Cauda Equina Compensation Payouts Guide

Cauda Equina Compensation Payouts Guide

Introduction

This is your Guide to Cauda Equina compensation payouts. If poor medical care has resulted in you (or a loved one) losing the opportunity to make a full recovery, then compensation can be claimed.

What is Cauda Equina Syndrome?

The Cauda Equina is a group of nerves at the base of the spine ( Latin for ‘horse’s tail’). This group of nerves supply the lower parts of the body. The cauda equina controls the bowel, bladder, sexual organs and lower limbs. Cauda Equina ‘syndrome’ happens when the nerves become compressed i.e. squashed. This is usually because of damage to the discs in the spine. The discs act as shock absorbers in the spine. When they are damaged, contents spill out into the Cauda Equina, compressing those nerves.

In the UK, every year about 400-600 patients are diagnosed with this spinal condition. You will need very urgent surgery to relieve the pressure if this happens to you. You should be treated as a patient with a medical emergency. Delays can lead to permanent and life-changing injuries.

What causes Cauda Equina Compression?

This condition happens because of traumatic accidents and also medical conditions, such as: –

  • degenerative spinal changes
  • complications of spinal anaesthesia
  • arthritis
  • a blood clot
  • complications from cancer
  • side-effect of medication
  • a car accident or fall
  • a penetrating injury, such as a knife or gunshot wound.

Do you have a claim?

If your cauda equina has happened because of something that should have been prevented, then you have a clinical negligence claim. This will be against the healthcare provider that has let you down.

For example, if you have suffered a blood clot that has caused the spinal injury and this was not been treated correctly. In some cases, a patient is given too much medication. Another example is if you were not given medication to prevent blood clot.

It is common to hear complaints that patients visited their GP, a chiropractor, osteopath, or the accident and emergency department, only to be turned away. In such cases,  crucial opportunities are missed for earlier MRI imaging. MRI scans diagnose this serious medical condition. In such cases, it can often be shown that earlier scanning would have led to earlier surgery. Earlier surgery can prevent a patient from suffering from permanent disabilities for life.

What symptoms of cauda equina compression should my doctor notice?

There are symptoms that should alert a GP, or other care providers, to be concerned. If so, they should refer you to a hospital for urgent investigation. Cauda Equina Syndrome can often come on after a patient has been suffering from back pain for a long time. A doctor should not assume that new symptoms are just part of a long-standing situation.

A doctor should be worried if a patient is complaining of loss of sensation in the genitals, around the anus, numb buttocks, bowel or bladder problems. Loss of sensation in the lower limbs (that can also be accompanied by shooting pains) and particularly reduced ankle movement are warning signs.

Claims for permanent injuries

If a patient is quickly diagnosed and receives prompt surgery, then a full recovery is possible. However, a delay can lead to permanent disabilities. This can have life-changing and financially devastating effects on the patient and their family. In such cases, a patient can often no longer walk normally and may have to use a stick or other aids. They may also suffer continence issues and lose sexual function.

Patients may lose function below the waist and can even be paralysed below the waist. Cauda Equina Syndrome can lead to loss of feeling, or tingling, in the genital area (in men perhaps the inability to have an erection). There can be mobility problems. Mobility issues can include difficulty walking or dragging feet. There can be weakness and loss of sensation or pain down one leg and particularly ankle issues. There is often incontinence s affecting the bowel and bladder (inability to urinate or to hold in urine or stools).

The problems detailed above can become permanent if surgery is delayed. There is a period of up to 48 hours to treat the patient. Within that period, the sooner surgery is done,  the better your chance of a full recovery is going to be.

 

How are cauda equina syndrome payouts calculated

What is the value of a back injury?

In other countries, compensation is awarded to punish the wrong-doer, called ‘Punitive’ Damages’. This is why there are such high figures for compensation in the United States. However, in the UK, punitive damages are not awarded. In the UK, compensation for pain and suffering is known as ‘General Damages’.

In the UK, an official body, called the Judicial College sets out a range of awards (brackets) for ‘general damages’. The figures below are for spinal injuries and are from the 14th edition of these Guidelines.

