What are some of the 'Red Flag' symptoms of Cauda Equina Syndrome?
With over 30 years experience Clinical Negligence Solicitor, David Dickie, explains some of the ‘red flag’ symptoms of Cauda Equina Syndrome (CES) and helps to answer ‘When does a GP have to refer you urgently to hospital?’
Establishing Fault Or Breach Of Duty
Establishing breach of duty (fault) will depend solely on whether you had any red flag symptoms. These can include perineal numbness around your genitalia, a different feeling when urinating, such as urinary urge, hesitancy & poor stream (not a continual flow), bilateral sciatica rather than sciatica in just one leg, severe or progressive bi-lateral neurological deficit in the legs such as major motor weakness with knee extension, ankle eversion, or foot dorsiflexion in the days before or the day you saw your GP. It will also depend on whether there was, in addition, an unreasonable delay by your GP in failing to refer you immediately to hospital for an urgent MRI scan the same day, which, if CES was confirmed, would then be followed by a spinal cord decompression operation that day.
Red Flag Symptoms For Clinical Negligence Claims
Urinary or faecal incontinence or retention, so far as a successful claim is concerned which needs to establish incomplete cauda equina syndrome at the time you are seen by your GP, aren’t helpful red flag symptoms because they usually mean that symptoms have progressed beyond the point where operating swiftly will make any difference to the outcome.
Neurological deficits have to be present in both legs, rather than just one, to be red flags.
The Importance Of Multiple Red Flag Symptoms
Ideally, the medical records, rather than your witness statement alone, will corroborate the presence of the red flag symptoms as reported by you to your GP. In the absence of this corroboration, it will be your word against the word of the doctor, which will be supported by the medical records. Multiple red flag symptoms help, as you would normally expect symptoms of peri-anal numbness to be accompanied by urinary symptoms.
Back pain alone, no matter how bad, is not a red flag symptom as many people have slipped discs causing back pain, but only a tiny fraction goes on to develop cauda equina syndrome. Instead, it would be reasonable in a scenario say of really bad back pain, for the GP in addition to referring you for an urgent MRI scan, which might take several days to happen, to also refer you for an urgent assessment at a Musculoskeletal Clinic. This would be with the proviso that the GP should also ‘safety net’ by informing you about the red flag symptoms and signs of cauda equina syndrome which, if they developed whilst you were awaiting the urgent MRI scan and musculoskeletal appointment, would instead mandate you going immediately to the A&E Department to seek urgent medical attention. Failure to safety net would also be a breach of duty by the GP.
How We Can Help
Our Clinical Negligence Solicitors specialise in this area and have achieved substantial settlements for clients as a result of successful litigation. For more information on pursuing a claim, please contact the team on freephone 0800 011 6666 or via email at legal@timms-law.com.
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