CAUDA EQUINA SYNDROME MEDICAL MALPRACTICE

Cauda equina syndrome medical malpractice is a rare cause of catastrophic injury which may result in paraplegia. CES is not a "back problem" but is a form of spinal cord injury which is caused by damage to a bundle of nerves situated at the lower end of the spinal column and may result in:

• severe pain in the back, buttocks, perineum, genitalia, thighs and legs
• loss of sensation including tingling or numbness in the saddle area
• weakness in the legs
• dysfunction in bladder, bowel, and sexual activities
• incontinence and retention of urine and feces
• impotence and loss of ejaculation or orgasm
• loss of reflexes

CES which arises suddenly should always be regarded as a medical emergency which requires immediate surgical intervention to avoid permanent nerve damage that can lead to chronic disability including paraplegia. The most common cause of CES results from a prolapsed disc pressing on the bundle of nerves at the base of the spinal column. CES may be caused by compression including prolapsed disc, spinal injury, chronic inflammatory arachnoiditis, stretching, slippage of one vertebra on another, demyelination and toxic damage due to spinal anesthetics.

Damages can be very substantial particularly in younger victims due to the potential for reduction of earning capacity in addition to damages for pain and suffering. Compensation claims usually arise as a result of inadequate or negligent surgery or as a result of delay in diagnosis and treatment which may worsen the condition often rendering it untreatable. Urgent surgical treatment is usually necessary to restore bladder and bowel function which can prevent further permanent deterioration in the lower extremities. Treating physicians must ensure that they are familiar with the symptoms of this condition and ensure surgical intervention by a competent neurosurgeon at the first possible opportunity.

CES does not always arise as a result of an obvious sudden traumatic injury and many patients who are at risk will attend their doctor suffering from relatively minor back ache. To avoid a claim for cauda equina syndrome medical malpractice, there are four vital questions that healthcare professionals should ask patients who are suffering from low back pain. Failure to ask these questions may be an indication of negligence if the condition subsequently manifests itself as problematic late diagnosed or untreated CES.

• ‘Has your bladder been working normally? Can you tell when it’s full? Have you had any loss of control or difficulty passing urine? Have you felt that you want to go all the time?’
• ‘Have you noticed any numbness or strange sensations around your buttocks or between your legs?'
• ‘Have you noticed any changes in sexual function including loss of feeling in your genitals or not being able to get an erection or ejaculate?’
• ‘Have you experienced any unusual problems with your bowels lately?’

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