£79,890-£141,150.  This bracket is for most severe injury, with damage to the spinal cord and nerve roots.  This will be a combination of severe pain and disability with incomplete paralysis. There will also be seriously impaired bladder, bowel and sexual function.

£65,030-£77,540. These figures are for a back injury, with complications like nerve root damage and  loss of sensation. There will also be impaired mobility, as well as bladder and bowel function, sexual difficulties and unsightly scarring.

£34,000-£61,140. This is the range for disc lesions/fractures of discs or of the vertebral bodies and soft tissue injuries. The injury leads to long term conditions where, despite treatment (usually involving surgery), disabilities remain. The remaining disabilities may be continuing severe pain and discomfort, impaired agility, and sexual function. Also, depression, personality change, alcoholism, unemployment and the risk of arthritis.

£24,340-£34,000. This is for cases where any disability you are left with is less severe than above. This covers a wide variety of injuries, including the risk of osteoarthritis and constant pain and discomfort. You may need spinal fusion surgery may be needed. There will also be nerve root irritation and reduced mobility.

£10,000-£24,340. This bracket is for injury to ligaments and muscles causing backache. There will be soft tissue injuries, making worse a pre-existing back condition, or causing a back condition that would have happened anyway to be suffered earlier. You may suffer from repeated relapses or even need back surgery (called ‘laminectomy’). The precise figure will depend upon how severe the original injury was. The amount of pain you have is also considered. Other considerations are the amount of treatment needed in the past and future and whether you can function day-to-day.  Whether your social life and hobbies have been affected and what the outlook is for your future will be taken into account.

£2150-£10,970. This is the range for three remaining brackets for lesser injuries, for example, where you recover without surgery within about 2 to 5 years. At the lower end, where a full recovery is made within three months.

Additional awards for ‘General Damages’

Other things can happen that also fall under the category of “general damages”. These are separate to pain and suffering above. For example:

  • compensation for the breakdown of a close relationship.
  • loss of enjoyment of a holiday.
  • if you have lost a job you really liked, then you can claim for ‘loss of Congenial Employment’.

What can I claim for past, current and future financial losses? Known as ‘Special Losses’

In addition to the value of your actual injury, you can claim any past financial loss. You can also claim for expected future losses. Such losses have to be reasonable, not too uncertain. These losses also need to be caused as a direct result of poor medical care.

For example, such losses can include: –

Loss of income                                                                                                                                                                If you have been unable to work for a period of time or have had to give up work altogether. Alternatively, a partner may have had to give up work to care for you.

Care                                                                                                                                                                            Your family or friends will probably have spent some time helping you. This could just be a past loss. However, you may still need ongoing care and support. If so, this can be costed on a commercial basis. This can allow you to employ professional carers. In turn, this allows family and friends to go back to being your family and friends, not carers.  In serious injury cases, often extensive packages of care are put in place.

Nursing Care Managers and Buddy support                                                                                                    You may feel isolated as a result of the injury. You may also find it difficult to cope with putting into place a care package. If so, a Nursing Case Manager can be instructed to deal with all practical arrangements, such as interviewing, training, employing and overseeing carers. A companion, known as a “buddy” can be employed to ease social isolation. A Buddy can regularly visit and support you the future. They can help to plan activities and will also accompany you.

Travel expenses                                                                                                                                                      You can claim for mileage, taxi costs and parking etc.  You can claim for any reasonable cost related to getting to and from medical appointments. However, you cannot claim for the cost of going to see your own medico-legal experts.

Accommodation costs                                                                                                                                              If you need to pay for home adaptations as a result of your injury or even move home,  this will need to be costed. An architect can be instructed to advise on costs. There are also ‘property finder’ experts who specialise in finding a new home to suit disabilities.

Aids and equipment                                                                                                                                                    This is the claim for anything you need to make your life easier in daily life. This can be ramps, grip rails, toilet rail, wheelchairs, scooters et cetera. It also covers disability vehicles.

Orthotics                                                                                                                                                                            Sometimes specialist foot support or spinal corsets are needed. The cost of buying these items and the future replacement costs can be significant.

Any other reasonable financial losses                                                                                                          Compensation can be given for anything else directly connected with the injury. For example, surrogacy costs, if a claimant has been left infertile as a result of spinal injury.

