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Mistakes happen when medical professionals fail to consider rare conditions. Nearly all cauda equina syndrome (CES) claims arise from GPs or (junior) A&E doctors mistaking the patient’s symptoms for more minor conditions, such as back pain.
A patient who complains of severe back pain may have other symptoms, which the doctor must check for to be sure that early warning signs of cauda equina are not missed. These signs and symptoms may include altered feeling in the lower limbs, sexual areas, perineum and anus, and urinary problems such as incontinence, retention and lack of sensation whilst urinating.
Early recognition of cauda equina is essential as, without emergency surgery, permanent disability occurs very quickly after the patient begins having symptoms.
Cauda equina may be missed when a doctor:
CES claims can also arise from:
A patient, who is thought to be developing cauda equina syndrome (CES) requires urgent neurosurgical review including an MRI scan of their spine and emergency surgery to release (decompress) the pressure on their spinal cord.
Boyes Turner’s spinal injury specialists have over 30 years’ experience of successfully handling cauda equina syndrome claims. We understand exactly what can and does go wrong and when a claim is likely to succeed.
We have recovered substantial compensation for clients whose CES treatment was negligently delayed, leading to:
Our thorough but sensitive approach to cauda equina cases gives each client the reassurance that their case is in skilled hands. Cauda equina can affect bowel and bladder function, sexual function and feeling around the genital, perineal and anal region as well as movement of the lower limbs. Whilst we understand that clients may initially be worried about discussing the deeply personal aspects of CES injury, our solicitors are experienced at supporting people through this process and putting our clients at ease.
As experts in successful cauda equina cases, we know the issues that the court needs to determine, and the information that independent medical experts will need to form their opinions. The key to winning a cauda equina claim is being able to give the court detailed and accurate evidence of the nature, timing and sequence of our client’s signs and symptoms.
We achieve this by:
The more accurately we can establish the facts of our client’s condition, the quicker and easier it is to identify where negligent healthcare (such as delay or misdiagnosis) caused or worsened the client’s CES disability.
We do this by:
Each client’s injury and the way it affects them is unique. Their compensation award takes this into account and reflects their individual circumstances. Most of our clients find that their CES disability reduces their independence and ability to carry out daily activities at home and at work. We work closely with our clients and a team of trusted experts to understand the impact that the injury has had on our client’s life.
Whilst compensation cannot take away the injury, it can pay for solutions to ease the day-to-day difficulties faced by people who have been injured by CES. Our past clients tell us that their compensation also provides peace of mind. A successful claim can replace lost income. It also provides the financial security that comes with knowing that their ongoing needs will be met.
We recover compensation for our clients’:
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Cauda Equina FAQs
What is cauda equina syndrome (CES)?
Cauda equina syndrome (CES) is a rare but serious neurological condition caused by compression of the nerves in the spinal column.
‘Cauda equina’ is the name given to the nerve roots at the base of the spinal cord. The cauda equina nerve roots emerge from the holes between the vertebra (bones in the spine) and fan out into a bundle of fibres - like a horse’s tail. ‘Cauda equina’ is Latin for ‘horse’s tail’.
These nerves are important for the lower body. Some control the legs and feet. Others give feeling and control to the bladder, bowel, anal and genital areas.
Cauda equina syndrome or CES occurs when these nerve roots are compressed or squashed. CES is a medical emergency. The nerve root compression which leads to CES can be caused by:
Cauda equina syndrome requires emergency surgery. If not treated urgently, it can leave an individual with permanent and devastating disabilities.
What causes cauda equina syndrome?
Cauda equina syndrome is caused by compression of a group of nerves, which can be very susceptible to injury. These nerves supply the muscles of the legs, the bladder, the bowel and genitals. If the pressure is relieved quickly, the nerves should recover without leaving the individual with permanent disability.
Causes of cauda equina syndrome include:
What are the symptoms of cauda equina syndrome?
Symptoms of cauda equina syndrome include:
Cauda equina syndrome can be difficult to diagnose because not all of the above symptoms will be experienced. The symptoms can be of varying degrees and over different timescales.
Cauda equina syndrome is a rare condition but it is also one of the most common types of negligence claim against GPs. Doctors must be alert to "red flag" symptoms and ready to act quickly to ensure CES patients receive urgent treatment.
Can the condition be reversed?
Surgeons working in this field of medicine will say that urgent surgery can prevent symptoms getting worse and can sometimes allow the patient to fully recover. However, once permanent damage has been caused to the spinal cord, reversal of symptoms is unlikely.
Cauda equina syndrome is a surgical emergency, owing to its devastating consequences and the limited time within which surgery can make a difference. Until the patient crosses the threshold from incomplete cauda equina syndrome (CESI) to complete cauda equina syndrome (CESR), urgent surgery is mandated. If caught soon enough, surgery can prevent further permanent injury and may lead to some recovery of function.
Why is cauda equina syndrome a medical emergency?
When the nerves at the base of the spine are squashed, this causes pain, weakness, numbness and disability. Without emergency surgery to relieve the pressure on the nerves, this disability can very quickly become permanent.
Cauda equina surgery usually involves a laminectomy. In this operation, part of the vertebra (back bone) is removed to free up more space and take the pressure off the nerves. During surgery any slipped disc which was pressing on the nerves will be removed.
Compensation claims for cauda equina syndrome usually arise from medical delays in:
Claims also arise where a patient with back pain is sent home without advice about the importance of seeking urgent medical help if CES symptoms develop.
Once the patient has red flag symptoms, even short delays in treatment of this dangerous condition can leave the patient with permanent disability.
How can you prove cauda equina syndrome was treated negligently?
Guidelines published by the National Institute for Health and Care Excellence (NICE), the British Association of Spine Surgeons (BASS) and the Society of British Neurological Surgeons (SBNS), together with recognised standards of good practise all require doctors to recognise and react quickly to red flag warning signs of cauda equina syndrome (CES).
Early signs of CES may be difficult to diagnose, as the patient’s main complaint may be back pain which can have many less dangerous causes. However, as CES is potentially so damaging, doctors are expected to take the necessary steps to identify or rule out CES when a patient complains of symptoms which could be an early warning of the condition.
GPs and hospital doctors should do this by:
Doctors must record in the patient’s medical notes:
If cauda equina is suspected, the doctor must refer the patient urgently for surgery to decompress (take pressure off) the cauda equina nerves before the patient suffers permanent loss of function and disability.
Red flag symptoms of cauda equina may include one or a combination of the following:
I am overwhelmed by the outcome in terms of the monetary value and know I should consider it as a near a 'sorry' as I am likely to get from the hospital. It will be nice to start the process of closure on the whole issue now and look towards the future for us as a family.
Mrs T, Surrey
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