Mark, a man in his 50s

Mark had to take early retirement after a catalogue of errors by medical professionals meant that there was a delay in diagnosing him with cauda equina syndrome. When surgery was eventually undertaken, further errors were made that resulted in Mark suffering permanent damage to the cauda equina nerves at the base of his spine. He is now left with permanent nerve pain in his legs and bladder and bowel issues which have forced him to give up participating in the sports he loved. Nothing could ever fully make up for the failures in Mark’s care and the devastating impact on his life. However, after a successful case for medical negligence was brought Sally Leonards, a partner specialising in cauda equina cases at JMW, Mark was awarded £1.7 million in compensation so that he could adapt his house and access the equipment, therapy, and financial security he needed.

What went wrong?

Mark had no history of back problems and was physically fit and active. However, that changed during a gym session, when he felt something ‘go’ in his back, which rapidly became very painful. Mark attended the urgent care centre at his local hospital and was diagnosed with muscle strain and advised to apply heat to the area.

Over the following few days Mark remained in pain and so attended his GP and was told about a spinal drop-in clinic at the hospital. He attended the clinic three days later and was seen by a physiotherapist. By this point Mark had developed several abnormal neurological symptoms that were red flags of cauda equina syndrome and required emergency medical intervention and investigation. The symptoms included pins and needles in his legs, numbness in his buttocks, not feeling the need to urinate as often and having to strain when he did, and a loss of feeling when he did pass urine. The physiotherapist included all these symptoms in her record of the appointment but did not carry out a full neurological examination or advise Mark to go straight to A&E as she ought to have done.

Mark’s case was discussed with a senior colleague of the physiotherapist who said that in light of his symptoms he would refer him for an ‘urgent’ MRI scan, with the appointment being made for more than four weeks later.

Over the next four days, Mark’s condition deteriorated significantly with increasingly severe pain in his legs and buttocks and a painful burning sensation in his scrotum and groin. Mark also had intermittent numbness in his penis, and his problems with urination continued, leading him to have some leakage overnight. The day after this episode of incontinence Mark called NHS 111 who told him to immediately attend A&E.

However, the doctors in A&E who spoke to Mark did a poor assessment and examination and so failed to appreciate the dire situation he was in. They saw fit to send him home and for him to attend the arranged MRI scan in a few weeks’ time.

Mark continued to suffer until the MRI scan, which revealed a bulging disc in his lower spine, which was causing severe compression of his cauda equina nerves. From this point on Mark was diagnosed with cauda equina syndrome and treated with urgency, but tragically the failures in his care did not end here.

Whist Mark was referred to a consultant spinal surgeon, and the operation to remove the disc was carried out two days later, the surgery was done very poorly. The bulging disc was not fully removed, meaning decompression was not achieved. Mistakes made by the surgeon during the operation also caused direct damage to a higher region of Mark’s spinal cord. Finally, Mark also suffered more post operative swelling due to the negligent surgery, causing further damage to the cauda equina nerves.

The outcome for Mark was very poor and he was left with bowel and bladder dysfunction, permanent pain in both his legs. He also has sexual dysfunction and persistent weakness in his right foot and ankle that significantly affects his mobility.

JMW’s investigation

Mark was dismayed that he had received such poor treatment for such a serious condition and contacted the specialist cauda equina syndrome team at JMW for advice. His case was taken on by Sally Leonards, a partner in the team who has dealt with many similar cases. Sally had a detailed discussion with Mark about what had gone on and said she would investigate a case for medical negligence under a no win, no fee agreement.

After examining Mark’s medical records, Sally believed the delays in diagnosing cauda equina syndrome and operating were potentially negligent, and she was also concerned about the failure of the eventual surgery. Sally instructed medical experts in the field of spinal conditions and surgery to prepare reports setting out their views, enabling her to build the strongest case possible. This led to admissions of negligence from the hospital trusts responsible for the physiotherapists, the A&E doctors, and the surgeon so that Sally could negotiate a significant compensation settlement of £1.7 million for Mark so that he could cope with the severe financial fall-out from his ordeal.