Cauda Equina Syndrome – are patients slipping through the net?

21st August 2019

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A very worrying article appeared on the BBC.co.uk website recently concerning Cauda Equina Syndrome and how it is being treated in the NHS. The article told the story of Catrina Farnell of Skipton, Yorkshire who suffered with Cauda Equina Syndrome at the very young age of 23.

Cauda Equina (translated as ”horses tail” in Latin) is the collection of nerves that form the - lower part of the spinal cord and supply nerve function and sensation to the bladder, bowel, sexual organs and legs. If a slipped disc compresses these nerve roots, then urgent treatment is required to decompress and restore function. Unfortunately, in Catrina’s case, now 31 years of age, she is reliant on crutches and a wheelchair and her bowel, bladder and sexual organs have been affected.

Time is of the essence in making a diagnosis and performing decompression surgery. In general, the diagnosis is made by an MRI scan..The condition is a neurosurgical emergency and surgery has to be undertaken within a matter of hours if long-term damage is to be avoided. The patient normally presents with a series of “red flag” symptoms including low back pain, leg pain and, critically, numbness in the groin or saddle.

Most concerning about the BBC article are the comments of the clinicians that it is critical patients get an MRI scan promptly as it is the only way to confirm the condition. Unfortunately, there is a shortage of MRI radiographers working out of hours which, in consequence, causes delay in the diagnosis and an adverse outcome. After 24 hours, the damage to the cauda equina nerve roots is such that the outcome can be lower limb paralysis, incontinence and impaired sexual function.

Between 2014 and 2016 compensation for Cauda Equina Syndrome claims was estimated to be in the region of £68,000,000. Compensation payments can reach £4m, excluding legal fees, because many of those who suffer Cauda Equina Syndrome, may not be able to work again and need lifetime care. It cannot be right that patients are not being diagnosed with Cauda Equina Syndrome quickly enough because of a shortage of radiological resources to make the diagnosis. Despite the NHS Resolution (formerly the NHS Litigation Authority) saying they are working closely with Trusts to reduce avoidable harm to patients, this article was a disturbing read.

Geldards’ specialist Medical Negligence team has acted in numerous successful claims for misdiagnosed/delay in treatment of Cauda Equina Syndrome and have witnessed first-hand the pain, misery and lifelong effects it creates when it is not diagnosed and treated in a timely fashion. Our specialist lawyers can help you make a Cauda Equina claim if your life has been changed by the condition.

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