Almost all compensation claims relating to Cauda Equina Syndrome concern a delay in undertaking decompression surgery. The reason for this is that a delay can leave the patient with permanent catastrophic injuries whereas timely surgery can bring about a recovery of function.
Decompression surgery timing
There continues to be debate about the optimum timing of surgery in cauda equina syndrome but there seems to be fairly widespread agreement about the circumstances in which surgery becomes a medical emergency.
Cauda equina syndrome can develop either acutely or gradually and this can affect the patient’s chances of accessing successful surgery.
The patient may start to experience lower back and leg pain and, at this point, it may not be clear that they are developing this appalling condition.
When they begin to develop additional symptoms, however, the picture starts to become clearer and the need for further investigation can become urgent.
If the patient begins to experience bilateral leg symptoms or loss of sensation in the saddle area or bowel or bladder difficulties, these are all indicators that they may be developing cauda equina syndrome.
The underlying cause of their symptoms needs to be confirmed as a matter of emergency. A delay can mean a deterioration in symptoms and the loss of any possibility of recovery.
Bladder symptoms
It seems to be agreed that, once the patient has lost bladder sensation and is retaining urine without experiencing pain, or has become incontinent of urine, the best moment for surgery may have passed. It is likely that urgent surgery (as opposed to emergency) will still be considered to be necessary but the chances of recovery of lost function are probably reduced.
If the patient still retains some bladder sensation and control at the time of surgery, they would seem to have a better chance of recovering than in the above scenario.
Medical negligence
For timely surgery to take place, a diagnosis is necessary and this requires an MRI scan. If a medical professional does not recognise or investigate the possible symptoms of cauda equina syndrome, allowing the patient’s condition to deteriorate prior to surgery, they may be considered to have provided a substandard level of medical care.
If the patient suffers a significantly worse physical outcome as a result, it may be appropriate to make a claim for compensation.
Contact us to talk to a specialist medical negligence. We have supported numerous highly-successful claims for negligence related to cauda equina syndrome and would be happy to advise you.