§ PUBLISHED JUDGMENT · 2018

Hewes v West Hertfordshire Hospitals NHS Trust & Ors

[2018] EWHC 1345 (QB)·High Court (Queen's Bench Division)·5 June 2018

A man with back pain and new groin numbness phoned his GP, who told him to go to A&E rather than ringing the hospital orthopaedic team directly. Master Cook found the GP had credible expert support for that approach and struck out the claim against him.

Outcome

Claim failed

Sum stated in judgment

Not stated

Claim type

Cauda Equina Syndrome

Decided

Liability decided at trial

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§ WHAT HAPPENED

The facts, in brief.

Defendant: West Hertfordshire Hospitals NHS Trust; East of England Ambulance Service NHS Trust; Dr Pankaj Tanna (GP) · this trust’s claims data

Injury: Cauda equina syndrome with permanent bladder, bowel and sexual dysfunction after delayed decompression surgery

Specialty: General practice / spinal (cauda equina) · England

§ WHAT THE COURT SAID

In the judgment’s own words.

“the Third Defendant has satisfied me that the Claimant has no reasonable prospect of success, the Third Defendant having adduced credible evidence that he acted in accordance with a responsible body of medical opinion”
[2018] EWHC 1345 (QB) at [64] · read the full judgment

The money

Summary judgment granted for the GP (third defendant) only; claim continued against the hospital and ambulance trusts. No sum stated.

§ WHY IT MATTERS

What this case shows.

Sending a suspected cauda equina patient to A&E by ambulance can be a defensible GP response. A GP claim will fail at an early stage if a responsible body of GPs would have done the same.

About cauda equina syndrome claims →

§ MORE CAUDA EQUINA SYNDROME JUDGMENTS

Claim failed

Rebecca Hepworth v Dr Amanda Coates

[2025] EWHC 1907 (KB)·2025·Liability decided at trial

A 27-year-old flight attendant saw her GP with severe back and leg pain, having mentioned perianal numbness in a message two days earlier; she had emergency surgery for cauda equina syndrome four days after the consultation. The judge accepted that the GP asked the right red-flag questions and that the patient answered no, so there was no breach of duty.

In cauda equina cases the court looks closely at what safety-netting questions the GP actually asked and what the patient answered on the day. Contemporaneous notes and messages matter greatly for both sides.

Claim failed

Karen Spellman v Portsmouth Hospitals University NHS Trust

[2024] EWHC 2011 (KB)·2024·Liability decided at trial

Ms Spellman alleged a hospital radiologist missed cauda equina compression on an MRI scan taken the day after her fall, delaying diagnosis until private surgery six days later. Damages had been agreed at £300,000 if she won, but the judge found the scan showed only mild stenosis with no compression to be found, so the claim failed.

Parties sometimes agree the damages figure in advance and fight only liability, so a claimant who loses on breach of duty recovers nothing. Expert evidence on what the scan actually showed was decisive.

Claim failed

Jarman v Brighton and Sussex University Hospitals NHS Trust

[2021] EWHC 323 (QB)·2021·Liability decided at trial

A teacher with a back injury attended A&E and was referred for a routine MRI; the scan two weeks later showed a disc prolapse and she had emergency surgery but was left with permanent damage. The court found the registrar was not negligent in not suspecting cauda equina at that visit, and that her condition had not materially worsened during the delay.

Not every back-pain patient with some red-flag features must be scanned urgently; the court looks at the full picture presented at the time. Claimants must also prove the delay itself made the outcome worse.

All cauda equina syndrome judgments →

Contains information licensed under the Open Justice - Licence v2.0. Judgments from Find Case Law, The National Archives. Summaries are ours; amounts only where printed in the judgment.

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