The BBC has reported this week that the failure to identify and treat the little-known spinal condition cauda equina is probably costing the NHS hundreds of millions of pounds per year.
What is cauda equina syndrome?
Cauda equina describes the spray of nerves that come off the bottom of the spinal cord and activate the bladder, bowel, sexual organs and legs.
Cauda equina syndrome is a rare and severe form of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed. Red flag signs include nerve pain down both legs as well as pins and needles or numbness around the bottom and inner thighs.
It is a rare condition, but it is vital that all doctors are on alert for it because of the severe consequences of delays in diagnosis and/or treatment.
The longer it remains untreated, the greater the chance that it can lead to permanent paralysis and incontinence. The condition, therefore, requires early detection, emergency hospital admission and emergency surgery.
The condition should ideally be caught in a matter of hours, an MRI should be carried out and decompressive surgery should follow.
BBC report on cauda equina compensation claims
It has been reported this week that a shortage of resources combined with a lack of awareness among medical professionals is making the problem much worse and resulting in missed opportunities to diagnose the condition in a timely manner.
It is estimated that the cost of cauda equina compensation claims for the period of 2014-16 was around £68 million, with two-thirds of this resulting from delay or failure to diagnose or treat the condition. This figure relates only to claims against hospitals and does not take into account claims against GPs for failing to spot the symptoms and refer for emergency treatment.
It is likely that the true figures are actually much higher, closer to £150 million to £200 million a year in compensation payments, covering legal costs.
NHS Resolution, who act on behalf of NHS Trusts in claims for clinical negligence, were reported as saying it was:
“committed to sharing information with our NHS trust members to highlight some of the red flags related to cauda equina syndrome. We are working closely with Trusts and the wider NHS system to reduce avoidable harm to patients.”
Comment
The figures associated with claims against the NHS for missed diagnosis and/or treatment of this serious condition are worrying. Where time is of the essence when it comes to diagnosis and treatment, it is imperative that this is a topic at the top of the list for learning lessons in how to improve. It must be time for action on the part of the medical profession to increase knowledge and awareness of this dangerous condition.
If medical professionals do not recognise the red flag symptoms and act quickly, the result can be irreparable and permanent damage. If that damage is the result of delayed diagnosis, a patient may be entitled to claim compensation, not only for their injuries but for the ongoing and future treatment and rehabilitation that will inevitably be required.
How can Nelsons help?
Danielle Young
is an Associate in our Medical Negligence team.
At Nelsons, our team has experience in assisting clients with cauda equina claims. As one of the top-rated medical negligence law firms in the UK, we have the expertise, experience and skill to handle your claim with care and compassion from beginning to end.
If you have any questions in relation to the subjects discussed in this article, then please get in touch with Danielle or another member of the team in Derby, Leicester or Nottingham on 0800 024 1976 or via our online form.