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Should I Have Been Referred For Cauda Equina Syndrome Sooner?

Should I Have Been Referred For Cauda Equina Syndrome Sooner?

If there was a delay in referring you to a specialist for suspected cauda equina syndrome, there could be grounds for a medical negligence compensation claim.

It may be that an earlier referral would have saved you from suffering severe neurological complications. If so, you could be entitled to compensation for the harm you have needlessly endured.

Red flag signs of cauda equina syndrome

Cauda equina syndrome is a neurological condition in which the nerves at the base of the spine are compressed. Therefore a diagnosis of cauda equina syndrome can only be made if there are signs of neurological dysfunction. With cauda equina syndrome, the following symptoms will arise:

  • Bilateral sciatica
  • Loss of sensation in the perineum, buttocks, and external genitalia
  • Loss of bladder sensation with associated incontinence

Together these neurological symptoms are called the 'red flag signs' of cauda equina syndrome and should prompt immediate medical action.

Referral for unilateral sciatica

A lot of people suffer from lower back pain and leg pain, but do not have cauda equina syndrome.

In the absence of neurological signs, a GP would not normally refer a patient with lower back pain and unilateral leg pain for an orthopaedic opinion unless it was persistent. Unilateral means the pain is only in one leg, as opposed to bilateral, which means the pain is in both legs.

If a GP did refer a patient with lower back pain and unilateral leg pain, it would not be an urgent referral. NICE guidance from 2001 says there must be a referral for nerve root pain if symptoms have not resolved after six weeks.

Referral for bilateral sciatica

However, the occurrence of any red flag symptoms should instigate a referral to an orthopaedic consultant. This includes bilateral leg pain, or bilateral sciatica, which is a red flag symptom. This should prompt medical practitioners to consider and investigate the possibility of cauda equina syndrome. Bilateral sciatica should result in the following action:

  • 1. Careful neurological examination
  • 2. Detailed questioning about the patient's symptoms
  • 3. Warning about cauda equina syndrome symptoms
  • 4. Urgent orthopaedic referral

If a patient develops bilateral sciatica or symptoms of cauda equina syndrome, but an urgent referral is not made, there will be a breach of duty. This breach of duty will typically relate to a GP or out-of-hours service, as patients often use their GP as a first port of call.

Cauda equina claims

If an earlier referral would have improved the patient's outcome, there could be a case of medical negligence. Please contact us for more information.

Expert legal advice

To find out if you can claim for cauda equina syndrome, please contact us at Glynns Solicitors. We specialise in cauda equina claims and can provide professional legal advice.

Please contact us if you would like to discuss your situation. Please call us free on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.

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