Settlement Agreed In Secondary Cauda Equina Syndrome Claim

Spencer Collier and Amy Beth Probert in Geldards’ Medical Negligence team recently concluded a medical negligence claim on behalf of a client who had the misfortune to suffer not only one cauda equina syndrome but a, very rare, second one which was not treated properly.

Cauda equina syndrome is a serious neurosurgical emergency that requires prompt diagnosis and emergency surgery. The cauda equina is the bottom part of the spinal cord whose nerves control bowel and bladder function, sexual function and the nervous system into the lower limbs. It is named such as it appears like a horse’s tail – cauda equina in Latin. These nerves become compressed by a central disc bulge in the lower spine and, unless treated promptly, can result in paralysis, difficulty walking and impaired bowel, bladder and sexual function.

Our client had suffered with the problem in 2009 when it was treated successfully. However, the problem reappeared in 2014 and she was admitted to hospital. Aware of and educated about the condition, she knew that she was suffering with the same problem and was able to fully articulate the red flag signs and symptoms to the doctors. Despite this, a decision was made to not intervene and operate but to treat conservatively. She deteriorated and the window of opportunity for successfully treating the condition closed with devastating consequences, including bowel and bladder incontinence and sexual dysfunction. She became wheelchair bound.

The case was very difficult. Cases of secondary cauda equina are very rare and as such there is very little published literature on the treatment options. Medical opinion was sought from Nick Todd, Consultant Neurosurgeon, who advised that surgery should have taken place and that the decision not to operate could not be defended. The allegations were put to the treating hospital. Some limited admissions were made but liability in principle remained in dispute.

During the national lockdown, our client accepted the Defendant’s offer to mediate the claim with an independently appointed mediator which we conducted via Zoom. After hearing arguments on both sides, an agreed settlement was reached to ensure our client had a secure and supported financial future.

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