Misdiagnosis by A&E Following GP Referral

The TSP Clinical Negligence team recently acted for Mrs T, who was 33 years old when she attended her GP complaining of significant back pain and numbness around her lower abdomen. She had also been unable to pass stools for several days. Her GP told her that he would refer her to an orthopaedics team at the hospital.

The next day, her symptoms worsened and she called a GP to see her at home. The GP diagnosed Cauda Equina Syndrome which is a condition whereby the nerve root endings at the bottom of the spine are compressed, very often by a prolapsed disc which, in turn, can cause partial or full paralysis and incontinence very often of a permanent nature. It is well-known, therefore, that if this is the diagnosis it is an extremely acute and urgent condition. The GP advised her to go straight to hospital and gave her a letter to give to the A&E department advising that she had suspected Cauda Equina Syndrome.

The A&E Department diagnosed Mrs T with constipation. She was discharged but her symptoms became progressively worse, her back pain became excruciating and she began to lose control of her bladder. She had not passed stools for over a week.

Three days after she had been sent away from A&E she called her doctor in desperation who sent her back to the A&E Department. She was again diagnosed with constipation and told to take laxatives and sent away.

The next day she could no longer control her bladder at all and her left leg and buttock were completely numb. She attended hospital again and was immediately transferred by air ambulance to a specialist neurology hospital where they undertook emergency spinal surgery to remove a prolapsed disc in her spine. The prolapsed disc had compressed and seriously damaged the nerve endings to her bladder, bowel and lower limbs.

Mrs T was left with very little sensation in her vaginal area, was unable to fully control her bladder or bowels, had reduced mobility and back pain. Investigations established that Mrs T’s condition should have been identified and treated much earlier which would have prevented permanent damage. She was awarded £90,000.