Compensation secured for man left with permanent injury after medical practitioners repeatedly missed red flags for cauda equina syndrome.

Find out how Simon Elliman secured a lump sum settlement for our client Stephen Lee, for injuries he sustained as a result of a delay in diagnosis of cauda equina syndrome. The delay resulted in permanent physical symptoms including impaired bladder function, impaired bowel sensation, impaired sexual function, reduced balance and reduced mobility.

Stephen had a history of lower back pain, and had experienced a particular flare-up in February to April 2021. He had initially requested an MRI upon attending his GP and physio but was instead advised he should be referred to the orthopaedic interface service for treatment. After the referral was made later that year, Stephen’s first appointment arrived in January 2022.

Between January and March 2022, during his many appointments with a musculoskeletal advanced physiotherapy practitioner – who had initially recorded that Stephen had no red flags and that he was negative for cauda equina syndrome – as well as repeat appointments with his GP, at no point was Stephen warned of the red flag symptoms of cauda equina syndrome. Similarly, requests for referral for an MRI were repeatedly rebuffed by Stephen’s GP. All this despite increasingly severe symptoms that at one point left him unable to sit and crying in pain as he spoke with his doctor.

Over the course of a few days in March, his symptoms took a turn for the worse. First, in early March Stephen saw the musculoskeletal physio about numbness in his left butt cheek, both in bed and whilst in the car. He was advised that he had a bulging disc pressing on his nerves, but was given no information on red flags for cauda equina syndrome at this stage.

In the following days, his partner found Stephen had been incontinent in bed overnight, and he was beginning to feel that he really had to push to urinate and had a bowel movement one morning where, he recalled, he could not feel anything at all when passing it. It was at this point that, after discussing these symptoms with his GP, Stephen was advised to call an ambulance.

Upon arriving at his local hospital Stephen was given a bladder scan, and it turned out after that Stephen was in urinary retention. He was told that he needed to be catheterised and in the meantime he had an MRI scan which confirmed cauda equina syndrome. A referral was made to the Neurosurgery Department at Southmead Hospital in Bristol later on that day, and he was transferred over to Southmead that evening wherein decompression surgery was commenced.

As a result of the delay to diagnose cauda equina syndrome, Stephen has suffered lifelong injuries. He now has to live with impaired bladder function, impaired bowel sensation, impact on his sexual function, as well as reduced balance and mobility.

After he contacted our expert medical negligence solicitors, we explored with Stephen the timeline of events leading up to his injury.

After reviewing his medical records, on Stephen’s behalf we alleged that there was negligence on the part of a specialist musculoskeletal physiotherapist to examine Stephen competently, consider cauda equina syndrome as a potential diagnosis, to warn him of “red flag” symptoms of cauda equina syndrome, and to and to refer him accordingly. Had he been given cauda equina syndrome safety-netting advice Stephen would have attended the local hospital as soon as his left buttock numbness presented. With competent care he would then have made a full recovery from the bulging disc which caused his injury.

Furthermore, we also alleged that had Stephen been reasonably examined when he saw his musculoskeletal physio in early March, he would have either been referred for an urgent MRI scan or for same day spinal review as an emergency. Again, with competent care at this stage he would have undergone prompt decompressive surgery and made a full recovery.

Negligence was admitted on the part of the physiotherapist, in that he failed to carry out a competent examination, failed to instigate further investigations, failed to give “red flag” safety-netting advice, and failed to advise Stephen to attend the Emergency Department.

It was further admitted that, but for these errors, Stephen would have been operated upon significantly earlier than in fact took place, and would have had a better outcome.

We then worked on quantifying Stephen’s claim, and entered into settlement negotiations which led to an early settlement of the case only a few months later.