Michelle, 49

Michelle is largely wheelchair dependant and has no control of her bladder and bowel after a physiotherapist failed to send her straight to A&E when she attended an appointment with symptoms of cauda equina syndrome.

Due to her disabilities Michelle lost her job and needs to move into a single storey house. After launching a legal case against the hospital trust responsible for the negligent physiotherapist with the help of JMW, Michelle was awarded compensation totalling £3.75 million to give her financial security and cover the cost of her specialist accommodation and equipment.

What went wrong?

Michelle had some history of back problems and had previously had an MRI scan of her spinal cord which had revealed some narrowing in her spine which was creating less space for her spinal cord nerves (spinal stenosis). However this was not causing her any problems and she was able to work and enjoy life as normal.

When Michelle had an attack of back pain several years later, that also affected her hip, she went to see her GP who said she needed physiotherapy. Michelle was able to refer herself to the NHS physiotherapy service and she only had to wait a couple of days to be seen.

The night before Michelle’s physio appointment she developed some new and concerning symptoms alongside the pain she was suffering from. She found she was unable to control her bladder as normal and had an episode of incontinence and the feeling was different in her genital area, both signs that there was a problem with the nerves at the base of her spina known as the cauda equina nerves.

At her appointment Michelle reported the incident of incontinence and the other symptoms and the physiotherapist made a record of them in his notes. However he failed to recognise that these were red flags of serious spinal injury cauda equina syndrome (CES) and send Michelle straight to A&E for emergency treatment. Instead he referred her for a non-emergency MRI scan.

Poor outcome

Michelle had the MRI scan about 10 days after she was referred which found that the stenosis was now affecting the cauda equina nerves and was causing them to become compressed and at risk of permanent damage. Once again, although Michelle should have been sent straight to hospital due to these findings, she was not.

Michelle’s symptoms persisted over the next few days and she had further episodes of incontinence and at one point her leg gave way because it lost all power. Not long after this Michelle had a follow-up appointment with the physiotherapist. This time when she recounted what had happened, he immediately recognised that she required urgent treatment. He told her to go straight to A&E at her local hospital and she was transferred to a hospital with a specialist neurosurgical department that evening for emergency surgery. However by this time it was too late to prevent permanent damage to the nerves and Michelle was left with lifelong cauda equina syndrome.

JMW’s investigation

Michelle was devastated by what had happened to her and searched for support online. After doing so she was recommended to speak to Eddie Jones, head of JMW’s medical negligence team and a CES specialist solicitor with many years of experience.

Eddie was able to take Michelle’s case on under a ‘no win, no fee’ agreement, meaning that if after investigation Michelle’s case was not successful, she would not have to pay any legal fees.

However by instructing leading independent medical experts operating in the field of spinal injury, Eddie was able to prove that it was negligent of the physiotherapist not to refer Michelle to A&E at the first appointment when her red flags had only just appeared. Furthermore, Eddie was able to show that if the physiotherapist had done the right thing, Michelle would have had surgery at a much earlier stage, made a complete recovery and not have permanent disabilities.

Eddie built a strong case against the hospital trust responsible for the physiotherapist, leading it to admit negligence and for Eddie to begin negotiating appropriate compensation for Michelle.