 

Cauda equina syndrome settlements

We act for a lady who was only 31 years old when she suffered cauda equina syndrome. In May 2014,  her GP sent her to a hospital where she was kept in overnight. However, the doctors did not send her for an MRI scan of her spine. If a scan had been done it would have led to a proper diagnosis. It was 16 days later that she was finally diagnosed. She then had surgery.

After surgery, sadly, our client has severe symptoms of bowel, bladder and sexual dysfunction. She also suffers from left leg symptoms, with a foot ‘drop’. Our client’s case is that these permanent complications would have been avoided with earlier diagnosis and surgery. Court proceedings have been issued and multiple speciality medical experts have been instructed to support her claim.

In this type of case, it is crucial to instruct many kinds of medical experts.  Experts are usually needed in fields such as Neurorehabilitation, Psychiatry, Physiotherapy, Occupational therapy, Care and even Architects for housing needs. Our client’s claim is of very high value.

Examples of past compensation for cauda equina

Some other examples of past awards in cauda equina cases are as follows: –

Compensation Payouts for Cauda Equina over £1 million 

  • £3.4 million                                                                                                                                                       To a 35-year-old gentleman who injured his back. The next day (Day 2), he was sent away from a hospital emergency department. Day 3 he went back to the hospital, as his condition had worsened. The diagnosis was then made of worsening cauda equina syndrome. In the early hours of Day 4, emergency decompression surgery was done. The hospital admitted that there had been a failure to recognise and treat the condition during the first hospital attendance. They also admitted some resulting injury. However, it was not admitted that the delay caused immobility, inability to work, dependency on crutches and mobility scooter. Despite this, the settlement award was agreed to before a trial in January 2019.
  • £1.6 million                                                                                                                                                       This was a 42-year-old man’s claim for neurological injuries. In 2005, a hospital failed to remove his bulging lumbar disc. During surgery, the surgeon also caused a dural tear. The dura is a thin covering over the spinal cord. This gentleman suffered cauda equina syndrome. He was left reliant on a wheelchair and incontinence of faeces. The settlement was in 2009. This type of claim would achieve a higher award in today’s terms.
  • £1.5 million                                                                                                                                              For a 46-year-old lady for injuries suffered following a delay in diagnosing and treating cauda equina syndrome in 2003. She suffered impaired sphincter control and right foot drop. Her bowel and bladder functions were affected. She had to have further medical procedures, after which she suffered MRSA. This was a settlement in 2009. Today a claimant in this position will receive a higher award.

Compensation Payouts for Cauda Equina awards under £1 million 

  • £750,000                                                                                                                                                    A In 2008, a 50-year-old gentleman suffered a large prolapse of a spinal disc. He suffered cauda equina syndrome, leading to permanent problems with mobility, incontinence, sexual dysfunction and nerve pain. Liability was admitted and pre-trial settlement was agreed in 2013.
  • £250,000                                                                                                                                                    To a lady who had suffered long-standing back problems and had undergone two past operations on her spine. She developed difficulty passing urine as well as numbness in her right buttock and thigh. Her GP and the local Accident and Emergency Department did not recognise the severity of her problems, so surgery was delayed. She was left with permanent and severe pain in one leg and foot, as well as loss of bowel and bladder control.
  • £225,000                                                                                                                                                     A This was for a 54-year-old man, a former lorry driver, who injured his back after moving road signs around in a lorry. He visited 2 GPs who both failed to spot Cauda Equina Syndrome. His job was lost. Permanent pain with mobility problems were suffered. He needed shin splints and walks with the aid of elbow crutches.

 

Q&A

  • Where do I go for support after spinal injury?

You may need practical, emotional, or financial advice and support. We have listed many sources of help in our separate web-page. Click on this link to access invaluable information and resources: Support after Cauda Equina

  • How can I pay for a claim for compensation?

All reputable and specialist clinical negligence solicitors offer no win, no fee. If a solicitor asks you for money upfront, then they may not be specialists.  Do look elsewhere to find a specialist who offers no win, no fee. Click on the following links for more info on funding medical negligence claims and no win no fee agreements that we offer.

Funding a medical negligence claim

Conditional fee agreements (no win no fee)

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