Cauda Equina Syndrome claims.

Cauda equina syndrome (CES) is a medical emergency in which the bundle of nerves at the base of the spinal cord is compressed — most often by a prolapsed (slipped) disc. Without urgent investigation and surgery, it can cause permanent paralysis of the legs, loss of bladder and bowel control, and loss of sexual function. It is one of the most devastating and most frequently missed conditions in medical negligence.

The red flags are well established: severe lower back pain with sciatica in one or both legs, numbness or tingling in the "saddle" area (inner thighs, buttocks, genitals), difficulty passing urine or loss of sensation when doing so, and loss of bowel control. Any clinician — GP, A&E doctor, physiotherapist or out-of-hours service — presented with these symptoms should arrange an emergency MRI scan — national guidance (the GIRFT suspected cauda equina pathway) expects the scan within 4 hours of request — because decompression surgery is most effective when performed as soon as possible, usually within 24 to 48 hours of symptoms starting.

Claims typically involve red-flag symptoms being dismissed as ordinary back pain, patients being sent home without examination of saddle sensation or bladder function, delayed MRI scanning, or delayed referral for emergency surgery once the scan showed compression. The claim must show the care fell below a reasonable standard and that earlier surgery would probably have avoided or materially reduced the permanent damage.

Because the injuries — paralysis, incontinence, chronic pain, loss of employment — are usually permanent and life-changing, cauda equina awards are substantial: typically several hundred thousand pounds, and £1 million to £2.5 million or more where there is significant paralysis and lifelong care need. The limitation period is generally 3 years from the injury or date of knowledge.