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Written by Julie Marsh

Boyes Turner’s medical negligence specialists have negotiated a £275,000 settlement from a GP for a man in his thirties with cauda equina syndrome

The claimant, who had a past history of sciatic back pain, attended his GP complaining of an exacerbation of his pain and a change in his condition. The pain was now radiating down both legs. He had pins and needles in both legs and feet, numbness in his perineum which extended across the front of his thighs and into his scrotum. He was also having difficulty with urinating.

The claimant’s GP failed to recognise that the claimant had red flag symptoms of cauda equina syndrome. Cauda equina is a medical emergency which requires urgent referral to hospital.

When red flag symptoms are present, such as lower limb numbness or weakness, bilateral pain which radiates down the legs below the knee, disturbance of bladder or bowel function and numbness to the saddle area, the patient needs urgent decompression surgery to relieve the pressure on the nerve roots below the bottom of the spinal cord before the patient suffers permanent loss of function.

In this case, the claimant’s GP failed to carry out a thorough neurological examination and his record of the consultation in the medical notes was inadequate. The GP failed to refer the claimant to hospital immediately. Instead, he sent him home with painkillers and planned to reassess him a week later.

The claimant’s condition deteriorated over the next three days. He went to his local hospital’s A&E where an MRI scan revealed a lumbar disc prolapse with secondary cauda equina. Emergency surgical decompression with discectomy and laminectomy was carried out the same day but he had already suffered permanent disability as a result of the GP’s delay in referring him to hospital.

The claimant has been left with fatigue, permanent pain and weakness in his legs, impaired urinary, bowel and sexual function. If he had been referred promptly to hospital when he first attended his GP, it is likely that following emergency decompression full function would have been restored.