£480,000 awarded after a delayed diagnosis of Cauda Equina, despite the defendant assessing it at £15,000

Background

In 2018, our client suffered from sudden severe back pain and experienced altered sensation in both lower limbs. On arrival at the emergency department, a junior doctor
conducted an assessment which noted that our client displayed several symptoms indicative of Cauda Equina. These included: saddle anaesthesia, loss of sensation while passing urine, diminished power and sensation in the left leg and reduced perianal sensation. Despite the junior doctor’s request for an emergency MRI of the lumbar spine, the Radiologist
downgraded this referral. Instead, she suggested an urgent outpatient MRI to be conducted within one week. The junior doctor questioned this downgrading, and an X-ray of the lumbar spine was performed instead and undertaken on the same day.

Following the X-ray, the Emergency Physician also sought an immediate MRI, however the Radiologist did not agree that it was a matter of urgency. An orthopaedic review also
advocated for an immediate MRI, but the Radiologist maintained that our client’s symptoms did not convincingly indicate towards Cauda Equina compression, nor merit a same-day MRI. Our client was consequently discharged and scheduled for an urgent outpatient MRI the next day.

Unfortunately, our client’s symptoms worsened rapidly at home, to the extent that she was in unbearable pain and unable to walk down the stairs. Returning to the emergency
department, an MRI of lumbar spine was conducted, identifying an L4-5 disc protrusion causing severe canal narrowing and compression of Cauda Equina nerve roots. Our client
underwent neurosurgery later that day.

Due to the delay in diagnosing Cauda Equina, our client was left with an ASIA D spinal cord injury. Our client had weakness in her lower limbs, which would give way when walking, thereby limiting her mobility. In addition, she continued to experience altered sensation in the saddle area and neuropathic pain.

A serious incident report confirmed that the Radiologist should not have overruled the doctor’s request for an MRI given the presenting symptoms, and had the MRI been
performed earlier, our client would have had surgery at an earlier point in time.

Our Support

Our client instructed spinal injury specialist solicitor, Raquel Siganporia, to pursue her claim. We instructed top medico-legal experts to review her medical records and provide reports on breach of duty, causation and quantum.

We pursued our client’s claim against the hospital on the basis that they failed to adequately consider the request for our client to undergo an immediate MRI from multiple healthcare staff, and diagnose her Cauda Equina. Breach of duty was not disputed by the Defendants, as the Hospital admitted that they failed to perform a neurological examination when our client attended her appointment. As a result of the failure to exercise all reasonable care, skill and judgment, our client’s Cauda Equina symptoms were not diagnosed for over 22 hours in which time her neurology significantly deteriorated. This delay caused permanent and irreparable damage. Therefore, any opportunity to fully reverse the damage early on was missed. Although the defendant accepted that they had breached their duty of care to our client, they disputed how much damage had been caused to her during the delayed period. The defendant maintained that the delay was minor and our client would have had a similar outcome in any event.

We therefore undertook a forensic examination of the records and investigations with our experts to show the injury caused by the defendant was worth more than £15,000.00. we
used our specialist knowledge to show that someone with an incomplete spinal cord injury can be impacted in many ways which affect their ability to carry out day-to-day activities
safely.

Outcome

Raquel Siganporia was assisted by Amanda Brown of Aspire Law. Raquel instructed Leading Counsel, Eliot Woolf KC of Outer Temple Chambers.

Following the defendant’s strong adherence with their initial offer of £15,000.00, we attended two joint settlement meetings with our client. At Aspire Law, expertise lies in our
understanding of the complexities behind liability and causation regarding Spinal Cord Injury cases, particularly in recognising that Cauda Equina cases are frequently undervalued. Our commitment to perseverance is crucial in achieving a settlement that reflects the severity of our client’s incomplete spinal cord injury. Our specialised knowledge, experience, and strong relationships with prominent barristers, led us to strive for the most favourable outcomes. Overall, Raquel and Eliot successfully negotiated a settlement of £480,000.00 for our client.

Comments from our client following settlement

‘Dear the most incredible team… I am writing to express my most sincere thanks for the most professional representation. Thank you for all of your support over the years. It has been so invaluable. I admire your dedication to my case and for settling today’

Comments from Raquel Siganporia, Senior Solicitor

‘This case demonstrates the importance of instructing specialist spinal cord injury medical negligence solicitors. Specifically those who have a thorough knowledge of Cauda Equina cases and the implications of having an incomplete spinal cord injury. A first glance, this would appear a straightforward case given the defendant had admitted liability, however, it required a tenacious lawyer to ensure the defendant did not undervalue the ASIA D injuries. Ultimately, we secured 32 times more compensation for our client than what the defendant was willing to pay for the duration of her case.’

We are delighted that this settlement has ensured that our client can seek suitable accommodation to prevent further falls and enable her to resume her life.’