Cauda Equina Syndrome: Why is The Little-Known Spinal Injury Costing the NHS Millions?

The BBC recently highlighted the little-known spine condition which is ‘costing the NHS millions’ – cauda equina compensation claims have been estimated by the NHS as securing £68m between 2014 and 2016, two-thirds of which for the delay or failure of diagnosis or treatment. So, what is going wrong?

 

What is Cauda Equina Syndrome and What Are Its Symptoms?

 ‘Cauda Equina Syndrome’ refers to the bundle of nerves at the bottom of the spinal cord and their compression. This can be caused by pressure on the nerves and requires rapid treatment to avoid significant disability.

You can find out more about the condition, its symptoms and how to treat cauda equina in our post: Cauda Equina Syndrome: A Missed Diagnosis

 

How is Cauda Equina Syndrome Treated?

 Certain ‘red flags’ should alert doctors to the condition and the condition needs to be caught within hours. Patients should have an MRI scan and then urgent surgery to relieve pressure on the spine.

Research suggests that most people developing the condition have urinary retention (being unable to pass urine) when they first see doctors, but between 30% and 50% have an incomplete version of the condition when they first attend doctors. These are the patients who need urgent treatment, before their condition gets worse.

Treatment cannot always undo the damage, but it can stop things getting worse. For patients with incomplete cauda equina syndrome surgery is generally effective. Of those who already have urinary retention, around 70% have what the research terms ‘a socially acceptable long term outcome’. In other words, they are able to manage to live a normal life.

 

So, What is Going Wrong?

Two factors are exacerbating the problem. The first is a shortage of resources. There are not enough MRI radiographers working out-of-hours, which means patients may have to wait longer than they should. Our experience is that patients also sometimes have to wait when an operating theatre is not available or there are too few specialists to make up an operating team at short notice.

The second is a lack of awareness among medical professionals. Again, in our experience, there is often a failure either by GPs or by Accident and Emergency staff to recognise the red flags. As a result, people get to hospital or are only referred to surgeons too late.

It is also our experience that the results of delays can be devastating, and failures to recognise and manage cauda equina syndrome are one of the main areas giving rise to claims in spinal surgery. For example, in Richard’s case in our article: What Effect Can Cauda Equina Negligence Have On Your Life?

 

Why Are Damages for Cauda Equina Negligence So High?

As previously stated, the NHS expects the cost of claims for medical negligence from 2014 to 2016 to be £68 million. However, this is an underestimate because it does not include claims against GPs – and many claims arise when GPs miss the red flags. One specialist urologist estimates that the true figure is nearer £150 million to £200 million.

Research by different bodies representing doctors has put the average level of damages at £117,331, £336,000 and £221,758 (although these are quite old figures). There have been settlements exceeding £2.5 million.

Cauda equina claims can be very high because mistakes can cause severe disability. Damages aim to put the patient back in the position they would have been in but for negligence. So, if someone loses their ability to walk, damages aim to make them mobile – to provide therapy to get them back on their feet, equipment to help them and transport.

High-tech wheelchairs and other aids can be expensive. If they need help looking after themselves, damages can pay for care at home. And, sometimes, people need to move house and adapt their homes. All this leads to high awards.

We are currently assisting someone whose cauda equina was missed on a claim which is likely to result in a multi-million-pound award. In that case, the result of a delay in treating a spinal infection causing cauda equina syndrome has been devastating, leading to a brain injury and tetraplegia – paralysis of the legs and arms.

 

Have You Suffered a Delayed Diagnosis of Cauda Equina Syndrome?

Claims for damages are complex and it is important to have the right specialist legal help. If you have suffered an injury due to negligent delays in diagnosis or treatment and would like to learn more about making a cauda equina claim for damages, our team of expert spinal injury solicitors are here to help.