Sam, 55

Mistakes made by a hospital that was treating Sam when she developed cauda equina syndrome red flags had lifelong consequences for her. Nicholas Young, a cauda equina specialist solicitor at JMW, took on Sam’s case and was able to secure her £580,000 in compensation to help her to cope with the financial impact of her permanent problems.

What went wrong?

Sam had suffered back pain for approximately two years when one evening it suddenly became much more severe. She took some pain killers and went to bed, hoping it would ease overnight.

The following morning when Sam woke up, she found she was still in significant pain. When she turned over in bed, she was alarmed to find that she has been doubly incontinent, with both her bowel and bladder having leaked without her being able to feel or control them. A family member called Sam’s GP practice who told them to ring for an ambulance urgently because they suspected cauda equina syndrome.

Sam was taken to the nearest hospital A&E department and while she was awaiting a full assessment a bladder scan was carried out. This revealed that her bladder was retaining more than 800ml of urine, and shortly after she had another episode of urinary incontinence. A doctor carried out a full neurological examination, spoke to a spinal specialist at the region’s spinal surgery hub to alert them to Sam’s condition as a transfer might be needed, and requested an MRI scan.

The MRI scan showed severe spinal canal stenosis (narrowing of the spine) was present compressing her cauda equina nerves. Transfer to the region’s spinal surgery hub was arranged with a view to undergoing surgery.

Surgeon’s refusal

In the early hours of the following morning, Sam was transferred to the specialist spinal surgical hospital. It was mid-morning she was reviewed by a spinal surgeon, who told Sam that, for her, the risks of operating on her spine, which included death, outweighed the benefits. There was no explanation of the pros and cons, and Sam was simply told that surgery would not be considered in her case.

Sam’s nearest spinal injury rehabilitation centre would not accept her and she was discharged back to her local general hospital for pain management and physiotherapy. Sam spent several days in the general hospital before being transferred to a care home until she was able to go back to her own home.

Recovery for Sam was poor, and she was left with significant pain in her back and both legs, with neurological symptoms of pins and needles and burning in both legs which caused limited mobility requiring use of crutches and difficulties using stairs.

JMW’s investigation

Sam contacted the cauda equina syndrome specialists at JMW for advice and her case was taken on by specialist solicitor Nicholas Young.

After a careful review of Sam’s medical records and listening to her story, Nicholas was concerned that she had been denied surgery when she had red flags of cauda equina syndrome.

Nicholas asked leading independent medical experts to give their opinion on the medical records and the care Sam received. When the experts reviewed the MRI scan, they advised that this had been misreported.

The experts also agreed that it was unacceptable for the surgeon to refuse to operate and to provide such incorrect advice to Sam. The conclusion of the experts was that these mistakes had been negligent, and poor outcome that Sam had suffered would have been avoided had surgery been performed.

With the support of the experts, Nicholas was able to build a strong case for Sam. While the hospitals initially denied liability, a formal admission of negligence was later made and an agreement about compensation was reached. Nicholas was able to negotiate a significant settlement for Sam that provided her with some financial security given she could no longer work, and access to the specialist housing and equipment she requires.