Cauda equina syndrome

Can you claim compensation for cauda equina syndrome?

A person who has suffered a serious injury as a result of an error or omission by a medical professional may be able to take legal action to claim compensation.

Birchall Blackburn Law is currently dealing with a number of cases where GPs and hospitals have not provided adequate care and treatment for CES patients.

Clinical (or medical) negligence is a serious breach of the duty of care that medical professionals ethically and legally owe their patients. The breach of care must have caused or materially contributed to the person’s injury.

As CES is rare and its symptoms are typical of many other illnesses, it can be difficult to diagnose. Recognising the condition in a patient can be made even more problematic in a busy, understaffed and underfunded medical setting where medical professionals do not have the time or, sometimes, the expertise to spot CES.

For example, low back pain caused by CES can be dismissed as typical back pain. The patient may simply be sent home with paracetamol and instructions to rest, which can have catastrophic consequences.

If the signs and symptoms of CES are present when attending hospital, a failure to act upon these symptoms within 48 hours, such as arranging for a MRI / CT scan, can be grounds for negligence.

In terms of CES a breach of care could include:

• Failure to recognise the symptoms of CES
• Missed or delayed diagnosis
• Failed or negligent surgery
• Post-operative complications

What should I do if I think I may have a claim?

If you think you may have a claim for cauda equina syndrome due to medical negligence, or just want to talk through your circumstances, you should contact us straight away on Freephone 0800 230 0573, or contact us through our “contact form”. One of our experienced experts will be able to discuss your circumstances with you in complete confidence, and we will give you free initial patient advice.

How much compensation can you expect for cauda equina syndrome claim?

The amount of compensation a person receives can vary greatly. It will depend on many factors, such as the severity of the physical injuries (e.g. incontinence and / or paralysis), psychological and emotional trauma and anxiety, medical expenses incurred, pain and practical impact on the person’s social and financial life, and future care needs.

Depending on the individual’s circumstances some patients will claim compensation for thousands of pounds, while a more severely affected patient will require compensation that can amount to millions of pounds.

What is cauda equina syndrome?

The cauda equina is a group of nerve roots at the base of the spine responsible for sensory and motor stimulation to the pelvis and lower limbs, as well as bowel and bladder function.

Cauda equina syndrome (CES) is caused by pressure and swelling on those spinal cord nerves. The pressure on the nerves at the very bottom of the spinal cord stops the nerves from working properly. It is a rare disorder but if it is not treated quickly it can cause permanent nerve damage with life changing consequences.

What causes cauda equina syndrome?

CES can be caused by any condition that directly puts pressure or pinches the nerves at the end of the spinal cord.

The most common cause of CES is a herniation of lumbar intervertebral disc or prolapsed disc (often called a ‘slipped disc’).

If a person has had a pain-killing injection into the spine, it can cause an infection and also lead to CES.

Other causes can be internal epidural bleeding, epidural abscess, bone cancer or Paget’s disease of the bone, which are localised in the lower spinal cord area.

How is cauda equina syndrome diagnosed?

CES is diagnosed based on the characteristic symptoms and confirmed by neurologic and radiology testing. Investigations will usually include an MRI scan to confirm the diagnosis, and may include a CT scan and tests of bladder and bowel control.

Early diagnosis is essential to ensure a favourable outcome.

What are the symptoms of cauda equina syndrome?

Diagnosing CES can be difficult because it is a rare condition and the symptoms are closely linked to other similar conditions. The symptoms of CES can occasionally start slowly but it is usual for the symptoms to develop suddenly and progress quickly.  Symptoms can include one or more of the following:

• Lower back pain
• Bowel problems
• Bladder function issues
• Sexual problems can occur
• Numbness or reduced sensation in the saddle area (around the anus)
• Weakness, reflex change, motor or sensory loss in one or both legs
• Sciatica type symptoms

How do you treat cauda equina syndrome?

CES is a medical emergency and requires immediate referral for investigation and treatment.

Treatment to relieve the pressure on the nerves at the base of the spine must take place quickly.

Urgent surgery is often needed to lift the pressure off the nerves and prevent lifelong nerve damage. But it will depend on the underlying cause of the CES.

What is the outlook (prognosis) of cauda equina syndrome?

The long term consequence of CES depends on the cause and how quickly treatment can be provided. Any delay in diagnosis or a misdiagnosis can have life changing consequences for the patient. They may need care and assistance from carers.

If an effective treatment is not administered quickly there is increased risks of long-term bladder, bowel and sexual problems. Late diagnosis and a delay in treatment can also risks permanent nerve damage affecting the bladder, bowel and legs.

A patient will require more care and assistance to live their everyday life and will often need single storey accommodation.

As well as the physical impact of CES, there will be emotional and psychological difficulties as the patient and their family come to terms with challenging changes to their lives and needs.