for him to have an urgent MRI scan and his cauda equina would have been diagnosed.
Another failure happened when he telephoned the hospital later that evening after wetting himself. This was a sign that the cauda equina was worsening and he should have been told to come into the hospital immediately, rather than on the following morning. The independent medical experts instructed by the solicitors felt that no reasonable A&E doctor would support the decisions to send him home and therefore the treatment was negligent. Their decisions caused a massive delay in DS getting the right treatment and led to permanent damage which should have been avoided. If he had been treated correctly when he first went to hospital he would have had surgery and suffered no permanent damage.
What did it mean for DS?
DS suffered permanent injuries including:
- Pain, numbness and weakness in both legs and his toes were clawed. This meant he had difficulty walking and balance problems.
- No control over his bladder or bowel and no sexual function.
- A significant psychiatric injury; he was depressed and struggled to adjust to his new life.
He could not return to work and because his bowel function was so difficult to manage – he couldn’t feel when he needed to go to the toilet so had 'accidents' all the time. Because he was embarrassed about this, he spent much of the first two years after the negligence in his bedroom, sitting on a commode. When he did go out, he had to wear pads all the time which regularly leaked and so he gradually stopped going out. About 6 months after the negligence took place, his long-term relationship ended.
As time went on, he became more alone and more depressed. His mental health became a big problem. He stopped caring for himself and stopped accepting help from others. Because the bowel incontinence was such a problem, he began to eat very little, in the hope that this would reduce the problems. However, he became very unwell, malnourished and lost lots of weight.
What help was available as a result of DS making a successful claim?
Fortunately, the hospital accepted the failures early on after the claim had been investigated. This meant DS was entitled to an immediate payment of compensation to help supplement his benefits and pay for the things he needed. He was initially very reluctant to have any help as he had lived a completely different life for the past 5 years and could not see any way forwards.
His solicitors went to see him at home in April 2016 and were shocked to see how far downhill he had gone. They were worried about his weight and overall health and thought he was risking his own life by not eating. They decided he needed help so spent considerable time talking to him and encouraging him to get help, and he eventually agreed.
As part of the claim it was arranged for an experienced case manager to be employed to work with him and address his needs.
The case manager worked with the solicitors and put in place:
- Weekly physiotherapy with a specialist physiotherapist as well as weekly gym and sports sessions to improve his mobility;
- Regular sessions with an experienced Clinical Psychologist to help his mood and overall mental health;
- A support worker who met with him three times a week to support him when going out so he could start to live a more normal life;
The case manager also arranged for him to have much needed appointments with different doctors and other healthcare professionals including:
- a urologist, who assessed his bladder incontinence and recommended medication to reduce his bladder activity, which meant he did not need to catheterise as often. If that treatment ever stopped being effective, the next option would be Botox injections into his bladder, and he got money to pay for those privately for the rest of his life;
- a colorectal surgeon, who advised him of the options for managing his bowel incontinence including a manual irrigation system, a nerve stimulator and ultimately a colostomy. At the time the case settled, DS was about to undergo a trial of a nerve stimulator and had recovered through the claim, money to fund that privately;
- an NHS dietician who worked with the case manager and the family to try and increase his food intake and encouraged him to take supplements so that he could become healthier and gain weight;
- a podiatrist and chiropodist to look after his clawed toes and feet which were at risk of skin breakdown and damage because they were numb;
The case manager also bought him equipment including a WiiFit, so that he could exercise at home and work on his balance. He also saw an orthotist who made special shoes that were wider around the toes so his clawed toes didn’t rub against them.
What difference did making a claim make to DS’s life?
After the first year of rehabilitation, DS's life had changed massively for the better. He still had permanent injuries but his outlook had changed significantly. He had money so that in the future he could access treatment that might enable him to have better control over his bladder and bowel function. He started eating again and had a more balanced diet with nutritional supplements thus gained weight, having more energy and feeling so much better. As he became more active, aided by regular physiotherapy and the guidance of his support worker, he started to get fitter and his mobility improved. He developed much more of a 'get up and go' attitude. He began to socialise with his family again. He even bought a new car and went out to locally, to meet friends at the pub or to go for dinner with his family.
He realised he would need to live in ground floor accommodation when he was older because his mobility was going to deteriorate with age and so stairs would become a problem. He purchased a house with his mum and dad after the claim settled and paid builders to build a ground floor extension for him to live in so that he had his own self-contained space.
Although he could not work, for the first time since he sustained his injuries, he was motivated to think about how he would invest his compensation so that he it would last him for the rest of his life. He would need care and help at home over the years and also help with the DIY and gardening that he would no longer be able to do. The money he received through the claim covered all of these needs and also paid for life-long physiotherapy and additional counselling that he would continue to need at different times in the future.
As a result of the tremendous work undertaken by the Cauda Equina Compensation specialist solicitor, DS’s life was massively and positively transformed from what it was immediately post diagnosis. Our specialist medical negligence compensation solicitors see their role as being about far more than recovering a sum of money as compensation (although that is the ultimate goal). It is also about ensuring that the right treatment, rehabilitation and assistance are made available to the client for the rest of the life of their condition, (which often means for the rest of their own lives). It is also about ensuring that they receive compensation to cover the cost of all this.
If you have been diagnosed with Cauda Equina syndrome as a result of misdiagnosis or delay in treatment, then contact Mayiclaim on 0800 756 7774 or leave your contact details via our contact form Contact Us and one of our experts will call you back with a view to helping you to make a claim for compensation under a No Win, No Fee agreement.