Failure to carry out emergency decompression surgery following an MRI scan resulting in cauda equina compression leading to permanent neurological and psychological injury – settled for £32,500

Richard Lodge acted for our client in a cauda equina claim.  Upon onset of his symptoms our client presented at his local A&E department complaining of severe lower back pain.  He was diagnosed as having a ligament/muscle injury and was prescribed painkillers before being discharged home.  Our client returned to the same hospital the following day complaining of severe back pain.  He also developed numbness in his left leg and buttocks, and in the groin and perianal region.  He was referred for an x-ray of the lumbar spine.  He was then assessed by an orthopaedic registrar who noted double incontinence and erectile dysfunction.  Our client was also noted to have reduced function (strength and sensation) in both of his lower limbs.  The registrar suspected cauda equina syndrome but no further action was taken that evening.  No attempt was made to contact a consultant for review.  Instead, our client was admitted overnight with a plan of performing an MRI the following morning.

The following morning the MRI went ahead which revealed a prolapsed disc at the L5/S1 spinal level.  Notwithstanding this abnormal appearance our client was discharged home and asked to attend in two weeks time for an outpatient orthopaedic review.

Unhappy with the treatment he received at his local NHS hospital our client sought a private referral using his private medical insurance attached to his contract of employment.  A consultant spinal surgeon reviewed the images taken at the NHS Hospital and conducted emergency spinal decompression surgery that evening.

Our client brought a claim against his local NHS Trust claiming that it was negligent in failing to carry out emergency decompression surgery after reviewing the MRI imaging.  Our client sustained permanent neurological injuries including disturbed motor function, deranged ability to sense degrees of bladder fullness, hesitancy and reduced strength of urinary flow, urinary urgency, post-micturition dribbling and mild disturbance of erectile function.  Thankfully our client’s injuries improved over time although he continued to experience reduced sensation of his bladder, mild erectile dysfunction and a psychological injury resulting in a panic disorder.

Liability was not admitted by the Defendant NHS Trust.  The Defendant acknowledged that our client received substandard care but argued the delay in decompression surgery did not make a difference to his outcome.  As a result of the improvement in our client’s condition he did not have any long term medical, therapy or care needs.  His claim settled out of court in the sum of £32,500.  This sum included an award for his pain and suffering and the cost of cognitive behaviour therapy sessions and future prescription charges.

If you, or a member of your family has experienced a similar situation and would like to know more, please visit our clinical negligence page or email

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