§ PUBLISHED JUDGMENT · 2018

Hewes v West Hertfordshire Hospitals NHS Trust & Ors (appeal)

[2018] EWHC 2715 (QB)·High Court (Queen's Bench Division), on appeal from a Master·18 October 2018

A man with a disc problem developed cauda equina symptoms and the out-of-hours GP told him to go to A&E rather than arranging direct orthopaedic assessment; surgery came many hours later and he was left with permanent bowel and bladder problems. A Master had struck out the claim against the GP by summary judgment, but the High Court allowed the claimant's appeal so the claim against the GP could go to a full trial.

Outcome

Mixed outcome

Sum stated in judgment

Not stated

Claim type

Cauda Equina Syndrome

Decided

Appeal decision

ClaimGavel Assistant

● Online · Cauda Equina Syndrome · free & confidential

FREE

Free · confidential · not legal adviceEngland

§ WHAT HAPPENED

The facts, in brief.

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

Injury: Cauda equina syndrome with permanent bowel and bladder dysfunction after decompression surgery about fourteen hours after arrival at hospital

Specialty: Out-of-hours primary care / spinal · England

§ WHAT THE COURT SAID

In the judgment’s own words.

“The appeal will, therefore, be allowed. There will have to be some revisions to the timetable set out in the directions order, but doubtless C will want to preserve the trial date.”
[2018] EWHC 2715 (QB) at [58] · read the full judgment

The money

Procedural appeal only; no decision on liability or damages.

§ WHY IT MATTERS

What this case shows.

Clinical negligence claims should rarely be disposed of by summary judgment before the expert evidence has been exchanged. The ruling did not decide whether the out-of-hours GP was negligent, only that the question had to be tried.

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.

This guide is general information about the law in England and Wales, not legal advice about your case. ClaimGavel is run by Costart Projects Ltd on behalf of Tomlin & Partners, a specialist medical negligence firm regulated by the SRA. The free assessment on this page is an AI overview to show you roughly where you stand; a solicitor confirms the position in a free, no-obligation conversation.