Stewarts’ client Caroline secured a settlement of more than £6m from St George’s University Hospitals NHS Foundation Trust following delays in diagnosing and treating cauda equina syndrome in April 2018. The delays caused Caroline avoidable and permanent neurological injury affecting her mobility, sensation, bladder and bowel function, pain and independence.
Background
Before the events leading to the claim, Caroline had undergone surgery for a disc bulge, from which she made a good recovery.
In April 2018, Caroline developed severe back pain, tingling and numbness in her leg and foot. She also had reduced feeling around her saddle area and difficulty passing urine. As her condition worsened, she called NHS 111 and was taken by ambulance to St George’s Hospital.
The ambulance crew and triage nurse were concerned that Caroline might have cauda equina syndrome, a serious condition caused by pressure on the nerves at the bottom of the spine. Although her case was classed as urgent, there was a delay before she was assessed by a doctor.
Caroline was referred to the neurosurgical team, but an urgent MRI scan was not arranged. There were further delays before she received a full neurological assessment and an MRI scan.
The MRI scan showed that Caroline had developed cauda equina syndrome after a large disc prolapse at L2/3 severely compressed the nerves in her lower spine. An urgent neurosurgical review was recommended. However, by the time Caroline was reviewed, she had developed severe weakness in both feet and significant loss of sensation.
Caroline underwent surgery to relieve the pressure on the nerves in her lower spine. Despite the surgery, Caroline was left with lasting weakness and loss of sensation in her legs and feet, poor balance, neuropathic pain, and bladder and bowel dysfunction.
The claim
Caroline instructed Stewarts to investigate whether the delays in her hospital treatment had made her condition worse. We obtained expert evidence about the treatment she should have received and the difference earlier surgery would have made.
High Court proceedings were brought against St George’s University Hospitals NHS Foundation Trust. The trust admitted that there had been negligent delays in Caroline’s assessment, MRI scan and surgery. It later accepted that, without those delays, Caroline would have retained essentially normal strength and sensation in her legs, avoided neuropathic pain and had less severe bowel problems.
Stewarts also obtained evidence about Caroline’s long-term rehabilitation, care, accommodation, equipment and employment needs. During the claim, we secured interim payments totalling £570,000 to help meet her needs before the final settlement.
The claim settled for a lump sum of £3,620,500 and an index-linked periodical payments order for life. The capitalised value of the overall settlement is expected to exceed £6m.
Rehabilitation and long-term financial security
Caroline spent more than two months at the London Spinal Cord Injury Centre for inpatient rehabilitation and has continuing rehabilitation, care, case management, accommodation and equipment needs.
The settlement gives Caroline long-term financial security and will help meet her ongoing rehabilitation, care, accommodation, and equipment needs. It will also support her independence as her needs change in the future.
