Is there anything different about pursuing a legal claim in relation to Cauda Equina Syndrome (CES)? Let’s take a closer look at the condition itself and some key information about pursuing a legal claim for medical negligence

What is Cauda Equina Syndrome?

CES is a neurological condition and a spinal cord injury, which may initially be referred to as having a ‘slipped disc’. It occurs when the nerves of the end of the spinal cord become compressed. The term “caudal equine” actually means ‘tail of horse’ and refers to the nerve roots at the end of the spinal cord resembling a horse’s tail. CES is a relatively uncommon condition and is considered a medical emergency if it occurs.

CES can affect people of any age. Depending on the severity of nerve compression and where the nerves are compressed, the condition can cause a number of injuries including lower back pain, sciatica, numbness, loss of feeling, and bladder and/or bowel dysfunction.

What are the symptoms?

CES usually starts with lower back pain. Other symptoms can include numbness or pins and needles around the lower back or buttocks, weakness in the legs and difficulty controlling your bladder and/or bowels.

How is it diagnosed?

Doctors should ask patients about their symptoms. If patients have one or more of symptoms listed above, further investigations should be undertaken to exclude CES, which can include a rectal examination to test for sensory loss. The syndrome can be confirmed using imaging, most commonly an MRI scan.

How is it treated?

Most patients are treated with decompression surgery which should be carried out urgently, to reduce the possibility of long term symptoms.

Legal claims relating to Cauda Equina Syndrome

1.    The majority of claims are against hospitals

Whilst claims are sometimes pursued against GPs or even physiotherapists, the most common claim, if you receive treatment under the NHS, is against a hospital.

This is because of the way that the condition usually progresses:  A patient will usually have one or more symptoms of CES, however as the symptoms at the start of the condition are not severe, patients initially tend to go to their GP, who will refer them to a hospital if they suspect Cauda Equina Syndrome. Should the referral be made promptly, a claim for a later delay in diagnosing CES will usually be made against the hospital.

2.    Initial symptoms often fluctuate

As the spinal cord nerves are being compressed, patients usually report initial symptoms of lower back pain which then seem to resolve. It is common to hear that patients do not become concerned and seek medical attention until sometime later (either hours or days) when further symptoms occur. In fact, what patients initially feel as the pain going away is actually nerve damage occurring; the pain is still there but patients cannot feel it due to compression of the nerves. As a result, once their symptoms deteriorate and the condition is diagnosed, it has usually been there for some time already.

3.    Most claims relate to a delay in diagnosis

Claims for compensation for medical negligence tend to arise when a patient has presented with symptoms of CES but there has either been a delay in diagnosis and treatment, which may be  because the right investigations were not undertaken. CES can progress very quickly and every minute matters – therefore any delay in diagnosing and treating the condition can leave patients with lifelong injuries.

4.    You need to prove that the negligence caused further inury

In order to succeed with a medical negligence claim, the person bringing the claim needs to prove two things: 1) That the medical treatment provided to them fell below the standard which they reasonably could have expected, and2) that this caused an injury which would not have otherwise occurred.

In the majority of claims relating to CES, proving what injuries were caused as a result of the negligence that would not have otherwise occurred is the more challenging aspect of the claim. This is done using the expert opinions of independent doctors. CES progresses very quickly and even with appropriate treatment it may already have been too late to make a difference to the patient’s condition and overall outcome.

5.    Specialist solicitors should be instructed

CES is a complex medical condition which can leave patients with lifelong injuries, requiring significant changes in both their personal and professional lives. It can result in patients suffering serious physical and psychological injuries.

A legal claim can assist patients in obtaining financial compensation. It is vital that anyone who wants to pursue a legal claim relating to CES instructs a firm of solicitors who not only specialise in medical negligence claims, but who also have experience of handling such complex spinal cord injuries.