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Cauda Equina Misdiagnosis
Successful Compensation Claim After NHS 111 CES Assessment Failings

Successful Compensation Claim After NHS 111 CES Assessment Failings

A substandard response from NHS 111 left Natalie believing that her symptoms did not require emergency treatment.

Natalie had a history of lower back pain and occasional bouts of sciatica so, when she developed familiar symptoms, she went to see her GP. After an examination the pain in her right buttock and running down her right leg was diagnosed as sciatica and she returned home with a prescription of pain relief and an arrangement for an orthopaedic referral.

The following day, however, Natalie's symptoms began to change. The pain she was experiencing had increased and she became aware of unusual sensations around her saddle area, specifically the vagina and anus, including a feeling of numbness and a burning sensation.

Although she had a diagnosis of sciatica, Natalie was worried about her new symptoms and decided to contact NHS 111 for advice. The initial call-handler arranged for a nurse to ring Natalie back, who then recommended that a doctor should speak to her.

The doctor who then spoke to Natalie maintained her diagnosis of sciatica and suggested an increase in her pain relief.

Unfortunately, Natalie's new symptoms of impaired perineal sensation, along with her existing lower back and leg pain, are symptoms of possible cauda equina syndrome. At this point, a more thorough assessment should have prompted Natalie to attend hospital for an MRI scan which would probably have triggered emergency decompression surgery.

However, neither the nurse nor the doctor who spoke with Natalie elicited the necessary information about these highly-important symptoms. The doctor did not ask Natalie about sensory loss or seek clarification of her symptoms. No arrangement or referral for examination was made and no red flag warning was given.

Consequently, it was another three days before Natalie attended the Emergency Department at hospital following an episode of urinary incontinence. An MRI scan showed a central disc prolapse and the following day she underwent surgery.

The episode of incontinence was a sign that Natalie's symptoms had deteriorated still further and, as a result of her delayed diagnosis and surgery, she has now been left with permanent bowel and bladder incontinence as well as significant mobility and balance issues.

When Natalie asked Glynns to assess the standard of care she had received, our medical experts agreed that the NHS 111 response had failed her. Furthermore, they noted that, had Natalie been advised to attend hospital following her NHS 111 consultation, it is likely that she would have undergone surgery the following day and have thereby avoided the appalling symptoms she now experiences.

Natalie's life has been turned upside-down by her cauda equina syndrome symptoms. She is unable to work and requires significant support to undertake personal and household tasks. Not surprisingly, it has been extremely difficult for Natalie to come to terms with what has happened to her and the impact it has had on her life.

As a result of the effects of the negligent treatment she received, Natalie was awarded in excess of £1,500,000 in compensation.

(Details which might identify our client have been changed.)

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