Paramedics fail to take man to hospital causing cauda equina surgery delay - £1.5 million in compensation

‘Paul’, a man in his 30s

Paul’s life was completely turned upside down after an ambulance crew failed to take him to hospital when he developed cauda equina syndrome, a spinal injury which is a medical emergency. This mistake caused the surgery Paul urgently needed to be delayed and led to irreparable damage to his cauda equina nerves at the base of his spine. He was left with physical disabilities, bowel and bladder incontinence, poor sexual function, and ongoing pain. The impact on Paul and his family was huge. However, after seeking advice from the specialist cauda equina solicitors at JMW, Paul was awarded compensation totalling £1.5 million so that he was able to cope with the financial consequences of his injuries.

What went wrong?

Prior to the ambulance service’s negligence, Paul was an active man who enjoyed caring for and playing with his children and held a manual job that could often be physically demanding. He’d had minor back pain in the past but nothing that caused him too much trouble and he’d always been able to work through it and continue all his parental responsibilities.

Things changed when Paul had an episode of back pain that was worse than he’d ever experienced before. Paul went to see a GP who diagnosed sciatica and prescribed strong pain medication. The GP warned Paul of some red flags to look out for, including any numbness or difficulty going to the toilet.

The next day, Paul felt a popping sensation in his back, after which his right leg began to go numb. Paul was also in a lot of pain and returned to the GP that day to request stronger pain relief and report his symptoms. The doctor wrote the prescription and reiterated the advice about numbness and going to the toilet, specifically referencing numbness in his bottom and genitals. The doctor said Paul should seek further medical advice if any of these symptoms appeared.

Paul struggled on with work the next day, but it was extremely difficult for him to carry out his duties due to the amount of pain he was in. When he returned home on the Friday evening, he went straight to bed and during the night the pain brought him to tears. During a toilet visit Paul realised he was numb in his groin area and remembered the doctors’ words about this being a sign of something serious. Paul called NHS 111, advising them about the numbness around his scrotum and testicles, and was told that an ambulance would be sent to him.

It took nearly an hour for the ambulance to arrive, and Paul told the crew about all the areas of numbness he was experiencing and the fact that he was struggling to pass urine. The paramedics examined Paul but said that as he could stand up, he was not an urgent case. They said if they took Paul to hospital, he would be waiting for hours to be seen for nothing and he would be better going to his own GP practice when they opened on Monday. Paul went back to bed and stayed there all weekend.

Paul struggled to his GP on Monday and the doctor who saw him told him to go straight to A&E at the local hospital. That afternoon, Paul had an MRI scan, which showed that a herniated disc in his lower spine was compressing his cauda equina nerves and that Paul had cauda equina syndrome (CES). After being transferred to a specialist spinal hospital that night, Paul underwent surgery to remove the disc and relieve the pressure on the nerves. However, Paul made a poor recovery as he had already suffered permanent nerve damage due to the delay caused by the ambulance crew’s negligence.

JMW’s investigation

Paul and his family were concerned that the paramedics who attended him had downplayed his condition and dissuaded him from attending hospital. At that time Paul had been in a very poor condition and it seemed like there may have been a missed opportunity to diagnose and treat him sooner due to the paramedics’ inaction This felt like a huge unresolved issue to Paul, and he wanted answers about whether anything should have been done differently. After contacting JMW for advice, his case was taken on by Jodie Miller, a specialist cauda equina solicitor, under a no win, no fee agreement.

Jodie listened to Paul’s story and all his concerns and started her own investigation. Jodie had dealt with many other CES cases and agreed that the paramedics’ failure to take Paul to hospital when he had CES red flags that included numbness and difficulty urinating, had caused an unacceptable delay to his surgery, meaning the window of opportunity to successfully treat him was missed.

Jodie obtained Paul’s medical records and then gathered evidence from leading independent paramedic and neurosurgical experts to see whether they agreed with her suspicions. The experts prepared reports on Paul’s care and agreed that the paramedics had acted negligently and that with earlier surgery he would have been able to make a full recovery.

Using the reports as key evidence, Jodie set out her case against the ambulance service. Whilst the ambulance service admitted that the paramedics’ care was negligent, it was initially denied that this poor treatment made any difference to Paul’s outcome, and they maintained that he would have suffered the same injuries in any event.

Jodie pushed on with Paul’s case as her experts continued to support the claim and maintained that the ambulance services’ claims about Paul’s outcome were false. As a result of Jodie’s continued persistence, the ambulance service agreed that it should compensate Paul so that he could afford to cope with his injuries. Jodie was then able to negotiate a compensation settlement totalling £1.5 million so that Paul could buy a single storey house and the equipment and therapy he requires. The settlement also provided Paul with financial security given that he is no longer able to work and provide for his family.

Jodie Miller, a partner at JMW specialising in spinal injuries caused by medical negligence, said: