‘Gemma’, a woman in her 30s

Gemma suffered severe vision loss and has significant physical disabilities after she experienced negligent treatment of a spinal injury, followed by failures in care for an eye condition two months later.

The impact on Gemma was devastating and she was left unable to work, live independently or take part in any social activities.

Absolutely nothing could make up for this, but after Gemma’s case was taken on by Angharad Hughes, a partner in JMW’s specialist medical negligence team, she was awarded £4.6 million in compensation so that she could access the best possible care, therapy and equipment. The compensation has also given Gemma financial security given she is unable to work for a living.

What went wrong?

Gemma had had grumbling back pain a few years before the tragic events that led to her medical negligence case. It had aways settled with physiotherapy, so she had not been overly concerned at that point.

However, when Gemma developed back pain that was accompanied by pins and needles in her right leg, she went to see her GP. Gemma was sent for an x-ray of her lower back, which revealed a small fracture. While the fracture healed, Gemma continued to suffer with pain in her back.

A couple of months later Gemma found that she was struggling to open her bowels and could not feel anything when she passed a bowel movement. During a physiotherapy appointment Gemma discussed this development and was advised to go back to her GP. The physiotherapist also warned Gemma about cauda equina syndrome and that this was a medical emergency.

Gemma’s GP referred her to hospital for an MRI scan, which was done six weeks later. While waiting for the scan Gemma’s pain spread to her buttocks and her right calf.

It was another two months before Gemma was told that the scan revealed some degeneration in the discs in her spine. Gemma had an epidural injection to try to relieve the pain, although this did not have a lasting effect.

Over the next few months, Gemma’s pain increased to a severe level, to the point that it would make her feel very sick. The GP and hospital doctors did not believe there was anything more they could do to help Gemma.

Eventually Gemma could take it no more and attended the A&E department of her local hospital. By this point she not only had pain in her back and leg, but also both of her feet were numb. The loss of feeling in her bowel was also still present. A further x-ray was done on Gemma’s spine, and she was told that there was no change to the previous x-ray, and she should go home and make another appointment with her GP. All Gemma’s GP suggested was to increase her morphine and help her with arrangements for a spinal block.

A few weeks later both Gemma’s buttocks became numb, and she couldn’t feel anything when she passed urine. After she rang NHS 111, she was told an ambulance would be sent out to her. Gemma continued to be in severe pain.

Gemma was transported to hospital in the early hours of the following morning but after being triaged did not see a doctor for several hours. Gemma’s bladder felt as though it was very full, and she felt relief when she was catheterised. Despite these worrying red flags of cauda equina syndrome, an MRI scan to confirm the diagnosis was not carried out for several more hours. After the MRI scan, Gemma was catheterised and left in a side room until 11pm that night when she transferred to another hospital for surgery, which was carried out at 2am.

The following day, while Gemma was recovering from the surgery, she was given the shocking news that surgeons had been waiting for to arrive for the operation from 5pm the previous day. They had told the first hospital that she should be sent by blue light ambulance as soon as possible but her transfer had not been arranged for many hours.

Eye failures

While Gemma continued to recover, she was transferred to a specialist rehabilitation hospital where she would stay until she was able to return home. A couple of months after her admission, Gemma started to suffer from headaches, nausea and light sensitivity. A doctor referred her to a general hospital for CT scan of her head, but no diagnosis or treatment was offered. Following this Gemma developed blurred and cloudy vision.

A couple of days later Gemma went to see an optician who said she had the classic signs of an eye condition called papilloedema, which causes vision loss and is triggered by fluid and swelling around the brain that results in high pressure (intracranial hypertension). Gemma went back to hospital and had a further CT scan. She was told she would need a lumbar puncture the following day, this is where fluid is extracted from the spinal canal and would help to reduce the pressure around Gemma’s brain and eyes.

However, the lumbar puncture was delayed to the following afternoon and while it relieved Gemma’s headache, there was no improvement in Gemma’s vision. Gemma was registered as legally blind as her vision was now so poor.

Gemma also had a very poor outcome from her cauda equina surgery due to the very lengthy delays she had faced. Due to the permanent damage to her cauda equina nerves, Gemma was left doubly incontinent, barely able to walk and in need of a specialist frame. This has also had a far-reaching impact on her mental health.

JMW’s investigation

Gemma and her family contacted JMW for advice and her case was taken on by Angharad Hughes, who specialises in helping people who’ve suffered catastrophic injuries due to medical negligence.

Angharad launched an investigation that involved analysing Gemma’s medical records and gathering reports from leading independent medical experts. The investigation revealed there had been numerous failures in Gemma’s cauda equina care including a delayed assessment by A&E doctors, a delayed referral to orthopaedics, not treating the diagnosis of cauda equina syndrome urgently enough, delaying the MRI scan and the delayed transfer to the specialist spinal hospital for surgery.

In terms of the care for Gemma’s eye condition, Angharad found that hospital doctors had failed to do a proper assessment, failed to diagnose or consider intracranial hypertension, failed to Gemma to refer to neurology team and delayed treating her with a lumbar puncture.

The two hospitals denied the majority of the allegations but given Angharad had assembled a strong team of experts, we were able to put forward a robust case on Gemma’s behalf. This allowed Angharad to negotiate the significant settlement for Gemma so that she could at least not have to worry about the financial aspect of her severe disabilities while she tried to cope with the catastrophic impact on her life.

Angharad Hughes, a partner at JMW specialising in catastrophic injuries caused by medical negligence, said: